by Katherine Baker, Pharm.D., PGY1
Pharmacy Practice Resident, North Mississippi Medical Center
International pharmacy experiences
are increasingly popular. Today, students are eager to see the world and
compare their learning environments to those of other students around the
globe. In 2010, a survey of 114 pharmacy schools in the United States revealed that
40 had an active global/international program.1 Having completed a global
pharmacy experience during pharmacy school, I can speak to their value. I was
fortunate to spend 5 weeks in Phitsanulok, Thailand at Naresuan University
teaching hospital. What seemed like a distant dream soon became a reality when
I found myself in rural Thailand with one of my best pharmacy school friends
relying on the Google translator application to help us communicate. While
international experiences have important benefits simply from “being there,” it
is equally important to know how to design these experiences to maximize learning.
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First, it important to ensure
that international experiences foster the development of the competencies
required for graduation. Second, that there should be policies in place to
ensure that the international site and faculty are qualified.2 To
address these requirements and the increasing demand for global health experiences,
several initiatives have sought to improve the quality of international
pharmacy rotations. Indeed, the American Association of Colleges of Pharmacy
developed a special interest group that includes a dedicated team of
individuals who discuss topics and ideas related to global healthcare.1
Prior to establishing an
international experience and sending student pharmacists across the globe, great
attention should be paid to ensuring that both the student and the host site
are prepared for the visit. The planning period for my international rotation
was stressful due to unknowns that come with living and learning in a foreign
country. These stresses were alleviated when the host site sent me documents
with helpful information about our living arrangements and coordinated everything
before arrival. A number of articles have explored important considerations
that must be taken into account before developing a Global/International
Advanced Pharmacy Practice Experience (G/I APPE). These considerations include
host country, home institution, host institution, faculty/preceptors, and
student issues.2
The host country is an
important factor to consider before establishing an international rotation. While
having a well-thought-out curriculum is necessary, ensuring a safe and
functional learning environment in a foreign country is even more important.
Pharmacy schools need to ensure that students are well informed about the
country they will be traveling to.
Students should try to learn about the local culture(s) and basic parts
of the native language. This will help them while navigating abroad as well as improving
patient interactions during the experience. While in Thailand, I worked in an
anticoagulation clinic and was asked to interview and counsel patients. I struggled
to communicate and had to rely on my preceptor. This particular experience
would have been much more meaningful had I learned the language ahead of time.
Logistics of the rotation such as visas, living arrangements, transportation,
and financial considerations should also be addressed well in advance.
Equally important are the host
institution and the curriculum. To justify an international experience, the
host institution should be vetted and deemed an appropriate pharmacy
experience. It is recommended that the host and home institutions have a designate
representative. These designated faculty members will be responsible for
communicating student educational needs, learning outcomes, and detecting any
red flags.1 In addition, a
thorough and thoughtful syllabus must be drafted and approved. Just like any other
course or experience in pharmacy school, the syllabus should lay out
expectations, goals, objectives, and grading criteria.1
Student interaction while on
rotation is another important consideration to create a meaningful experience
abroad. For students to take full advantage of their international pharmacy
experience, they should be meaningfully engaged and aware of what they are
learning. One descriptive study discusses the importance of reflective writing
while on rotation. Based on student reflections, the authors noted a pattern to
student learning while on a G/I APPE. Students use “communication,
problem-solving, and adaptability”3 skills while on rotation and
then reflect on the major differences between their home and host country. There
a couple of ways to get students to reflect about their experiences. One method is to ask students to keep a
personal journal and regularly writing entries.
Another way to encourage reflection is to require students to give a
presentation to peers after completing the experience. My pharmacy school
required each student to create a weekly travel blog reflecting on their experiences (check out our blog: Thailand Adventures - Two Pharmacy Students Finding Their Way Through Thailand).
This exercise helped us to reflect and translate what we learned abroad and
apply it to our lives in the United States. Our blog essays were also useful to
future participants. Indeed, many of our weekend excursions were based on blog
posts from previous students!
Global pharmacy experiences are
not only an adventurous, once-in-a-lifetime experience, they also enhance a
pharmacy student’s professional advancement. In a world that is becoming
smaller and more connected through technology, a G/I APPE will give students an
opportunity to grow their perspective and sensitivity towards people from other
cultures.1 Students who have participated in a global pharmacy rotation
are more likely to be culturally aware and “demonstrate increased interest in
volunteerism, humanitarianism, and public health.”2 Moreover,
international experiences often help students improve their communication
skills, problem-solving skills, and adaptability.3
Having participated in an
international rotation myself, I can attest to many of these benefits. If I
could give any piece of advice, I would encourage students heading into an
international experience to learn some of the host country’s language and keep
a travel journal or blog. It’s also important to give both the host and home sites
feedback. The home institution often go to great lengths to ensure that the
rotation will be maximally beneficial but the best information is feedback
based on personal experience. The host institution that I completed my rotation
at required students to complete an in-depth exit survey. The institution
wanted an honest review of the experience and it was important to openly
discuss any concerns to better serve students for the future.
International pharmacy experiences
are a once-in-a-lifetime opportunity that I would recommend to all pharmacy
students. If the experience is well planned and executed by both the host and
home institutions and if the student approaches the experience with enthusiasm
and an open mind, it will be a personal and professional growth experience
the student will never forget.
References:
- Steeb DR, Overman RA, Sleath BL, Joyner PU. Global Experiential and Didactic Education Opportunities at US Colleges and Schools of Pharmacy. Am J Pharm Educ. 2016;80(1): Article 7. doi:10.5688/ajpe8017
- Alsharif NZ, Dakkuri A, Abrons JP, et al. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations. Am J Pharm Educ. 2016;80(3): Article 38. doi:10.5688/ajpe80338.
- Steeb DR, Miller ML, Schellhase EM, et al. Assessment of Global Health Learning Outcomes on International Experiences. Am J Pharm Educ. 2019. doi: 10.5688/apje7586
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