Competitive Care: Students Working With Professional Athletes

At the University of Nebraska College of Pharmacy, experiential learning may involve working with world-famous international athletes. Students from the school, along with their counterparts from the university’s other health care schools, serve as on-site medical staff for several high-visibility sporting events, including the 2012 US Olympic Swim Trials, the 2013 US Figure Skating Championships, and several professional volleyball events.

“International athletes are one of the best groups of patients to care for,” said Allison Dering-Anderson, PharmD, RPh, clinical assistant professor of pharmacy practice, pharmacy preceptor, and a finalist for Civic Leader of the Year in Pharmacy Times’ Next-Generation Pharmacist^TM Awards. “They are gracious. They say, ‘thank you’ more than any other group of patients I’ve ever cared for.”

Unique Opportunity

The opportunity springs from a simple portion of Nebraska’s pharmacy laws: in the state, drugs cannot be dispensed from any location that is not a pharmacy. As a result, sports facilities cannot simply open a medication room during an event to temporarily store and dispense medicines, Dering-Anderson said.

She credits the University of Nebraska at Omaha’s head athletic trainer, Rusty McKune, and Dean Collier, PharmD, assistant professor of pharmacy practice at the University of Nebraska College of Pharmacy, for developing the collaborative practice model that meets the state law requirements—and allows students from the school to showcase their skills.

“Our students have the ability to work with the medical students, the physician assistant students, the physical therapy students, and the massage therapy students—who were a very big deal at the swim trials,” Dering-Anderson said.

The University of Nebraska Medical Center works with a retail pharmacy chain to fill the prescription orders during the athletic events, Dering-Anderson said. Although their preceptors are present, students from the various medical colleges diagnose, counsel, and treat the various health problems that arise on site. At the events, pharmacy preceptors oversee approximately 3 students each, which offers almost over-the-shoulder supervision, if needed.

Although several of the students work the sporting events as a for-credit experiential practice program, most of the students are volunteers, Dering-Anderson stresses. The opportunity is open to all pharmacy students, regardless of their year in school.

“It’s a great learning opportunity and a great way to give back,” she said.

Like most professional sporting events, students from all health professions must be aware of banned substances and banned routes of administration—but it’s an area where the pharmacy students shine.

“It was a very different concept for the other schools, dealing with banned substances, and that’s where our students really showed they were the experts,” Dering-Anderson said. “You could watch the students’ from the other professions eyes glaze over as [the pharmacy students] explained the substances that could not be used. The integrity in the clinical decisions was paramount—could these athletes be able to compete if they took this?”

“There were approximately 2 prescriptions that needed to be rewritten [at the swim trials], to ensure that the athlete would be able to compete,” she added. “Both times, the pharmacy students were armed with a solution. They were able to go to the physician and say, ‘Hey, this may cause some problems. Here is another option.’”

Privacy Concerns

Banned substances are not the only concern for the pharmacy and medical students. The events are also an exercise in medical privacy. The students and preceptors cannot disclose the names of the patients they treated, how they were treated, or even that they met a certain athlete, Dering-Anderson said. There have been no attempts to skirt the regulations she adds—although the rules can come as a surprise to the athletes.

“One of the athletes was so exceptionally kind,” Dering-Anderson recalls. “That I said, ‘I would very much like to tell my mother how kind you are, but I will not without your permission.’ He looked at my students and said, ‘Is that true for all of you?’” After the students confirmed Dering-Anderson’s statement, the athlete involved quickly gave permission to the students—though Dering-Anderson jokes that she’s still only allowed to tell her mother.

For the pharmacy students, days at the events begin around 7 am, with sick call for all participating athletes. The pharmacy students’ responsibilities during sick call include dispensing OTC medications and maintaining records for those medications, Dering-Anderson said. The on-call physician typically arrives around 9 am, and handles any prescriptions that need to be written. The medications tend to include antibiotics, antiemetics, and some muscle relaxers and pain relievers.

When the medications are delivered and picked up, the pharmacy students display their counseling skills. The deliveries occur 60 to 90 minutes after the prescription is issued, so students have the opportunity to look up drug information or practice counseling 1 of their fellow students or a preceptor, Dering-Anderson said.

“Our students counsel the athletes, they counsel the parents, they counsel the coaches if the athletes were unable to pick up the medication themselves,” Dering-Anderson said. “I think that maybe serving people with international acclaim helped them say, ‘I will not be embarrassed. I will not be embarrassed in front of someone who is famous.’”

Although the schedule does allow for downtime and access to the athlete’s viewing area where students can watch the events with athletes who are not competing, the day tends to last between 14 and 16 hours, Dering-Anderson said.

“I think this really did show how important it is to have a drug expert on-hand,” Dering-Anderson said. “I think the students just showed they are an important part of the team for that reason. The profession just can’t look any better than that.”