In the Field: University's Concept Pharmacy Teaches Students Real-World Skills

North Dakota State University (NDSU)’s Thrifty White Concept Pharmacy transforms abstract lessons learned in class into real-world skills.

The concept pharmacy, built in 2003, offers students a chance to provide medication therapy management (MTM) services to qualified faculty, staff, and patients in the community. Those accepted as patients of the concept pharmacy take 3 or more prescription medications and receive free blood glucose, blood pressure, and cholesterol screenings from the pharmacy.

The MTM work that students perform includes evaluating health information, conducting a comprehensive medication review, providing patients with required documentation, and performing point-of-care screening services.

One patient complimented the work of 2 PharmD students and a supervising pharmacist for their MTM services. The patient said the students helped determine that one medication was not working well with another.

“They also made many good suggestions about generic medications I could take in place of some of the more expensive medications I now take, which is a real concern to me,” the patient said. “I was so happy to be offered such a great opportunity.”

Another patient, who said the experience has been “very beneficial,” noted that the students were friendly and helpful, and the adviser did a great job moderating.

“Learn by doing,” the patient noted. “The students get plenty of experience in the classroom, and this program is invaluable experience for future pharmacists.”

Thrifty White Concept Pharmacy Background

The concept pharmacy program is led by 4 faculty members: Jeanne Frenzel, PharmD; Elizabeth Skoy, PharmD; Heidi Eukel, PharmD; and Alicia Fitz, PharmD.

According to the faculty members, the concept pharmacy allows NDSU School of Pharmacy to meet accreditation requirements and gives students the opportunity to explore pharmacy experiences in a simulated environment.

“The concept pharmacy was designed as a unique and innovative educational environment used to prepare students to be successful in both community and institutional pharmacy settings,” the faculty members wrote in a collective statement to Pharmacy Careers.

As part of the required pharmaceutical laboratory series, students work in the pharmacy for 2 hours per week over 4 semesters. The pharmacy can hold 32 students, 4 faculty members, 2 pharmacy residents, and 2 advanced pharmacy practice experience students.

The pharmacy has nonprescription and prescription medications, physical assessment and point-of-care testing equipment, and areas for patient consultation, long-term care, and compounding.

“This specialized training environment capitalizes on the benefits of exposing students to a comprehensive pharmacy experience using multiple teaching methods reinforced by longitudinal learning,” the faculty members said.

Technology at the Concept Pharmacy

NDSU pharmacy students have access to a range of technological tools, including medication dispensing automation, electronic medical records, specialty compounding equipment, telepharmacy, and point-of-care testing equipment, such as CardioChek and Cholestech.

Each student also has an iPad, which can be used for video assessments of skills or research on medication information.

Dispensing software also teaches students about directions for use and day supply calculations, and Parata Max is used to simulate dispensing work flow for pharmacists across the state.

In addition, students can practice their blood pressure assessments and intramuscular and subcutaneous injection administrations using training arms, and they work interprofessionally with nursing students on a patient simulator.

An electronic medical record also keeps track of patient information, vital signs, and laboratory and radiology reports for students. They can use this information, plus disease state management guidelines, to write SOAP (subjective, objective, assessment, plan) notes.

Compounding Medications at the Concept Pharmacy

At the concept pharmacy, NDSU students learn how to compound medications in various forms, including ointments, lotions, creams, suspensions, suppositories, capsules, and pluronic lecithin organogel.

The faculty members explained that for each preparation, students create a master formulation record and a compounding record to ensure that they gain proficiency in compounding, documentation, and quality assurance.

Sterile compounding is also taught in the concept pharmacy. Students are tasked with small- and large-volume preparations, ophthalmic medications, total parenteral nutrition, and hazardous medications.

The students wear appropriate dress and practice aseptic technique, all the while working in hoods with a simulated clean room environment for compounded sterile preparations, according to the faculty members.

Student Perspective on the Concept Pharmacy

Justin Jones, PharmD, a critical care pharmacist in the Intensive Care Unit at Sanford Medical Center in Fargo, North Dakota, was both a student and a student educator in the concept pharmacy.

As a student, he said the most rewarding aspect of the experience was seeing his schoolwork and lectures translate into real-life skills inside the pharmacy. He gained experience counseling patients, compounding intravenous (IV) medications, and writing notes in a fictional patient’s electronic medical record.

“It was a great environment to practice skills that we simply couldn’t practice in a traditional classroom setting,” he said.

Dr. Jones gave the example of a classroom lecture in which students are taught how to calculate the volume and concentration of a drug they might need to compound an IV. In the concept pharmacy, students are able to experience how they would actually do that in real life. They find the medication, perform calculations, draw up the appropriate volume of the drug, and aseptically inject it into a compatible base, he explained.

Another example: in class, students might learn about the adverse effects of lisinopril, a drug that can be used to treat high blood pressure and heart failure, but in the lab, students are offered an opportunity to counsel fictional patients on these adverse effects and provide them with recommendations on how to avoid or alleviate them.

“You’re given the opportunity to apply and practice many of the things you’ve learned in class in an environment that is safe and educational,” Dr. Jones, who graduated from NDSU in 2013, told Pharmacy Careers.

In his experience as student educator on rotation in his fourth professional year, Dr. Jones said he enjoyed seeing that he had learned the information well enough to teach someone else. Also, he said he appreciated being able to help another student become a better pharmacist.

Now a preceptor at Sanford Medical Center, Dr. Jones said the experience as a student educator in the pharmacy reinforced his interest in teaching and helped him improve his skills as a preceptor.

“Experiences in the concept pharmacy introduced me to many of the skills I now use on a daily basis,” Dr. Jones said. “It helped me to learn how to effectively communicate with fellow health care professionals, it taught me the basics of sterile and non-sterile compounding, and it allowed me to become familiar with many of the pharmacy resources I now use every day.”