Structured practical experience for Canadian student pharmacists in Ghana

Abstract

Volunteering in developing countries is becoming popular for pharmacists and student pharmacists. Additionally, students may receive academic credit for these experiences. It is rare, however, for these internships to be structured and precepted by a practising pharmacist with significant experience working in the local environment. This letter reports a structured practical experience in Ghana for six student pharmacists from the University of Saskatchewan (Saskatoon, Canada), who received academic credit for their time spent in Ghana. The rotation occurred over 5 weeks in March to April 2012 and the primary instructor was a practising pharmacist in Canada who had previously spent 1 year in Ghana developing and coordinating health and medical internships. Local staff at each placement site (described below) were designated as supervisors for the students’ daily work. The objectives by the end of the rotation were to describe contributions of pharmacists in international health settings, to perform daily pharmacy-related activities at a supervised placement site, to create and disseminate at least one health promotion project and to describe pharmacotherapy and treatment principles for malaria, tuberculosis and HIV/ AIDS. In order to accomplish these objectives, the rotation consisted of three core components: a supervised placement, weekly therapeutic topic discussions and a major health promotion/education project. The rotation was supplemented with smaller health promotion projects and cultural integration activities. The students also had the opportunity to visit different regions of Ghana, in order to observe pharmacy practice and health needs of communities throughout the country. Placement sites consisted of an urban hospital, three rural clinics, an out-patient pharmacy and multiple chemical shops (selling analgesics, antimalarials and herbal products) in various localities. Medications were available at each establishment, with chemist shops being the most limited in terms of medication availability (some examples include: antibiotics, antimalarial drugs, antihistamines, cough and cold preparations, herbal products and non-narcotic analgesics). Students worked alongside local staff at each site.All activities were completed under supervision of placement staff and in correspondence with the preceptor from Canada. Students engaged in medication dispensing, counselling and patient education, assistance with physical assessments, health record documentation, diagnostic and laboratory assessments and administrative activities. The health promotion project was based on needs reported by local health workers, and content covered both sanitation (hand hygiene, waste management) and principles of medication use (purpose of medications, dosage instructions, adverse effects). The students developed the presentation in collaboration with both local staff and the preceptor in Canada. The presentation was given verbally in English and the local dialect of the audience (translated by a community member). Students used visual aids and interactions with the audience where applicable. Topic discussions were an integral part of the rotation and covered the disease states of malaria, tuberculosis and HIV/ AIDS. Leading questions were developed by the preceptor and distributed to students throughout the rotation. The students were also supplied with treatment guidelines and primary literature as resources for discussions. Students were expected to relate their learning to each practice site they encountered and to compare and contrast diagnosis, treatment and monitoring of these conditions between placement sites. Each week, the preceptor spent approximately 1 hour with the students facilitating discussion and ensuring learning points were achieved. Students were evaluated by the staff at placement sites and the instructor in Canada. Evaluations were based on a standardized form from the University of Saskatchewan Structured Practical Experiences Program. The domains of the form included demonstration of learning, communication with instructors and patients, attendance and reliability, task accomplishment, professionalism, leadership and decisionmaking, integration into the workplace, preparedness for topic discussions and overall assessment. Students were asked to evaluate the rotation with respect to satisfaction, meeting of objectives, strengths and areas to improve for both the rotation and preceptorship, and an overall assessment. Student feedback was favourable, with specific comments incorporated into future directions described below. bs_bs_banner