Pharmacy students learn to work in teams during emergency management simulation

Real-world experiences. Hands-on learning. Critical-thinking skills. We constantly hear and read about practical training for students to give them the skills they need to pursue the professional careers of their choice.

At the School of Pharmacy and Pharmaceutical Sciences, practical training starts in the classroom with an introduction to interprofessional practice – and it takes students beyond the classroom into simulations that test their skills and confidence.

Gail B. Rattinger, professor and associate dean for academic affairs and assessment, has worked with leaders in Binghamton University’s nursing, social work and public health programs as well as at SUNY Upstate Medical University to develop a number of interprofessional educational experiences that expose students to some of those real-world experiences that will help hone their abilities.

First-year students work in their interprofessional teams in their fall semester to select an insurance plan and provide guidance to a client or patient. In their spring semester, they learn about interprofessional communication and participate in a poverty simulation where they have to navigate insurance, transportation, work and a number of issues. “The poverty simulation is the culmination of learning about interprofessional communication and patient-centered care,” Rattinger said. “The interprofessional communication course has been forged together with an introduction to interprofessional practice and why we have it, a focus on social determinants of health, another focus on patient-centered care and then the poverty simulation. We follow it all up with a reflection.”

During their second year, students are cast into another simulation – this one is an emergency management one – but this time, third-year medical students from the Binghamton Clinical Campus of SUNY Upstate Medical University and geography students from Binghamton University also participate in the simulation.

“It’s an extension of what they’ve learned in their first year on social determinants of health,” Rattinger said, “but now it’s extended to an emergency and civic level that affects people to different degrees based on their standard of living.”

“In the emergency management simulation, the students are split into different groups with third- and fourth-year medical students on the Binghamton Clinical Campus of SUNY Upstate Medical University and geography students from Binghamton University,” said Emily E. Leppien, clinical assistant professor of pharmacy practice. “They basically work through what would happen – the triage and the chain of command – if an emergency situation occurred here in Binghamton. The details of the simulated experience change from year to year and are not released.”

The simulation broke students into teams including an office of emergency services, a health department, a news media team, the mayor’s office, the morgue/medical examiner’s office, etc.

“All of these offices have a different role or task and they have to come together to figure out that something is happening and there’s some sort of crisis that needs to be addressed,” Leppien said. “They don’t know what is happening when they come in, so they have to figure that out within their team and by communicating with other teams. Then they go through the incident chain of command on how to address the situation that’s occurring.”

Students completed FEMA training before the simulation took place so they knew the terminology and roles used in the chain of command.

“Then, once we start implementing the incident command, each team steps up and takes one of the leadership roles and the team members have to decide how they’ll address a potential emergency,” Leppien added.

“The whole point of the simulation is that pharmacists are not serving as pharmacists, medical students are not serving as medical students, there is no predefined role of who they are,” Leppien said. “They’re not sitting down and working on a clinical case. This simulation gets at a lot of the softer skills such as communicating with other team members, being a team player, interprofessional communication and understanding, and determining what your role is.

“It’s not meant to be a clinical case so there’s no preparation,” she said. “Students do take an interprofessional communications course as P1s, but they walk in blind and even have to figure out whether an emergency is happening. It’s different here because a lot of other schools, when they think of interprofessional education, they think of working through a patient case, but not getting at how these two professions can work together.”

Students debriefed following the simulation, admitting that it was difficult to assume non-pharmacy roles.

“We try and relate it to what did you learn then, now and what’s different?” Leppien said. “In the poverty simulation, students are playing a societal role and trying to meet day-to-day needs for themselves and their families. It’s a little more difficult here because we are asking our students to use their leadership, problem-solving, critical-thinking and communication skills to improve a public health situation, as they can contribute a lot more than just their knowledge of drugs.”

Communication – or lack of – affected all of the teams.

“We found it difficult because every time we got information, we were always the last ones to know and to get asked,” said Oluwafemi “Femi” Popoola, who was on a community activist team. “We weren’t asked for our opinions or needs. It was an issue that the people affected the most were the last to know.”

Christina Anderson was assigned to the mayor’s office team. “It was hard to figure out which crisis was the most important,” she said. “I would get calls from businesses, but there was a larger problem for the whole community that we had to deal with. It gave me respect for community leaders.”

But there were benefits from learning to work with others as part of a team as well.

“It forced us to think out of the box and not use our pharmacy skills,” said Sulemana Mohammed, a member of the health department team.

And it also helped them learn about the skills others brought to the team.

“On some of the lulls, I was talking to some of the medical students,” said Jessica Corbett, who served on the health department team. “And they were, ‘Wait. You can do that?’ so it was interesting to see from them that they had no idea what I can do.”

“Anyone’s opinion is fair and it’s helpful to hear different points of view,” said Brianna Flint, who served on a public works team. “The goal was to have a well-rounded look.”

“Being able to relate to others should always be a goal,” Popoola said.

“We hope the students realize that, even as pharmacists, they have knowledge and skills and abilities to go out into the field and do things that may not necessarily be related to their job description,” Leppien said. “That they have critical-thinking skills, decision-making skills and they can communicate effectively and apply them in a non-pharmacy-related way. People of different professions have to fill in where they can and their role might not be clearly defined.”