Rebekah Harris: Helping students find their ’aha’ moment
Rebekah Harris has been a preceptor for Binghamton University’s School of Pharmacy and Pharmaceutical Sciences for about a year now, and she’s nailed the role. As a staff pharmacist at Lourdes Hospital, part of Ascension, she is helping P4 students learn to practice in a clinical setting.
After earning her Doctor of Pharmacy degree at the Nesbitt School of Pharmacy at Wilkes University in Wilkes-Barre, Pa., Harris completed a PGY-1 residency with UHS in Binghamton, N.Y. Additionally, she holds a certification as a Board Certified Pharmacotherapy Specialist. She has been at Lourdes Hospital since October 2020.
Harris works in the inpatient pharmacy doing clinical initiatives, chemotherapy and sterile compounding. She also participates in clinical rounding on the first and third floor clinical shifts. Pharmacist roles on clinical shifts include rounding with the patient care team, dosing antibiotics and monitoring antimicrobial stewardship.
“That’s where the students I have working with me will go,” she said. “They get to participate in multidisciplinary rounding daily. We have rounds on medical/surgical floors and in our intensive care unit, so the students coming for a general medicine rotation will be on those rounds with the pharmacists.”
Harris encourages the students to bring up the medication recommendations they would like to present on multidisciplinary rounds to the pharmacist they are working with before they round each day. “The students are always welcome on rounds and encouraged to voice recommendations once they are a little more comfortable. They are able to actively learn how to engage and communicate with the providers and nurses,” she said. “It is something that many students enjoy. Most students have never had the opportunity to speak directly to providers so it’s something that a lot of them find very valuable.”
Throughout the rotation, called an APPE (advanced pharmacy practice experience), students also gain experience working with a clinical surveillance software called Sentri7. “Sentri7 aids in identifying patients that meet specific medication criteria,” Harris said. “It allows us to follow all of our patients and suggests clinical areas pharmacists might want to look into further.
“On top of actually working each patient up for rounds, Sentri7 helps to guide us to important medication monitoring such as dosing for a patient’s kidney function or new microbiology culture results. Within Sentri7, pharmacists can document if changes are made or if we have conversations with the provider ensuring smooth communication between pharmacists within the department,” she added.
“The students have a Sentri7 login and get to practice documenting. They have the opportunity to live that role of being a pharmacist while still under preceptor supervision,” Harris said. “They also have access to the electronic medical record.”
Another aspect of the APPE experience for the students is the completion of a variety of projects including journal clubs and patient case presentations. This provides students an opportunity to break into areas where they have room for improvement or an area they are interested in specializing in after graduation.
“A journal club is when a student finds a clinical research article about a topic they are interested in, maybe a new study that came out on a medication or a condition,” Harris said. “They will read the article and present a journal club in the appropriate written format.
“This allows the student to deconstruct the article, evaluating strengths and weaknesses as well as how it can relate to clinical practice,” Harris said. “I encourage them to come to a final point where they can explain how it applies to them as a pharmacist practicing in the future.”
A typical day for students includes preparing for rounds and rounding in the morning, then working with pharmacists on journal clubs and topic discussions in the afternoon, Harris said. “I’ll have them look up information on a topic and then have them present it to me. This is an effective way to facilitate a discussion,” she said. “Also, they will do SOAP notes (subjective, objective assessment and plans) that teach them to effectively document their patient assessment and plan. In the final week of the rotation they do a patient case presentation showcasing their skills in evaluating patients and their medical conditions.”
The bottom line, she added, is for the students to come up with a patient care plan.
“Because of the way our shifts rotate, the students get to work with a multitude of pharmacists,” she said. “I find it is really beneficial to them. Many of the students I’ve had have commented that it allows them to see different perspectives, different learning styles and different viewpoints. While they may not be personally with me the entire rotation, they have the opportunity to work through patients and projects with many members of our pharmacy team.”
Harris enjoys the role of a preceptor because the students teach her just as much as she teaches them, she said. “They’re keeping me fresh and engaged in the profession, and they’re always so excited to learn and interested to be here. It’s rewarding that we can both benefit from that,” she added.
No one memory as a preceptor stands out for Harris, but she loves that ‘aha’ moment when things start to click for the students after that initial period when they are starting to learn.
“It’s seeing each student have that moment when suddenly it makes sense and they’re confident and comfortable going on rounds to make positive recommendations,” she said. “For me it’s seeing in every student when that moment happens. They are always the most rewarding memories of having students.”
And as for being a member of the healthcare profession, Harris admits it has been challenging with COVID restrictions and serving as a preceptor during the COVID pandemic. Students, too, have been impacted throughout the pandemic. “They didn’t have quite as many hands-on experiences at the beginning,” she said, but that has begun to return to normal.
To relax when she’s not at work, she spends time with her family and her dogs. “I’m very close with my family,” she said. “They are my rock who help me keep going, especially with all of the struggles of working in healthcare throughout the pandemic. They have definitely been the ones who have helped me get through.”