Healthcare professionals sometimes face challenging encounters with patients who need care. To gain skills to communicate effectively, simulations help NDSU third-year professional pharmacy students gain first-hand experience dealing with difficult conversations.
The pharmacy students engage with people acting as patients to learn professional and empathetic communication during simulations in the NDSU Aldevron Tower. The NDPhA Pharmacy Instructional Lab and a 10-room exam-room wing serve as the setting for the simulation. The facilities are similar to those that students will find in healthcare facilities when they graduate.
The actors portray patients in scripted clinical scenarios that coincide with a specific medical challenge to help students build their skills. Patients may be hurried, upset about prescription drug costs, embarrassed about a personal symptom or disagree with the plan of care.
During the training, nine simulation scenarios represent difficult patient encounters in a variety of settings, such as community pharmacy, ambulatory care, emergency department, telehealth, institutional pharmacy and transition between care locations.
Third-year pharmacy student Brennen Kuntz found the simulation helpful and realistic. “For the patients who are angry or bothered, showing you care about their needs and that you are trying to help can go a long way. As the pharmacist, you may not have been the one to anger the patient, but you do have the power to change how they feel by providing quality care,” said Kuntz.
The trained actors role-play as patients or caregivers. Some are unwilling to take prescription medications. Others are overwhelmed, confused or doubtful. One scenario includes a provider who is demeaning and unhelpful regarding a medication cost concern.
The simulation was designed by Heidi Eukel, associate professor in pharmacy practice at NDSU.
“This simulation encourages students to think on their feet, respond to each individual patient and allows them to practice with these difficult encounters in a safe environment and reflect on their performance,” said Eukel.
Students complete self-assessments both before and after the simulations.
“I was surprised with how capable I was helping certain types of difficult patients and how much I need to work on my skills with others,” said third-year pharmacy student Brendon Wehri. “I feel like I was adequately prepared helping emotional patients, but I definitely need more work on OTC recommendations.”
Gabrielle Coudron, another third-year pharmacy student who participated, said it shows a professional pharmacist needs many different skills. “Having pharmacy knowledge is not enough in situations like this,” Coudron said. “Being able to apply this knowledge, using ‘soft skills’ is important. The information you are trying to provide will be lost if you can't show empathy, understanding and care with these conversations.”
Each simulated situation requires students to respond using communication techniques to call upon pharmacotherapy skills. One scenario includes the need for a language translator and addresses cultural competencies. In another, a family member is scared and confused about her mother’s end-of-life care plan.
“I gained valuable feedback from the actors after each encounter and learned new tips for success from my partner, as she approached each situation slightly different than I may have, which was great to get a new perspective,” said Emily Lothspeich, third-year pharmacy student.
The simulation requires limited resources, transfers easily to other schools and has the potential to meet accreditation expectations of pharmacy schools across the country, according to Eukel.
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