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ACCP Anticoagulation Training Program: A Student’s Perspective

Written by Megan Anderson

How did you first learn of the anticoagulation traineeship and what made the opportunity attractive to you?
I first learned of the anticoagulation traineeship during my second year of pharmacy school. One of my fellow members of Phi Delta Chi had applied for this rotation and was accepted. She had mentioned what a great opportunity it was and all of the interesting information she learned while attending. A year later, my husband applied for this traineeship and was accepted. Upon visiting him in Texas during this rotation, he told me about all of the great opportunities this rotation presented, and how this was by far one of the best learning experiences that he had. I became very interested in the anticoagulation area of practice and wanted to select some rotations that presented opportunity in this area. This was an area of pharmacy practice that can play a significant role in health care today and I wanted to gain as much knowledge as possible to help promote pharmacist-run anticoagulation clinics. I did not want to miss out on this traineeship opportunity so I knew I needed to apply for a spot during my fourth year. I was honored to be selected.

An entrepreneurial leader works to advance the profession of pharmacy by proactively identifying and pursuing new opportunities to create value for patients and society. This means recognizing and fulfilling a professional obligation to promote change, to identify and pursue opportunities and to improve patients’ lives. What aspects of the program would you describe as entrepreneurial in nature?
This program demonstrates that pharmacists can create opportunities to better manage patient anticoagulation. Due to lack of time and limited access in certain areas to physicians or other health care providers, this rotation sets a great example of how pharmacists can accommodate patient needs. With more time and accessibility, we are able to see patients more often than may have been previously possible so that we can more closely and effectively manage their anticoagulation therapy.

Another aspect of this program involves the research that is directed by Dr. Bussey, the mentor for this rotation. He facilitates many studies used by major drug companies to research new anticoagulation therapy. Students have the opportunity to see the research side of pharmacy practice and to become involved with many interesting studies revolving around patient care. I was specifically able to screen patient profiles for a study involving a new anticoagulation drug being tested and also assisted with a study to determine how many visits to the anticoagulation clinic required patient change in warfarin dose to properly maintain their anticoagulation therapy.

Describe the activities you participated in as part of the program.
I enjoyed the variety of opportunities presented during this traineeship. Part of each day was spent reading research articles and other information that helped me to learn, in-depth, how anticoagulation therapies work, how the clotting system works, and appropriate therapy for specific patient conditions. There are limits to the material that can be covered in pharmacy school and this site provided for expansion of comprehension and experience in this area.

I was amazed by what I was able to learn during my five weeks in a site such as this. Another part of the day was spent in the anticoagulation clinic seeing patients. A patient interview was conducted and a change to therapy was recommended if needed. I would then discuss any needed changes with the other health care providers and we would make a final dose adjustment and set up the next appointment. This was a very enjoyable part of the rotation as there was ample opportunity for patient contact and the opportunity to develop strong interviewing skills. Other activities included in the experience were weekly attendance at lectures hosted by the University of Texas at San Antonio. The topics were directed at pharmacy residents and students and participating in research. The lectures were a great opportunity to strengthen knowledge in many areas. Finally, the research aspect of the traineeship was a new experience for me and I enjoyed to chance to see how a study is conducted from the beginning. I also met with Dr. Bussey for weekly review sessions where I would answer questions and address certain topics that were assigned in a mini-presentation format.

Describe any challenges you may have faced during your experience. How did you address those challenges and what did you learn as a result?
Accepting a new challenge outside of my initial comfort zone was a bit intimidating. I felt as though I should have known most of this information, but had to step back and remind myself that this was a learning opportunity designed to improve my knowledge in a specific area. I read the articles and information presented to me and engaged in discussions with Dr. Bussey, while attempting to learn as much as I could so I could use the information in future practice. I now understand the clotting cascade extremely well, as well as the various genetic factors that may cause patients to be more susceptible to clotting than others. I have a good grasp on managing anticoagulation therapy effectively and expanded both my interviewing skills and my ability to communicate with other health care professionals on the team to work toward the best patient outcome possible.

How did the experience help you develop your entrepreneurial leadership skills? Have you been able to put those skills to use in your practice today?
This experience has given me, above all else, the confidence to pursue new areas of pharmacy. In my current position, I am not able to start an anticoagulation clinic, but I am able to speak with many of my patients and share my knowledge in this area. This experience has motivated me to improve in other areas in my practice and to promote many other patient care activities.