LAWRENCE — Many of the brightest, most promising students in the School of Pharmacy at the University of Kansas were raised in homes and communities where English wasn’t spoken on a day-to-day basis.
“These students are often very strong academically — they’ve excelled in didactic coursework,” said Joe Heidrick, assistant dean of experiential education and director of the Pharm.D. program at the school. “But their ability to understand the English language becomes an issue when they’re on their clinical rotation.”
An essential part of a pharmacist’s education, these clinical clerkships send Pharm.D. students to work in pharmacies and hospitals around the state of Kansas, acquiring practical experience with medical professionals, pharmacy practitioners and patients. Students can cycle through community and retail pharmacies, hospitals, managed care facilities, compounding and long-term care facilities.
In these settings, occasionally students from backgrounds where English isn’t the primary language can struggle to succeed.
“These students are bright and do well in written exams when they can take time to process information,” Heidrick said. “But in a practice setting — because oftentimes they’re hearing English, and translating in their head to their native language, and translating an answer back into English, so they take a lot of time — they’re not performing as well as they could in their clerkship rotations.”
Assessing the challenge to the students, the School of Pharmacy determined that English-language instruction should be incorporated into the Pharm.D curriculum.
“We thought, ‘Whose fault is this?’” Heidrick said. “It isn’t the students’ fault. We thought the school needs to look at this and to make sure the students are equipped to succeed.”
This semester, the School of Pharmacy launched a new high-intensity class for ESL students, titled English for International Students in Pharmacy, in partnership with KU’s Applied English Center. Students will meet for two hours twice per week for one-on-one instruction.
“They’ll be able to record these sessions, benchmark students’ ability at this point and provide simulated interactions typical of the pharmacy, with the ultimate goal of being able to communicate effectively in health care settings,” Heidrick said. “With students not understanding things correctly in a pharmacy environment comes significant safety issues. So, this is not just about making sure of student success, but making sure that we’re meeting our obligation toward patients.”
According to Heidrick, oftentimes prescriptions are verbally communicated from a physician to a pharmacist, with particular instructions for dosage and frequency. “Those are things a pharmacy student has to be perfect with every time,” he said.
The course also aims to make students’ English sound more familiar to patients in a Kansas pharmacy setting. Rotations will take place in metropolitan areas like Wichita, but also in rural areas, where residents may be less accustomed to interaction with non-native speakers of English.
Recordings of each class session will complement course materials and simulated situations. Students will be assessed based on changes to speech that make them more comprehensible to Kansans, whom they’ll be guiding with instructions on taking prescriptions.
“A lot of times, the patient doesn’t know how many times they’re supposed to take a medication,” Heidrick said. “If you’re telling a patient to take something once a day versus four times a day, communicating that accurately is a big safety issue. The same goes for asking them about allergies or immunizations, to make sure a medication doesn’t have a harmful interaction.”
Additionally, clear and accurate communication with health care providers is an essential component of success in a pharmacy student’s clerkship rotation.
“A lot of that communication is two-way,” Heidrick said. “Not only can students at times have a hard time understanding what’s being told to them, but what they’re providing back to health care providers — asking for clarification on a prescription, for example — can’t be clearly understood. Here’s where accent reduction or accent therapy comes into play. They could be speaking perfect English, but if the accent is such that the other person can’t understand them, that’s a big issue as well.”
Language instruction is customized to needs of students on their clinical clerkship rotation, and specialists from the Applied English Center have taken care to focus instruction on language specific to facilitating communication in a real-world pharmacist’s setting.
Heidrick stressed that students are eager to better their language skills in order to succeed at the same level as their peers.
“They don’t view this as a remediation program,” he said. “A lot of these students are near the top of their class didactically, and they want to perform in their rotation just as well as other students in their class. We, as their school, take a big responsibility to make sure they don’t feel they’re at a disadvantage because they’re non-native speakers. We accepted them as students as they were into our program, and we have the responsibility to enable them to succeed.”
Image: Lab work in the School of Pharmacy. Photo by the KU School of Pharmacy.