Title: Telehealth Activities in the School of Pharmacy
Author: Dr. Sara Kim

Background
With the recent events in regard to COVID-19, many schools switched to online education and moved away from traditional face-to-face classroom teaching by default. Many pharmacy schools adopted an online platform which allowed distant lecturing and learning. However, the use of an online platform was limited to carry out a meaningful co-curricular activity, especially when it comes to patient care activities which required seeing patients. To meet the increasing need of clinical experiences for pharmacy students, the co-curricular committee (CCC) at American University Health Sciences School of Pharmacy have developed a list of virtual activities to fulfill P1 student requirement of Standards 3 and 4 with corresponding assessment tools to ensure the effectiveness of each of the activities. One of the virtual activities that fulfilled patient care was a Tele Brown Bag event. Traditionally, students would visit a nursing facility or senior apartments to review patients’ home medications and provide counseling by checking for appropriate indication, dose, route, frequency, and drug-drug interaction. The CCC implemented a telehealth service to the patient by participating in a virtual home visit by calling the patient. The students were asked to provide the consultation and continual care as well as address any issues or concerns by the community. Upon the interview, we found out that many of the patients were concerned with contracting the virus when going to the pharmacy. The students made handouts to educate patients on how to receive pharmacy services such as receiving a 90-day refill, and delivery services to minimize potential exposure to the virus.

Method
The interview was done on June 18th to June 20th, 2020 with the patients selected as residents of Living Opportunities Management Company (LOMCO) in Long Beach, California. Students received an average of three patients to call in order to do a medication review with supervision with at least one faculty. Both students and faculty received a brief orientation before dispersing to make phone calls. If the patient did not pick up a call after a third trial, the student tried calling the next day and if the patient fails to pick up the next day, the student will drop the case. Each student was able to get in touch with at least one patient. Before the interview, students and the residents filled out a pre-event survey and the post-survey after the interview. During the phone call, students went over a two-way verification asking for their name, birthday, medication name, dose, route, frequency, indication, and any experienced side effect. After going over each medication, if adjustment was necessary, students consulted the preceptor and made appropriate recommendations.

Result
Most students truly appreciated this opportunity to be exposed to patient care especially during this time, which may be difficult for students to do any kind of meaningful direct patient care. This experience also has enhanced their understanding in telehealth and the role of a pharmacist in clinical service during an emergency situation. Also, they developed a communication skill with emphasis in expressing empathy toward patients. By comparing the pre-activity survey and post-activity survey, we were able to find out that students became more aware of their individual level of empathy skills. It was interesting to find out that students scored lower post-survey on the Likert scale (1 indicating strongly disagree and 5 indicating strongly agree) on the question, “It is very easy for me to perceive how the other person is feeling without asking them.” Some possible reasons to this change can be explained by students overestimating their empathy skills. Other comments we received were:
1. The most helpful part would be the experience. I came in thinking it would be straight forward but that is not the case. You have to gently guide them back on topic so that you can answer all the questions that you have for the patient. It definitely will take more practice so that the interview can be smoother and more efficient.
2. The patient interaction was the most helpful part to me. Another part that was very helpful was that I got to learn about side effects and patient medication adherence.
3. It is hard to understand the patient because they go off-topic a lot when you ask them a specific question. It took a lot longer because the patient couldn’t focus on my questions, but eventually she did.

Conclusion
The telehealth brown bag activity gave unique opportunities to practice skills such as empathy skills that are essential to achieve the learning outcomes within nontraditional classrooms or clinical settings.

1. (USDOE) United States Department of Education. (2010). evaluation of evidence-based practices in online learning: A meta-analysis and review of online learning studies. Washington, DC, USA: Office of Planning, Evaluation, and Policy Development. Retrieved November 13, 2013, from http://www.ed.gov/rschstat/eval/tech/evidence-based-practices/finalreport.pdf