It often is said that the best way to learn a topic is to teach it—an aphorism that is taken seriously at the Ochsner Health System in New Orleans, where pharmacists instruct third- and fourth-year medical students how to write detailed drug orders, take accurate medication histories and master other basic tenets of pharmacotherapy.

The payoff for the health system? Better-trained physicians who graduate “with a heightened awareness of medication safety and Joint Commission compliance issues, and who have the skills needed to work well in the Ochsner system,” said Marianne Billeter, PharmD, BCPS, who coordinates the program and is herself one of the primary instructors.

“But it’s not just a one-way street,” Dr. Billeter told Pharmacy Practice News during the publication’s exclusive site visit to the hospital. “The pharmacists who have begun teaching the program find that the experience also hones their own medication management skills.”

The program was made possible by a unique partnership with the University of Queensland Medical School in Brisbane, one of the top medical schools in Australia. Under the program, U.S. medical students travel to Australia for the first two years of their didactic training, then return to Ochsner for two years of clinical rotations. “But within that rotation, they still need classroom instruction, and that’s where the pharmacy department comes in—we provide the pharmacotherapy component of their coursework, because that’s our expertise,” said Dr. Billeter, manager of clinical and ambulatory pharmacy services at Ochsner.

For its part, the University of Queensland Medical School benefits by sending Aussie students to Ochsner to obtain the same type of in-depth clinical work that U.S. students will be experiencing—with an underpinning of pharmacotherapy instruction at the hands of the Ochsner pharmacy team.

The program, known officially as The University of Queensland–Ochsner Clinical School, began in January 2009 when 16 U.S. medical students traveled to Australia to begin their two-year classroom stint. That same year, seven Australian students came to Ochsner to complete elective and core clinical rotations, along with pharmacotherapy classes.

School officials hope to have 80 additional American students enrolled by the end of 2010. When that expansion occurs, the hope is that the program will serve as a powerful recruitment tool and help ease the ongoing physician shortage.

“By focusing our recruiting efforts on medical students in the southeastern United States, we believe the long-term benefit [of this program] will be a reduction in physician shortages in our region,” said William W. Pinsky, MD, executive vice president and chief academic officer at Ochsner Health System.

Dr. Billeter said she’s excited about the opportunity to mold medical students into physicians who will be more effective members of the collaborative care team. “Many of the medication management principles we cover will haunt these students throughout their career if they don’t understand them early on,” she said. “In essence, we’re helping to build better physicians for hospital-based care.”

Program in Detail

The pharmacotherapy training at Ochsner is done in a modular fashion, with students taking classes in eight-week blocks, Dr. Billeter noted. With a week off between courses, “we’re teaching classes six times a year,” she said.

The first class covers the basics of medication safety, such as how to recognize and prevent a potential medication error. Several specialty areas are also covered, including anticoagulation, electrolyte replacement, insulin and pain management and discharge counseling.

The second class teaches students how to write an appropriate medication order for the hospital. “In at least one class, we’ll review abbreviations that have led to dangerous drug errors, based on work done by the ISMP [Institute for Safe Medication Practices] and other sources,” she noted. “We’ll also review Joint Commission requirements for those orders as well.”

The third class focuses on medication history-taking and medication reconciliation. “We really show [students] how to go through our computer system, which has a section called Med Card, where all of the drug and allergy information is stored,” she noted. “When physicians are in the clinic, they can use this system to do a thorough history check, generate an electronic script and then send it to the pharmacy. So if we teach them how to use this system correctly, we’ll get clean scripts and everyone’s efficiency and productivity will rise.”

Dr. Billeter and her clinical pharmacy staff teach the eight-week medication safety/pharmacotherapy module exclusively. “We learned that in Australia, these modules also are taught by pharmacists,” she said. “So this was a natural fit for our pharmacy department.”

Most of the information in the classes is fairly basic for the instructors, she added. “Not much research is needed; most of our prep work focuses more on how to organize our thoughts and present the information.”

Dr. Billeter said it takes about two to three hours to prepare for a pharmacotherapy class. “We could have said we’re too busy to do this,” she said. “But we all realized the opportunity here: If we reach our interns early and instill in them a strong foundation for safe medication practices, that will not only help them in their careers; it will also strengthen the entire collaborative care team.”

In addition to expanding the number of U.S. students participating in the program, there also are plans for broadening the scope of the curriculum, Dr. Billeter noted. Future classes, for example, will focus on infectious diseases, transplant medicine and other specialty areas. “We already have clinical pharmacists with advanced training and credentialing in these disciplines, so the knowledge base is already there to assist in teaching these modules,” she said.

A History of Instruction

Debbie Simonson, PharmD, manager of clinical pharmacy services at Ochsner Health System, said that although the partnership with the University of Queensland Medical School is a new endeavor, her department has long been relied on for its pedagogical skills. “We have partnered with our Medical Academics program for more than 15 years,” she stressed. “We started with morning report topics for the internal medicine residents, which expanded to adding clinical pharmacists to the hospitalist teams.”

Asked to comment on the Ochsner-Queensland partnership, John E. Prescott, MD, chief academic officer, Association of American Medical Colleges, said that “many schools and teaching hospitals have clinical pharmacists actively participate on interprofessional teams to ensure best practices and quality care.”

That collaboration, Dr. Prescott added, “is becoming more commonplace, and it often results in improved patient outcomes and a better learning experience. The key is coordination of effort and content.”

Part 1 of a Two-Part Series
Part 1: Collaboration overseas: The Ochsner–Aussie connection (July 2010 issue).
Part 2: Collaboration at home: specialty partnerships (Sept 2010 issue).