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Pharmacy Residency Podcast


Jun 4, 2018

Eric Christianson found his calling in geriatrics and medication management and loves working as a consultant pharmacist for long-term care and assisted living facilities as well as working with patients and families doing medication therapy management. Son of a teacher, education is in his blood as well. He shares real-world scenarios on his blog Meded101.com and also on his podcast geared towards healthcare students and young professionals (RealLifePharmacology.com). His objective is to teach as many individuals as possible about the safe, economical, and appropriate use of medications. 

Full Transcript:
 
welcome to the pharmacy leaders podcast
with your host Tony Guerra the pharmacy
leaders podcast is a member of the
pharmacy podcast network with interviews
and advice from building your
professional network brand and a
purposeful second income from students
residents and innovative professionals
hey welcome to the pharmacy leaders
podcast today I have Eric Christensen
who is cgp BCPs he is a consultant
pharmacist he found his calling in
geriatrics and medication management he
loves working as a consultant pharmacist
but because he is the son of a teacher
education is in his blood and you know
him better probably from med ed 101 he
shares real-world scenarios on his blog
med ed 101.com and then he has a new
podcast real life pharmacology calm that
we'll start talking about and his
objective is to teach in as many people
as possible in a safe economical and
appropriate use of medication so Eric
welcome back to the pharmacy leaders
podcast it's good to be back Tony I
appreciate it yeah we're actually not
that far from each other
Iowa and Minnesota are next to each
other but we have a good rivalry I guess
you would say between the the northern
state in the southern state but friendly
friendly rivalry yeah so it's a Midwest
nice is you can get between the time
there you go okay so right now people
are graduating and you see all that you
know Facebook applause and all this
stuff where yeah you know I'm doctor and
all that stuff
but now they have to take the Netflix so
tell me a little bit about your journey
where you started studying for the
Netflix and how you became confident to
pass than that place cuz I think
confidence most first and foremost is
part of succeeding at this longer six
hour test yeah absolutely it takes it
takes a lot of time for most people I
think to study for the NAP Lex I think
as as a whole if you've done pretty well
in school grade wise and you feel pretty
comfortable with the math portion of
pharmacy if you feel comfortable with
pharmacology mechanism of that
side effects contraindications I think
those are the the big big topics that
you're gonna have to focus on and and do
well at and if you've got a track record
of doing well in that I think you're
probably set up to do pretty well on the
NAP lex with that said if you're tend to
forget things like I do over time
definitely that year off from that
classroom test taking type thing can
definitely get you out of the groove a
little bit so I definitely did a lot of
practice questions I had a really hard
time learning from a bigger book and rx
prep went when I was preparing and in
studying sometimes that was a little bit
challenging for me to kind of read
through get through that information and
most importantly retain information I
mean that that's really what you're
after so I'm more of a bullet point
person give me the highlights given to
me as quickly as you can and you know
let me try to memorize them and now kind
of with the newer and a Plex format we
do have to have a little bit more of an
application then maybe more so straight
memorization to some of those clinical
facts particularly so things are
definitely changing a little bit and I
probably would alter my test taking
strategy a little bit making sure I'm
very comfortable with cases reading
cases evaluating clinical lab work
different things like that that's going
to be coming up more and more so on the
NAP Lex as we've shifted to a more
clinical style exam test anxiety that
people are just worried because you
can't and I'm not trying to freak people
out by telling them the facts but you
can't go backwards on an exam question
so let's say you don't know
question number one you know how much
time do you spend figuring out whether
you should spend more time hoping the
muse will come to you or how do you just
let it go yeah I think I was kind of
disappointed that they they've switched
to that model I know and taking BCPs and
and BC GP geriatric and pharmacotherapy
exams I believe you are still able to go
back and kind of flag questions and go
back to them I you know I I do get a
little bit frustrated with that but it
is what it is so students definitely
have to deal with that if they're taking
the nap like so my recommendation would
be to probably set a mental timer in
your head fifteen to thirty seconds if
you're gonna sit there and think about
something because you absolutely have to
keep moving it's very very critical that
you finish the exam so if you take five
minutes and you're five or ten minutes
short on the back end your exam and you
miss you know five to ten questions or
don't get to them that's obviously way
way more important than that one
question that you maybe mister just
couldn't quite go into the memory vault
and figure out that answer so you got to
keep moving you got to like I mentioned
practice questions I think will help you
learn how to do that because certainly
we need to practice questions you're not
gonna know all the answers but
recognizing which answers you can rule
out is a really important tool that I've
used so if you're given five choices and
you've got to select one
okay well two and two or three of those
choices are probably nonsense
or you know maybe don't make a lot of
sense so definitely rule those out and
you know then yeah just got to end up
picking and making a decision between
the the answers that do or potentially
could make sense okay
well past rates actually went up last
year I wonder if maybe schools just I've
heard that schools are giving our ex
prep to their students their schools are
being much more focused on on the actual
exam so it went up from about let's just
round for easy sake so 86% to 88% but
that's still 12 people out of every
hundred in the pharmacy school class
what recommendation do you have for
somebody that unfortunately doesn't pass
the NAT Plex now they've got a deal with
unfortunately in this kind of and I
don't want to call it a saturated market
because different parts of the country
are in different aren't but right now
some of the contracts are saying you
have to get a license in X number of
days or I'm sorry you know we're not
going to be able to keep you on this
contract or you may even lose your
residency so passing first-time has kind
of become a little bit more important
but what would you say to somebody who
didn't pass it how do you get back on
the horse cuz that's that's a kind of a
big blow to the ego like I've been
studying for four years what happened
yeah exactly and you know can I go back
to that you know thinking about our ex
prep or Kaplan or you know whatever test
prep material you're using me in my mind
you know doing the same thing over and
over again and expecting a different
result doesn't make a lot of sense to me
so I would definitely encourage folks to
look at a different type of study
material maybe reach out to friends
reach out to to someone else and say is
is there other options available that
may present the information in a
different way maybe you're better able
to retain that information maybe it's
just more simplified and and kind of
easier to work with and easier to
understand rather than some of the the
books that do get a little bit more
overwhelming so I would encourage
looking at and reviewing different
sources that would be kind of my first
step to do something different than what
you did before in your
preparation house met at 101 a little
bit different than our ex prep I've
heard rx prep called the RX prep
doorstop because they'll get the book
and then they'll put it we'll put it
down and it ends up being a doorstop and
then it becomes this huge thing and I've
actually recommended that people rip
pieces out of it to make it smaller but
you kind of work a little bit
differently you said you're a list guy
how is the meta at 101 material maybe a
little bit different than our ex prep or
like a kaplan yeah so I've got a couple
of practice exams available on my
website you can find a met at 101.com
slash now Plex you can find everything I
have there so I got a couple Pratt
practice exams and then I also have
Knapp Lex nuggets which is just your
your bare bones you know the most highly
testable most common disease states that
you're gonna see so or excuse me not
disease days but but medications that
you're going to see so with that I
highlight things that are really really
important so let's take SSRIs for
example so you can have a million
different side effects from SSRIs and
I've seen a lot of different rare and
unique side effects from SSRIs but what
you really want to know is what are the
most common side effects and the ones
you are most likely going to see and
that may differ depending upon the SSRI
you choose I'm not going to discuss that
you can check out real-life pharmacology
comm I've I did a podcast done on SSRIs
but the Knapp flex nugget book was
really meant to highlight those really
really important
highly testable pearls that kind of I've
seen throughout my pharmacy careers so
getting that information distilled a
little bit and then my most recent
release was the Knapp Plex webinar
series which was over a 16-hour course
of recorded lectures you also get the
PDF slides for that so again that kind
of gives you a more bullet point format
of really highly important testable
things rather than
that doorstop like you so eloquently
mentioned sorry yeah I mean it's it's
huge you think same thing with you know
the big pharmacotherapy book that we all
use from DP roll throughout pharmacy
school I mean it's just massive and it
makes your header just kind of looking
at it so let's talk about that podcast
and I remember search for liens
quarreling you know from and from your
podcast episode but but it sounds like
in each of these podcast episodes you
take a class or you take a single drug
like glucophage and you say this is what
you got to know or if you're in practice
you should know this or if you're in
fact or if you're an AP PE or your
preceptor is gonna expect that you know
you know for example that metformin is
probably going to cause weight loss
whereas certain other anti diabetics are
gonna cause weight gain or SSRIs you
know sertraline with the diarrhea and
then paxil with certain sexual effects
and things like that so talk a little
bit about why you started a podcast to
kind of maybe give a little more breadth
to pharmacology yeah exactly it's a it's
a challenge for me ecology is a
challenging topic I think pharmacy
students tend to like it obviously much
more so than other professions I did
want to kind of widen that scope help
promote what we do as pharmacists and
what we know as pharmacists maybe teach
some of these other nurse practitioners
pas med students as well so I really
wanted to kind of broaden that scope and
I remember being a student the thing
that I always wanted to know is okay how
is this applicable in real life and does
it really actually happen and so I
within the podcast I really try to share
those stories those pearls and give you
some guidance as to you know this is
something you're going to see in
clinical practice so take the example of
metformin you're gonna see patients
report diarrhea it is very very common
now you compare
that to the risk of lactic acidosis that
is extremely extremely rare I've only
seen it a couple of times so again just
kind of helping teach those pearls kind
of through the the power of of story and
an audio story which is kind of how my
my blog initiated as well so meant to
really be a nice resource as far as
preparing for whether you got
pharmacology exams throughout school you
know now Plex BCPs just a good reminder
and good refresher on those different
drugs and drug classes so Bryan Fung
took BCPs he's an informatics guy I
think he was a University of Florida
grad and he took BCPs and he said that
his residency was 70% of his studying
and then 30% was kind of getting the
math and statistics and those things but
I feel like the NAP Lex is the inverse
where pharmacy the the AP PE s are so
scattered like you can have electives
you can maybe you know do some am care
maybe do some hospital but they're so
disparate that I feel like you have to
do 70% studying versus 30% what was in
your AP PE can you tell me a little bit
about how you kind of bring in
pharmacotherapy with the pharmacotherapy
pearls book that you had and the case
studies and kind of just keep going with
that case studies in those sections yeah
with the pharmacotherapy pearls book you
can can find that on Amazon but those
are really some of my favorites
case studies case scenarios and it's
really helped I think it's helped a lot
of pharmacists and students learn kind
of some of the clinical reasoning and
the the case the case aspect behind some
of those really important pharmacology
pearls that were we're told in school to
simply memorize this but you know I'm
kind of a wide guy it's like
why do I need to memorize that is that
truly something valuable is that
something I'm going to see in clinical
practice where I could help a patient
out potentially so that that case study
book with my kind of my favorite case
studies blog posts was really meant to
kind of be a reference a teaser to get
you to get students to get young
pharmacist thinking about thinking
clinically and to kind of stimulate that
clinical thought process one of your
cases has this list of current
medications I think it was like eight
medicines or something like that I think
it was talking about Falls that happens
a lot on the NAP flex how do you quickly
get through the medication list itself
do you have a process for that because
you're looking at eight medicines and
you know it's like you have six hours
now six hours in five hours and 59
minutes five hours 58 minutes so you
know it's a ticking clock yeah how do
you get through big lists like that
what are you looking for yeah I think a
lot of students get distracted by all
the information sometimes that are
presented in an app Lex question and you
have got to remember when you're reading
a question remember what the question is
don't get distracted yeah I mean I'm
oversimplifying it a little bit
certainly but what are they asking for
are they asking for you to describe a
mechanism of action are they asking you
to you know pick out a side effect
that's happening that's so so important
because you read this case you presented
all this information and you know you're
kind of blown away by by what's going on
and really the only thing you care about
at least on the Netflix is what's the
question that I have to answer and I
remember reviewing cases and questions
and you know you read through this whole
pile of information and the questions
goes in a totally different direction
than you ever thought it would go so I'm
definitely an advocate
a proponent for looking at the question
first and seeing what exactly are they
asking if they're simply asking for a
mechanism of action on a specific
medication well you don't even need to
the question just answer the question
you don't even need to review the case
and so I think that's where a lot of
students sometimes get distracted is not
recognizing what the question I'm
supposed to answer is and they want to
you know go through and do a whole care
plan and work up the whole case it's
just like no we're not doing a
presentation yeah we're not doing
journal club on Wednesday we're just
just exactly just answer the question it
just keep it simple for sure okay so
tell me a little bit about how that kind
of went to BCPs bullets where you've
you've kind of gone from nap flex to
pharmacotherapy stories that help you
with the Netflix but also you're now
kind of transitioning to higher end
practitioner on top of licensed
practitioner tell me a little bit about
BCPs bullets yeah definitely there's
there's a lot of there's a lot of
information a lot of study material out
for for now flex which is a great thing
I mean I'm always an advocate for for
more options that way with BCPs it's a
little more limited and I felt that um
when I took my BCPs exam and
unfortunately passed
BCPs pass rates are more along the lines
of 60% 65% if that tells you about the
the difficulty of no idea what they were
yeah okay yeah so you're not alone if
you've failed for sure the the BCPs exam
but with that yes study material is
pretty limited you know to some of the
big major organizations and and kind of
having you know there aren't that many
people that take BCPs compared to the
nap Plex every year so like I said that
study material is limited and again it's
kind of that doorstop like you mentioned
as well where you get this big huge
reading material and it's hard to know
exactly kind of what to focus on what to
study for what's gonna come up on there
as we've gone on with more and more ears
of BCPs certification that's slowly
become a little bit clearer over time
but my BCPs bullets reference as well as
you know my webinars and things on on my
website they are really intended to
distill things down you know what are
the drugs of choice in this specific
disease state why would you choose these
drugs why wouldn't you choose these
drugs and you know that goes into drug
interactions and side effects and
contraindications and all that sort of
stuff so again I just I'm a simple
person so I really wanted to kind of
simplify the the mindset and really have
a good review of each disease state
focusing on drugs of choice clinical
reasoning and those type of things
NCLEX so if any pharmacists have any
nursing colleagues or know people that
are going to nursing school
what was your kind of intent with that
one what's on the inside of navigating
the NCLEX
yeah I wanted to create a resource you
know to kind of share with our nursing
friends they my work with a lot of those
nurses that struggled in pharmacology
they generally don't like medications
nurses don't at least that's been been
my experience in chatting with them
about pharmacology so just wanted again
to create a drug resource to kind of
give them some guidance as to things
that actually commonly happen or
commonly occur in real life I really I
guess I got the inspiration for that one
from looking at another drug info study
guide on the NCLEX and they think they
had like claritin or zyrtec or something
and they've got like 30 side-effects
listed for claritin it's just like
information overload yeah it's just like
come on it's like I've never you know
it's like I've been practicing for nine
ten years whatever here it's like I've
never seen this happen I'm just like
should this really be listed and
something you should study for
so again just wanted to kind of create
another resource there to kind of
distill that information down into
things that are clinically relevant and
and things you're probably likely going
to be tested on okay is there anything
you want to make sure people hear from
you because it sounds like you're
actually a resource from when you get to
p3 year and on like that's you know
that's when med ed 101 or even you know
maybe a little before that but you're
also all the way through BCPs where I
kind of just focus straight on
pharmacology is there anything else that
you want to mention yeah definitely I'd
agree with that I really have always had
an interest and a passion in the
clinical reasoning and learning that
process and you know learning from our
primary care providers that I work with
in clinic and in long-term cares just
being able to share that information
with growing budding clinical pharmacist
and maybe not so clinical pharmacists to
just giving a sense of what we do what
the value we can can provide that's
really how the blog started and I'm
gonna continue to do that and try to
share whatever information and in case
scenarios I I stumble into thanks so
much for being on the pharmacy leaders
podcast thanks Tony appreciate it
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