October 2021 | Tara Higgins, PharmD, BCPPS, FFSHP
At last year’s ASHP National Pharmacy Preceptors Conference, Tara Higgins, PharmD, BCPPS, FFSHP, FPPA, presented “Virtual Precepting Best Practices: Mentoring Residents in a New Reality.” In this guest blog, Dr. Higgins continues her discussion by reflecting on the struggles the pharmacy community faced moving to an on-line world and evaluating the effectiveness of virtual meeting platforms when used for patient care, employee recruitment, and professional meetings.
Dr. Higgins is a Pediatric Hematology/Oncology/Bone Marrow Transplant Clinical Pharmacist at Johns Hopkins All Children’s Hospital and is active in the pharmacy residency community. She served as a PGY2 Pediatric Residency Program Director for the past five years, and after earning her Doctor of Pharmacy degree from the University of Rhode Island College of Pharmacy, she completed a PGY1 pharmacy residency program at Massachusetts General Hospital and a PGY2 pediatric pharmacy residency program at the University of Kentucky Healthcare.
Pharmacy’s Abrupt Adoption of Virtual Meeting Platforms: A Reflection on the Struggles and Benefits of Moving On-Line
The COVID-19 pandemic brought changes to every aspect of our lives at work and at home. These included mandatory masking, social distancing, working from home, home schooling, and travel restrictions. For pharmacy, this impacted the continuation of all clinical services, staffing models, professional development, and teaching learners. These changes to our daily lives thrust the field of pharmacy and other disciplines into discovering how to recruit, provide care without compromising the health of staff, and participate in professional development through continuing education and networking. Each institution had to develop a method to perform everyday tasks, such as meetings or patient care rounds, without actually being face-to-face.
Patient Care
Overnight with state and federal shutdowns, hospitals had new rules and mandates put into place for employees, such as temperature checks, mandatory masking, social distancing, and avoiding large gatherings. Plans were made in case large numbers of employees became sick or needed to be quarantined, and many institutions elected to have some employees work from home. Health care institutions developed ways to proceed with student/resident learning experiences, committee meetings, and patient care without having everyone on site or being able to congregate. Secure messaging, telehealth and virtual platforms came to the forefront in healthcare; an industry that had largely underutilized these platforms previously.
Secure messaging could be done through a virtual platform (i.e. Skype or Microsoft Teams) or through electronic health medical records. This allowed for safer, less in-person face-to-face discussions and was less interruptive to workflows than a phone call. The burden with using these platforms was trying to have access to all these apps at all times while at work. Virtual platforms such as Zoom, Go to Webinar, Microsoft Teams, Webex or Skype became mainstays to hold meetings within an institution (i.e. departmental or committee meetings). They also could be used for day to day meetings with learners for topic discussions, patient discussions, or journal clubs. While this technology allowed for these meetings to occur, it became harder for genuine interaction due to people multi-tasking, unfamiliarity with the software, not having a camera or mic available or on, not wanting to talk over someone, or not wanting to type out a question. We found that for meetings larger than a few people, the meetings became less productive, there were fewer questions for speakers, and fewer people volunteered when help was requested.
These virtual platforms made it easier to attend all meetings on your calendar, even when double booked. Employees often had dual zoomed meetings open while also trying to work on other project at the same time. This made it easier to join meetings, but harder to be a meaningful participant. Some institutions even utilized virtual platforms for patient care rounds. Institutions then had to contemplate privacy settings to keep all meetings and information being discussed safe, so passwords or screen sharing restrictions needed to be in place. Potentially, this could mean more concise table rounds, but could also result in medical providers spending more time with bedside rounds as they would have to go see all the patients after discussing them on a virtual platform.
Telehealth may have previously been used by some institutions, but it was uncommon. The pandemic drove this format into mainstream usage in order to decrease the number of patients entering a clinic. This brought new challenges to developing billing strategies and questions on how to get information such as vitals while the patient is at home. Smart watches and cellular phones helped provide some of this information, including heart rate, respiratory rate, and sometimes even pulse oximetry. To help with this transition, the widespread use of virtual platforms by the public made visits in this format less foreign for patients.
Recruitment
Travel and COVID-19 restrictions placed hospitals in a position where it was impossible to bring perspective new employees on site. Of course, this applied to new pharmacists, technicians, and residents. Institutions utilized virtual platforms in order to perform these interviews. This became particularly tricky for resident recruitment and interviews as these typically were done with large groups of people and multiple sessions per day. Recruitment was now performed through virtual platform sessions that required organization beyond setting a time and just speaking to people at a booth. It required setting up breakout rooms within virtual platforms and a moderator to be present to help people get to the correct rooms. This led to a lot of traffic and sometimes resulted in people going into incorrect rooms or experiencing issues with breakout rooms not working correctly. Also, the breakout rooms occasionally would not have mic features, so chats were done through typing which resulted in a less personable experience.
Some institutions had their own private recruitment virtual platform sessions outside of usual national pharmacy meetings. Using social media helped to advertise these sessions and to give more information about the residency program. Twitter was a social media platform used by many programs. For example, @UFHealthRxRes provided resident updates on grand rounds given, day in the life of a resident, fun facts, preceptor updates, resident activities, etc. This allowed for perspective candidates to obtain information they usually would have obtained during recruitment or interview dinners and allowed them to have some interaction with current residents. It is still unknown at this time whether interviews and recruitment will return to in-person, especially for residents. The positives for virtual recruitment are lower costs and the ability to interview more candidates. However, potential employees’ inability to see an institution before accepting a position may outweigh these benefits as a new normal develops.
Professional Meetings
Another change that happened quickly was professional societies needing to cancel meetings or move to a virtual format and figuring out how to do it. As it was impossible to appropriately social distance prior to vaccine implementation, virtual format was the only way to hold a conference. Additionally, with national and state shutdowns, hospitals decreased revenue causing travel funds to be reallocated to other areas. There was little or no travel support to conferences for employees. Utilizing virtual platforms allowed for attendees and speakers to continue to participate and even allowed for speakers to record their lectures ahead of time, which often was necessary because pharmacists were frequently unable to take off from work during the pandemic. Participation grew from a broader audience because travel was not needed and the ability to watch recorded lectures at a later date incentivized registering for the event. Many societies attained record attendance at their meetings.
One obstacle with using virtual platforms for conferences was how to integrate audience participation and networking. Through virtual platforms, polling and Q&A features assisted with increasing engagement from audience members. However, this was not helpful for recorded lectures. Recording a lecture was beneficial to the speaker, but the format may cause decreased participation or the ability to have in the moment question and answer sessions. Audience members may have been at work while watching, thus having their attention pulled in multiple directions. This allowed for a less friendly learning environment. The alternative was to watch at home after work or on the weekends where multitasking may still occur. Also, some conferences may only allow questions through chat function which is less personable, and people may not want to type out a full question that would be easier to say out loud if in person. Finally, what seemed to suffer the most at virtual meetings was networking. There wasn’t an easy way to grab a meal with friends or have roundtable discussions. Some organizations planned lunch events with break out rooms to try to mimic these opportunities. These sessions often had mixed reviews as eating while on video call made some people uncomfortable. Less discussion took place as it was difficult to tell who was speaking or when to jump in. At this time, the perfect virtual networking opportunity is still being sought after.
What will happen when a new normal is found and in-person events occur regularly? Will the virtual format disappear? The jury is still out, and some organizations are trialing hybrid formats with small in-person gatherings and virtual registration option as well. Another approach is to allow speakers to present in person or virtually. Will this become the new normal for conferences? Of course, the downside to hybrid formats is the cost for in-person plus virtual technology and recording may not outweigh the benefit of reaching people who are unable to or unwilling to travel at this time.
Virtual learning platforms enabled all aspects of our lives to continue despite a pandemic. It is unknown how much of the current use of virtual platforms will continue in the post-pandemic world. The attractiveness of its ease of use and low cost may be implemented into our work lives in the future, and I am sure we will continue to see innovative ways to implement it into our daily lives.