Hello everyone! I've been thinking a lot lately about my experiences on APPE thus far and how I've felt about making the transition from didactic academia to clinicals. It also led me to think: what advice will I give to incoming APPE students after I graduate? So, I devised a list of some of the things I thought of. Here it is:

1. Show up with enthusiasm, every single day

This one seems self explanatory, but I've heard stories from preceptors before about the indifferent student, the student that may care about the rotation but doesn't show off a single inkling of that interest in their personality. My question to you, indifferent student, is how!? It is not difficult to be engaged and excited about what you're learning, and it shouldn't be if pharmacy is the career you want! So get some sleep, perk up, ask questions and come excited!

2. Pack a snack and hydrate

I've been the student that passes out at rotation (IPPE, P2 year, it wasn't fun), so my friends I highly suggest investing in a few boxes of Belvita biscuits and some granola bars to avoid that sort of disaster on APPE. You will get a lunch break but small snacks will keep your energy up the whole day. I also recommend investing in an insulated water bottle to keep your water cold all day.

3. Think before you speak

I'm a person who says every single thing that comes to her mind. While there are aspects of this trait that can be advantageous in a healthcare setting, it also has its pitfalls. When asked questions its hard for me to not blurt out the first thing that comes to my mind. I've found that when I do leap without thinking, I've usually misunderstood the question. I'm absolutely still working on this one, but take it from me, you don't want to be blurting out wrong answers here and there because you didn't take a few seconds to think about the question.

4. Know your resources

With each new block I've been picking up different resources from my preceptors! Obviously we have the basics: Pubmed, Lexicomp, knowing which journals to access, and which guidelines are relevant. There are also many apps that can help in your day to day. Read from QxMD is a great app that funnels articles relevant to your favorite subjects into a queue for you to read! ACC also has an ASCVD risk calculator app for download!  If you poke around the itunes or android store you'll find some really useful apps, but you should also ask your preceptors! 

5. Keep a dropbox or google drive accessible

This is one of the best things I ever did for myself and was recommended to me by my block 1 preceptor. I use dropbox for no particular reason over google drive, but I love having all of my assignments accessible in a minute through this app. I keep a drop box folder for each rotation and I divide that folder further into assignments, and studies/guidelines. I also accumulate random infographs or diagrams I've found in these folders to help in those moments where I don't have time to go combing through guidelines. So do yourself a favor and keep your stuff accessible.

6. Ask about expectations

This is two fold. You should know what is expected of you but you should also ask what you could be doing better to get there. It is difficult to put yourself in that position of vulnerability but it is important to remember that you are on rotation to improve. If you can't accept advice or criticism you will never improve. So be open, and flexible to the direction your preceptors give you.

7. Make friends with your team

Med students, nursing students and PA students are your friends!!! We're all in the same place, with the same goals, fears, and desire for learning! Take advantage of that and rely on them. You'll be happy you did when you want to make an intervention and need to run it by someone who knows the attending first. 

8. Develop a "work-up" method

Developing a method when it comes to working up your patients is really a long term goal while on APPE. Each patient care setting is going to require different things for you to focus on in a patient's record. The weeks you spend in each setting will teach you what is important and what you should be looking for, so if you develop a good baseline "work-up" you can adapt it to these changes. 

9. Anticipate (and accept) failure

This is a difficult one, and it is directly related to the one right below this. We are not perfect, and we most certainly do not know everything. Regardless of how much we prepare there is nothing that will teach us like direct experience will. I've learned that being an APPE student means being wrong, sometimes being right, and accepting that the both of those are okay.

10. Be kind to yourself

I saved this one for last because I believe it is absolutely the hardest one on this list. At least personally, I know I am my biggest critic. We aren't taught how to transition from didactic mode to pseudo-practitioner mode emotionally and so I've found myself scrambling to keep my confidence afloat. It is really hard to take a step back, see the bigger picture and empathize with YOURSELF. To do this, I developed a positive affirmation for when I'm feeling insecure: "you are confident, capable and doing well". If you have a problem with being kind to yourself, I encourage you to create a positive affirmation as well!