Leylah Azali, PharmD

Can we teach effective habits? Is there a blueprint for helping pharmacy students and interns be more proactive, prioritize more efficiently, and embrace a strong work ethic? As a professor and preceptor who strives to instill these behaviors and attitudes in future pharmacists, I often turn to a trusted guide: 

Initially published in 1989, this self-help book explains the importance of achieving success through personal change. As suggested by the book’s title, Covey encourages his readers to develop and nurture 7 essential and lifelong habits:

 Don’t wait for problems to happen before taking action.

 Envision what you want in the future so that you can work toward it.

 Prioritize what is important and urgent.

 Foster positive relationships and look for mutually beneficial solutions.

Seek First to Understand, Then to Be Understood.

 Use empathetic listening to understand others.

 Use the different strengths of your team to achieve goals together.

 Continue to strive for personal improvement.

I first read this famous book as a pharmacy resident, and ever since I’ve wished that I had known about it as a student. Learning the 7 habits was life changing, and when I became a preceptor and clinical professor, I made it my teaching mission to creatively incorporate them into my students’ rotations and clinical work.

Since 2014, I have instructed interns on the first day of their 6-week rotation to research and list the 7 habits. Every week, the interns focused on applying 1 habit in their daily life or on rotation; at the end of the week, they reflected on how the habit helped them achieve their goals. During week 6, the interns would incorporate both habits 6 and 7, which is meaningful, because habit 7 reminds them of the importance of continuous improvement. The ultimate goal of this project is to instill in interns a love of lifelong learning and the motivation to apply the 7 habits in their daily lives.

After seeing considerable success in this project from my interns, I decided to incorporate the 7 habits into the geriatrics elective course that I taught this past fall. In the classroom, I similarly instructed my students to research and list the 7 habits as listed above and implement each habit weekly at school or in daily life. The students were then assigned to reflect on how the habit helped them achieve their academic goals and hone their leadership skills.

So, are these 7 habits applicable to future pharmacists? Perhaps that is best answered by my students’ and interns’ descriptions of their experiences in applying each habit:

I had several barriers to my professional growth, such as shyness and insecurities; I was just going through pharmacy school doing the bare minimum. While listening to a professor’s lecture, I realized that I was missing many opportunities by not participating in projects, research, or extracurriculars.

 During my first hospital Advanced Pharmacy Practice Experience (APPE) rotation, my preceptor told me during my midpoint evaluation that I was not proactive; that observation stung, and I mulled over it obsessively. However, I soon learned that my preceptor was right: As a new pharmacy intern in a foreign environment, I did not actively pursue any tasks outside the ones he assigned me. Instead of being proactive, I was retroactive. I resolved to change my learning approach and actively asked for more responsibilities.

Even with everything going on in school and life, I always kept my ultimate goal in mind: Become a pharmacist. To get there, I began making short-term goals such as studying for classes, preparing for exams, working on projects, and seeking tutors. Additionally, I applied for internships in the community pharmacy setting and became involved with projects with professors to enhance my learning and gain experience. Think of each short-term goal as a step along a stone path to success; you just need to form the steps that will get you to the end.

 During P4 year, I started thinking about my short- and long-term goals. Only after taking the time to craft my own personal mission and vision did I fully realize the importance of setting goals. Therefore, I set personal goals for each rotation and strove to meet them over each 6-week period. At the same time, I kept the big picture goal in mind: the looming North American Pharmacist Licensure Examination (NAPLEX). I drafted a study schedule that required me to finish a certain number of topics every single week. By having clear-cut milestones to reach at certain points, I was able to keep myself on the path to success.

Pharmacy school is a continuum of things to complete in a narrow time frame, whether related to work, school organizations, or class. I designate my weekends to working in the pharmacy, when there is no interference with classes or organization meetings. In addition, I am a member of Rho Chi, an academic honor society, where I tutor other pharmacy students. I schedule and create problems to go over in review sessions at both the classroom and individual level. For class, I prioritize assignments that are worth more points. For example, I prioritize studying for upcoming exams, which are urgent and important, and then complete other nonurgent assignments as time permits.

 During my APPE rotations, I was part of a longitudinal program that was basically a mini residency. Not only did I have my required rotation responsibilities, but I was also involved in a longitudinal research project, weekly meetings, journal clubs, and various other activities. From day 1 of the rotation, I created a calendar with deadlines for assignments and projects to see what I had coming up in the near and far future. I also set weekly goals to complete the bigger projects on time. In addition, balancing work with family and exercise was a priority. Having a clear mind-set regarding your goals from the beginning allows you to work effectively each day.

 I come from a very competitive family. Through my time as an undergraduate, I competed with others for better grades. I came to pharmacy school thinking it would be the same, but I realized that my competitiveness was not suitable for my professional growth. I decided to help my classmates by explaining difficult material taught in class and would remind them about due dates for assignments. Likewise, some classmates helped me prepare for internship interviews and provided tips to improve my résumé. This was a win-win for all of us.

The motto for my pharmacy class was “If we fail together, we pass together.” We believed that if everybody in the class did poorly, the curve would work in our favor to pass the class. Although this did not always hold true, the sentiment that we were all in this together shone through. During my didactic years and stretching into my APPE rotations, I was blessed to be surrounded by people who were more cooperative than competitive. No one purposely tried to sabotage the other; we tried our best to help each other instead. Misery loves company, and the sufferings of pharmacy students helped form an instant sense of camaraderie even between strangers.

Seek first to understand, then to be understood.

 Not everybody is gifted with the ability to listen to others, much less understand them. I must admit, I was 1 of those people. I would always talk about 

 worries. I failed to actively listen to the concerns of others. After I read habit 5, I identified my deficiency in seeking to understand first. I changed my mind-set and became more empathetic to my patients and started to lend an open ear to family and friends. This was a much-needed change, especially because my whole profession revolves around listening and caring!

 While on my internal medicine rotation, I was responsible for patient discharge counseling. One day, I went into my patient’s room to clarify how she took her anticoagulation medication, Eliquis, for her atrial fibrillation. I asked her some open-ended questions and confirmed that the patient had paroxysmal atrial fibrillation. After interviewing the patient, there was an evident problem that the patient took her medication just “every now and then” when she felt her heart beating irregularly. I spent 20 minutes explaining to her the reason the medication was prescribed and the importance of taking it daily. Taking the time to understand a patient’s perspective can have a significant impact on their care.   

 One of my courses, Rounds and Recitation, involved working on patient cases with different groups. This could either be a stressful or rewarding experience, depending on the level of communication between team members. I worked with a team more focused on criticizing the work of others, without providing input when creating an optimal treatment plan. Later in the year, I worked with a more cohesive group in which we discussed problems as a team. Each team member worked on a specific aspect of the assignment: managing drug—drug interactions, researching guidelines, and creating a plan. Good communication and a common goal helped synergize our efforts into a better outcome.

During my last rotation, I participated in Interprofessional Education Day, a conference that involved medical, pharmacy, and public health students. We were provided a clinical case and then instructed to form an assessment and plan together. We all approached the case from different angles. Pharmacy students looked at the medications first, identifying medications without indications and drug—drug interactions. Medical students looked at the laboratory values first, seeking to correct any abnormal values. Public health students looked for the cause of the diseases first and brainstormed prevention strategies. From this experience, we were able to gain a more comprehensive outlook and use our respective areas of expertise to better treat the patient.

 As a student, I have many things to balance: studying, extracurricular activities, and my personal life. However, I try to take 15 to 30 minutes each weekday to rest, nap, or play games. I try to finish all my activities during the weekdays so I can leave Sunday entirely to my family to go shopping, eat out, or visit new places. I also started new hobbies to serve as de-stressors: music and photography. I play the violin a few hours during the weekend to unwind from the stress of pharmacy school. As for photography, I go to the park, particularly during dusk or dawn, and take pictures of nature. These activities help me relax and allow me to prepare myself for the upcoming school week.

While on rotation with a daily 8-hour time commitment, it became difficult to squeeze “me time” into my life. I created a schedule where I devoted Monday through Friday to rotation, working on assigned tasks efficiently during rotation and studying for the NAPLEX at home. On weekends, I took time for myself to recharge for the workweek. I went to the movies with family, had dinner with friends, and took my dog to the park. By taking the time to treat myself, I sharpened the saw to stay active and productive.

provides an overview of the 7 habits and tips on how pharmacy students and interns can apply them throughout their academic journey.

Victoria Pho, PharmD, BCGP, is a clinical assistant professor at the Texas A&M University Irma Lerma Rangel College of Pharmacy in Kingsville

and a clinical pharmacy specialist at San José Clinic in Houston, Texas. Leylah Azali, PharmD, and Connie Wang, PharmD, are 2018 graduates of the Texas A&M University Irma Lerma Rangel College of Pharmacy. Gabriela Garcia Villa is a 2019 PharmD candidate at the Texas A&M University Irma Lerma Rangel College of Pharmacy.

. London, England: Simon & Schuster; 1989.

Articles

Can we teach effective habits? Is there a blueprint for helping pharmacy students and interns be more proactive, prioritize more efficiently, and embrace a strong work ethic?