The most enduring resources a preceptor can give students are the confidence and tools to ask deeper questions.
As I embarked on my inpatient pediatric general medicine advanced pharmacy practice experience, I wholeheartedly believed that my biggest challenge would be learning the specifics of pediatric medicine. I expected to spend my rotation learning weight-based dosing, developmental differences, limited clinical trial–based evidence in specific populations, and disease states that may be rarely encountered outside of specialized settings.
Shatila Zaman is a 2027 PharmD candidate at the University of Michigan College of Pharmacy in Ann Arbor. She has interests in pediatric pharmacy, critical care, and clinical research, and is passionate about mentorship, lifelong learning, and helping student pharmacists build confidence through meaningful clinical experiences.
What I had not expected was that my greatest lesson would have little to do with specific diseases or medications. Instead, it would be about learning how to approach uncertainty with conviction and how exceptional mentorship can shape the way a student pharmacist thinks.
One experience that challenged me involved caring for a child with chronic granulomatous disease (CGD). Before my rotation, I had no idea what CGD was; one morning on rounds, as I wheeled my computer alongside the treatment team, I learned through our discussion and a brief search that it was an inherited immune disorder that increased susceptibility to bacterial and fungal infections. I realized that I did not fully appreciate the layered, complex relationship between immune dysfunction, infection risk, antimicrobial therapy, and long-term prevention strategies. Consequently, this raised a new set of questions about how these principles translated into our patient’s treatment.
My first instinct was to ask, “What do the guidelines say?” As pharmacy students, we are often trained to identify guideline recommendations and appropriate medication, dose, and monitoring parameters based on patient-specific factors. However, this case required something deeper: I needed to understand the pathophysiology underlying the clinical decisions we were making. Why were certain antimicrobial agents selected? Did the underlying immune defect influence the treatment approach? How should I evaluate the available evidence when large clinical trials are limited?
This was where the guidance of my preceptors became pivotal. Instead of simply explaining the treatment plan, they helped me work through the reasoning behind it. They encouraged me to start with the fundamentals: What is happening in the body of a patient with CGD? What problems are we trying to solve? What outcomes are we hoping to prevent? How does each medication contribute to those goals?
Based on my own deeper dive and conversations with my preceptors, I began to see the treatment plan differently. Each medication represented a response to a specific clinical concern resulting from the disease. Understanding the why behind the regimen allowed me to better appreciate not only what the patient was receiving, but also why these decisions were made and which factors could impact future management.
This lesson was reaffirmed throughout my rotation as I encountered other complex conditions, including Kawasaki disease and macrophage activation syndrome. I realized that pharmacy practice required more than recalling information from my therapeutics notes: I had to synthesize foundational knowledge with patient-specific factors, evaluate unfamiliar evidence (often limited in pediatrics), and remain comfortable asking questions.
One of the most important lessons my preceptors taught me was that saying “I don’t know” when asked a question is not indicative of weakness or failure as a health care provider. On the contrary, uncertainty creates an opportunity for continued growth and lifelong learning. What distinguishes effective clinicians is not the ability to know every answer immediately, but the ability to recognize what information is needed, thoughtfully research it, and use it to provide optimal care for each patient.
My preceptors created an environment in which uncertainty became a learning opportunity rather than something to avoid. They challenged me to explain my thought process, identify areas where I needed more information, and develop recommendations supported by clinical evidence.
Over time, I started to approach the literature with a more critical question: Does this make sense, and is it applicable to my patient? I was no longer simply searching for an answer; I was learning how to determine whether that answer was the right one for the patient in front of me.
Pediatrics also impressed upon me the importance of individualized patient care. As my preceptors reiterated, children are not smaller adults. Their medication management requires consideration of various patient-specific factors. Even when a medication choice was appropriate, additional questions remained: Is this medication easily accessible? Could the dose be accurately measured? Are the dosing schedule and formulation manageable for the patient and their family? Did the available evidence truly apply to this child? These considerations emphasized that a pharmacist’s role extends beyond selecting a medication; it involves ensuring that the entire treatment plan is safe, effective, and feasible.
Before this rotation, I viewed knowledge as the foundation of confidence: The more I knew, the better pharmacist I would be. However, my preceptors’ mentorship changed this perspective and how I learn. Although knowledge remains essential, confidence also comes from establishing a reliable process for approaching unfamiliar situations. Breaking down a complex problem, identifying key clinical questions, evaluating the available evidence, and communicating a rationale are skills that extend far beyond pediatrics.
I entered the rotation hoping to become more familiar with pediatric disease states and therapies. I left with something more valuable: a framework for approaching the unknown with curiosity and confidence.
This experience showed me the lasting impact of mentorship in my professional development. My preceptors taught me that not knowing an answer was not something to feel guilty about, but an invitation to ask better questions. They challenged me to think more deeply, defend my reasoning, and become comfortable navigating the inevitable uncertainty in patient care. Long after learning the details of a particular disease state or treatment regimen, I will remember how they taught me to approach the questions I could not answer.
Perhaps the most enduring gifts a preceptor can give students are not the answers themselves, but the confidence and tools to ask deeper questions and seek the why and how to help patients.
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