A Creative Picture of Mental Health and More with Dr. Elizabeth Skoy!
Dr. Elizabeth Skoy is an Associate Professor of Pharmacy Practice at the North Dakota State University School of Pharmacy. She has a strong passion for innovation in education and within community pharmacy and uses this passion to drive her service, teaching and research.
Book Recommendations: -- Classroom Assessment Techniques: A Handbook for College Teachers - Thomas A. Angelo, K. Patricia Cross
-- What the Best College Teachers Do - Ken Bain
-- How Things Work
-- Best Science Medicine
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L: Welcome everyone to Two Pills Podcast. I am so excited about our guest Dr. Elizabeth Skoy. We are going to talk about quite a few things including her work with student resilience and mental health. Just to get started, can you tell us a little bit about yourself and your teaching style?
E: Sure. I teach primarily in a pharmacy practice skills laboratory. A lot of my teaching is very hands-on and application based. My teaching style is more mentorship or coaching. I am very fortunate that I get to work with students one-on-one.
L: What kind of topics are you teaching and skills lab and in the classroom?
E: My practice background is Community Pharmacy. I touch on the expansion of Community Pharmacy rather than the traditional roles. I teach non-sterile compounding, point-of-care testing like hypercholesterolemia and glucose, and some of the newer point-of-care test such as strep or influenza. I also teach in the immunizations course.
L: If someone is interested in starting a practice site in Community Pharmacy, do you have any advice for them on mentoring students in that setting?
E: Don't let the students or interns get lost in the regular workflow. Community pharmacies get busy, but don't forget about those teaching moments. Pull your learners into moments when you are calling providers are reviewing profiles. That way, they are exposed to more of the pharmacist role than the technician role. Bring them into those behind the scenes of behind the counter moments that we use our knowledge in our license for.
L: From Community Pharmacy, what led you to this path of mental health and resilience?
E: I have always been passionate about service. A colleague and I decided to start up a medical mission rotation to Guatemala. We started it eight or nine years ago. As we were setting up this rotation, we were brainstorming how we could capture learning. It felt like surveys, preceptor evaluations, or even reflections would not capture the in-depth learning that is happening. So, we discovered the methodology of Photovoice. It uses a camera to capture a time, moment, or experience. We wanted to use photography to capture their learning. We found their reflections to be so much deeper doing that.
L: Can you talk a little bit about how to implement Photovoice?
E: Typically, we start with our students and a disposable camera. The reason for that is to have students not get so wrapped up in the quality of the photo. Also, with a disposable camera, you have a limited number of exposures. We tell the participants to imagine that they are creating a photographic display of a topic. They take the photographs and then they are usually given a journal. As they take the photographs, they write a brief reflection. You then get the photos developed and make them in duplicates. We then sat down with the students one-on-one and they go through the photographs with us. We then audio transcribe those interviews with them. After we reflect with them individually, we get back together in a larger group. They would show the five photographs that are most important to them. There has been a group reflection that is audio transcribed. Our publications on this topic have been based on the qualitative analysis of those transcriptions.
From there, my colleague and I thought about how we could capture a medication experience. My colleague has a practice site in a psychiatric clinic. We decided to focus on patients who were taking medications for mental health. Our findings were fascinating and we learn so much from our participants. We noticed that the college students in our cohort had a slightly different experience than the other participants. We received a seed Grant from our School of Pharmacy to study our North Dakota State University college students. We then recruited college students to participate in Photovoice. It has drastically expanded in such a positive way.
Our Counseling Center sat in on the interviews and thought that this could be a new way to approach group therapy. They have done some Photovoice sessions within the Counseling Center. Participants have often been resistant to group therapy due to stigma, anxiety, etc. When they were talking about a photograph, the focus was on the photo and not on them and their illness. We collected those photographs and reflections. It has become a campus-wide movement to start to talk about mental health from the viewpoint of our college students in a different way. A professor of photography on campus is working with us. She puts it really well by saying that “everyone can relate to a photograph”. Once we can agree that we can relate to a photograph, we come a step closer to being able to relate to someone with mental illness.
L: What are some photos of these medication experiences that have stood out to you?
E: There's so many, but I will touch on one about stigma. One of the photographs was at the counter full of medication bottles. The participant said if someone is fighting cancer or HIV or taking medication to sustain life, our society looks at them as brave and strong. When I need my medication to sustain life, I am not looked at as brave and strong. I am looked at as weak.
We have a lot of photos of pets, including a lizard as a therapy animal. Pets have been a big theme. When you have an animal, they depend on you, so it makes you be your best self. Maybe that day they don't feel like getting out of bed, but they have to take care of their dog on a walk. They depend on me so I have to get out of bed. Once I get out of bed, feed them, and take them for a walk, I feel better. They talk about how animals love them unconditionally without judgment.
As for side effects, we have seen a picture of a bed. This medication makes me sleepy. We have seen pictures of an alarm clock or a timer. They talk about how incredibly important it is for them to get sleep. As a college student, that is really challenging. They are balancing course workload, having a job, and extracurricular activities. It is difficult to balance their mental well being with the activities that they want to participate that are in line with their expectations of college.
L: We hear a lot about social media and mental health. I feel like this photo voice approach really lends itself well because students are taking so many photos. This is maybe a healthier way to do it, rather than looking at everyone else's highlight reel.
It sounds like you are also incorporating your teaching, practice, and scholarship. I think that is a goal for all of us and something that faculty should keep in mind.
E: For someone who is starting out, I would say let your passion be your guide. See where that takes you. When I started, I got advice not to get too wrapped up in service because we have other parts of our job description. I knew that that was where my heart is. So, finding a way to grasp that service. It may be your practice site or serving others in the community. That passion will drive your research. Research will not become a burden, it will become a passion. Do not let the what-ifs and the outside voices deter you.
L: You mentioned some advice for someone starting out, are there any books, podcasts, or resources that you recommend?
E: There is a book on classroom assessment techniques that I have read a few times. “What the best college teachers do”. I do not have a lot of time to read, so when I do read I want it to be something that I am interested in. I really like to listen to a wide variety of podcast from face base 2 2 fun stories to how things work with random facts. When it comes to Pharmacy, I feel like it is really hard to catch up. There is a group outside of Canada that puts on the podcast best science medicine. They take important topics in current literature and break it down in a really easy to follow way. They are a quick way for me to stay up-to-date and then if I want to I can look more into the Articles once I get to work.
L: Where do you get your best ideas? Who inspires you?
E: So much of what I do is focus on collaboration. Everything is better in a team. I do not have all the answers or the strengths. Other people bring skills and information to the table. I try to take advantage of any educational opportunities that come about. My husband works in the student affairs side of higher education. Sometimes I just get really cool ideas from him and what he knows. I also collaborate with my colleagues here. I team-teach with a couple of individuals and we have published together. We are better together as a team. We complement each other really well. Getting to know people and learning their strengths makes me a better teacher.
L: What is your overall prescription for success and happiness in life and in Academia?
E: I do not think there is any such thing as balance, but I heard someone once put it as homeostasis. Understanding that there will be times in life where you have to devote more time to something and less to others, and being okay with that. You want to make that decision and move forward without regrets and moving backwards. What grounds me is a strong faith. Love what you do. I wake up every morning and I do not dread going to work. Find your passion and let that guide you.