This past summer a group of pharmacy students from the Concordia University Wisconsin School of Pharmacy traveled to Spain for two weeks and experienced the “Spanish World of Pharmacy”, as part of a new elective course.


Studying Pharmacy Practice in Spain

During the course, students had the opportunity to learn and experience pharmacy practice, education, and culture in Spain. Students attended classes in both English, relating to the formation and practice of pharmacy in Spain, and in Spanish, relating to Spanish language and culture, at Universidad San Pablo CEU in Madrid. In addition to learning about pharmacy practice and culture, students were able to experience them firsthand through selected pharmacy experiences such as visiting local pharmacies, hospitals, and a pharmaceutical company. Students also participated in cultural experiences such as taking a day trip to Toledo, touring the Prado museum, and visiting the Royal Palace.

The Challenge: Buy Medicine from a Pharmacy!

While in Spain, the students also had several specific assignments to complete.  One assignment required that each student go into a pharmacy and try to buy some Tylenol® (or acetaminophen) in Spanish.  Yes, the assignment sounds easy, and if the students had to do it in the United States, it would be very easy.  In the United States, the students would not have any fear or questions about completing this simple task nor would it even require talking to a pharmacist.  But, not so in Spain…

Initial Student Concerns

Initially, the students were excited about this opportunity, but then a mix of other emotions including nervousness, frustration, pride, discouragement, helplessness, embarrassment, and anxiety set in as they processed some of their own questions about how they should proceed.  Questions like,

  • How do you request a medication in Spanish?
  • Why are there no medications visible in front of the pharmacy counter?
  • Does Tylenol require a prescription in Spain?
  • Is Tylenol® even called Tylenol®, or acetaminophen, in Spain? (Spoiler alert, it’s not!)
  • Do I need insurance to purchase a medication?
  • Do I have to show an identification card and if so would my driver’s license from the United States be valid?
  • How would I respond if the pharmacist asks me questions or talks to me but I don’t understand them?

Success?

By the end of the trip, all the students completed this assignment.  Some students attempted to speak only in Spanish while others were forced, or gladly submitted to, speaking in English.  Other students did communicate exclusively in Spanish, but experienced some miscommunication, and frustrating exchanges.  Several students attempted communicating by using hand gestures, written communication, or translating apps on their phones.  For students that knew no Spanish, they quickly realized that a pharmacist talking slower, louder, or simply repeating themselves over and over did not result in understanding.

Student Reactions: The Need for Empathy

During their experience in the Spanish pharmacies, some students felt they were welcomed, valued and respected while the pharmacists actively listened to them, and were patient with their attempts to utilize their Spanish skills.  Other students felt like they were an annoyance and some even felt neglected, belittled, taken advantage of, or duped.   Perhaps not surprisingly, despite their years of education and experience with pharmacies in the United States, in Spain several pharmacy students stated they felt “dumb” when trying to request a medication in Spanish.  Numerous students admitted to saying “Sí” to things they did not understand and even paying for medications other than what they set out to buy because they were unable to communicate otherwise.  Many students correctly realized a person’s intelligence is not directly related to one’s ability to speak a language.

Then, it clicked.  Students asked themselves, does this happens to our patients in the United States?  Do our patients ever experience anxiety when coming to the pharmacy or talking with a pharmacist?  Are they ever forced to use a language they do not understand?  Do patients sometimes accept what their pharmacists tell them or give them even if it is different than what they expected?  The answer to all these questions is yes.

The purpose of this assignment was instill in the students a sense of empathy that will remain with them throughout their pharmacy careers.  In the future, when the students encounter a patient not from the United States, or someone who is not familiar with the healthcare process, or someone who doesn’t speak their same language, they can look back at the their time in Spain, remember how they felt in a similar situation when they were outside their comfort zone, and then serve their patients with humility, gentleness, and respect. One student summarized what she learned by stating, “I now understand why empathy is so important. If I only learned about being empathetic to patients from textbooks and through word of mouth, I might not have experienced the discomfort and frustration that non-native English speakers experience daily in the United States.  I found it was important to experience this situation in the real-world and practice empathy towards others.”

Servant Leadership and the CUW School of Pharmacy

This one assignment, and this one course, point to a larger, overarching goal that the CUW School of Pharmacy has for all of our students, which is that they would embrace their role as servant leaders and grow in empathy, humility, and look toward the interest of others.  The thread of servant leadership is one of the key mission elements of the School of Pharmacy, and is woven throughout the curriculum with courses like Servant Leadership, in various assignments that encourage community service, in pharmacy organizations that provide outreach opportunities to the community, and in the faculty who serve alongside their students.  This is a unique aspect about Concordia because we not only care about what the students know and do as pharmacists, but also how and why they do it. This study abroad experience gave the students a window into a very different way of practicing pharmacy, but ultimately it was an experience that impacted their lives so they can positively impact the lives of others.

Robert Mueller, Pharm.D., BCPS
Assistant Professor of Pharmacy Practice

Learn more about Dr. Mueller’s efforts to teach medical Spanish.

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