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USC honors Justo with clinical practice teaching award

Throughout pharmacy school, Julie Justo pictured herself as a hospital-based pharmacist caring for patients.

But during her first year of residency training at the University of Illinois at Chicago, she gave a talk to pharmacy students about how bacteria invade the immune system.

Suddenly her plans changed.

“It was the most fun I’d ever had in my training to date, and I was kind of on a high when I walked out of that class,” she said. “And the more I thought about it, I realized the thing I love about pharmacy is that I got to teach people every day, whether it was patients, doctors, nurses, other pharmacists or social workers.”

Justo, an assistant professor in the USC College of Pharmacy, said she realized her position was valuable because the education she provided allowed others to make informed decisions in her absence, and once she recognized how rewarding teaching was to her, she knew she needed to pursue an academic career.

After finishing her residency and fellowship training, Justo applied for academic positions and chose Carolina, in part because of the family-friendly atmosphere at the College of Pharmacy.

At the college, her teaching responsibilities include lecturing in clinical pharmacokinetics and pharmacotherapy courses, coordinating a clinical applications course, moderating in the transforming health care course, teaching acute care electives and precepting fourth-year students. She also works closely with other health educators to develop interprofessional learning opportunities throughout the university, including a novel rotation experience at the USC Immunology clinic where medical, pharmacy, nursing and social work students learn to care for HIV-positive patients together as a team.

And now just a few years into her teaching career, Justo has been honored with the university’s Clinical Practice Teaching Award.

Her students describe her as passionate — “that might just be because I talk a lot…and fast and loudly” — and patient, a quality Justo didn’t necessarily see in herself until she reflected on how she will work with a student to describe complex concepts in multiple ways until the student latches onto one that makes sense to them.

Regardless of the topic, one of Justo’s guiding principles is her emphasis on mastery to fulfill the pharmacist’s professional obligation — providing the best care possible for the patient — rather than to record a high test score. Inspiring students to be lifelong learners who can self-evaluate their comprehension is part of her approach.

She will pose the question, “Based on what you learned with urinary tract infections, would you trust yourself to take care of your loved one, your mother, your spouse, your brother? If you feel you could provide the same high-quality care as you would want for yourself, then that means you’ve probably mastered the content.”

Justo emphasizes the connections between the material, its application and the implications for patients. “At the end of the day, the decisions (students will) be making as licensed pharmacists are going to affect people’s lives,” she said. “They have the capacity to save them, and they also have the responsibility to prevent dangerous medication-related errors.”

To promote student success, Justo creates a concept map for each classroom session to highlight learning objectives and make it easy for students to follow the lecture. For visual learners, she’ll reach for one of her stuffed microbes — Chlamydia, HIV, E. coli, etc. — and toss it around the classroom to keep the material engaging and fun.

With the students she precepts on rotation at Palmetto Health Richland, Justo promotes self-directed learning and asks them to identify what they want to learn during their time together.

She models her precepting style after one of her mentors at UIC, Robert DiDomenico. When a patient coded after surgery in the cardiac intensive care unit because of a medication complication, Didomenico took charge running the code protocols. It was the first time Justo had seen a pharmacist take on that kind of leadership role on a health care team.

“He was so well-respected as a calm, confident leader of the team that you could just feel everyone was much more comfortable when he was around,” she said. “I knew that was the kind of pharmacist and educator I wanted to be.”

Justo aims to empower her students to become confident, competent caregivers. She relayed how one of her recent students successfully persuaded a skeptical attending physician to discontinue vancomycin and switch to narrower spectrum therapy for treatment of pneumonia in a hospitalized patient after explaining that a negative nasal screen for methicillin-resistant Staphylococcus aureus (MRSA) supported the recommendation.

In response to the physician’s questions about her recommendation, the student researched and shared supporting evidence, all without help from Justo or the pharmacy resident. “I was very proud!” Justo said.

“She made a lasting impression and taught that attending physician something he had not known before. She won him over with her skill and knowledge. Those are the moments that re-energize me for the next day.”