EXPERIENTIAL UPDATES FROM UAMS AND HOW TO CREATE MOMENTS FOR STUDENT PHARMACISTS ON ROTATION

1. EXPERIENTIAL UPDATES FROM UAMS AND HOW TO CREATE MOMENTS FOR STUDENT PHARMACISTS ON ROTATION Lindsey Dayer, PharmD, BCACP Associate Professor UAMS College of Pharmacy

2. OBJECTIVES • Review recent changes to the UAMS College of Pharmacy Experiential Program. • Describe the importance of heightened ‘moments’ in education and a student’s career. • Discuss how the contributions of others can create satisfaction in students. • Give examples of how improving shared meaning can increase personal connection regarding student interaction.

3. EXPERIENTIAL GOALS/MISSION • Provide structured, practical and supervised pharmacy experiences • Enable students to develop and apply skills in a real world practice environment • Students can assume role of a practicing pharmacist • Professional judgment • Practice competency • Technical skills

4. APPE CHANGES THIS YEAR (MAY 2018)

5. 2018 APPE CHANGES • Health-system changes • Students can select to the level of the site and preceptor • Students may select 1 more Acute/AmbCare rotation • up from 4 required to 5 • 7 possible if all electives used for Acute/AmbCare • Google doc of all rotations and rotation descriptions sent to students

6. 2018 APPE CHANGES • Community Rotation Changes • Students can select to the level of site/preceptor • Can have up to 4 community experiences • Community Management will become an elective known as Community Ownership/Management • MTM and OTC direct patient care rotation will be folded into a new Enhanced Pharmacy Services (EPS) direct patient care rotation • All community pharmacies will be visited/contacted to determine • What Enhanced Pharmacy Service they offer • If they want to continue to be a site that offers Community Management/Ownership

7. SO WHAT ARE ENHANCED PHARMACY SERVICES?(NOT AN ALL INCLUSIVE LIST) • Adherence Packaging • Collection of Vital Signs • Compounding (sterile/non-sterile) • Comprehensive Medication Reviews • CMR with chronic care management • Medication Synchronization Program • Clinical Medication Synchronization Program • Point of Care Testing (A1c, Strep, Flu, Hep C) • Smoking Cessation program • Home Visits/Delivery • Naloxone Dispensing • Standardized assessments (PHQ-9, Med adherence Morisky Scale, pain assessment) • Nutritional Counseling • Disease State Management and Education Programs  • Medication Reconciliation • Immunization screening and administration • Travel Vaccines • Transitions of Care  • DME • In depth counseling/coaching • Care plan development and reinforcement • Pharmacogenomics Testing

8. SO WHY DID WE CHANGE APPE STRUCTURE FOR 2018? • Years of preceptor/site feedback • Changes in the NAPLEX exam • Increased items from 185 to 250 • Increase in clinically-based and patient-centered items • Possibly moving to a Pass/Fail exam • Drop in NAPLEX pass rates for GY2016 • PCOA (Pharmacy Curriculum Outcomes Assessment) • Given near or at the end of the didactic curriculum • Lets COPs benchmark themselves with other comparator schools • Clinical and basic science questions • We benchmarked near the 50th percentile

9. THE PHARMACY SCHOOL CURRICULUM It is changing Curriculum 2025 Integrated curriculum LOTS of working groups We see the changes in practice and the changes in the licensure exam

11. ROTATION SELECTIONS • P3 students get to select to the level of the preceptor • Rank specific preceptors for acute, ambulatory care, hospital management, community EPS • Selectives • Electives • A change from previous years when could only rank the city • CORE does a lot of cool stuff!!

12. WHAT IS THE IMPACT OF STUDENT WORD OF MOUTH? IT DEPENDS…

13. WHAT KIND OF PRECEPTOR DO YOU WANT TO BE?

14. SO, HOW DID THESE NEW CHANGES GO? • Preceptor/site selection • Went well!! • Students received ~6/10 rotations in their top 5 rankings • Out of 329 rotations that went through the lottery • 150 were #1 preferences • 87 were #2 picks • 44 were #3 picks • Others were hand placed based on other circumstances • Distant sites • ~30% students were placed at a distant site • Changes for next year • Selectives (less specific) • Google docs sheet-REMOVE • Students can view site descriptions in CORE

15. FUTURE DIRECTIONS • Education about the Pharmacists’ Patient Care Process (PPCP) • Rotations Fair • Preferences released to preceptors • Other?

16. SURVEY • How to play: • Go to kahoot.it • Enter in game PIN: 613057 • Create your name

17. STUDENT EVALUATIONS

19. TIPS FOR READING STUDENT EVALUATIONS • First off, don’t ignore them. • They may be trying to tell you something • Look for themes and patterns • I didn’t get proper orientation/know what to expect • Schedule • I didn’t see my preceptor much • No feed • Consider “studying” your evaluations with someone you trust (experienced preceptor) or having someone read over them • Do your research • Ask others questions • Read a book about precepting • Experience… • Take more students ☺

20. TIPS FOR “DEALING WITH” STUDENT EVALUATIONS • Eliminate inappropriate/just plain mean comments • Look for outliers and eliminate those • Look for your strengths and positive comments and dwell on these too • Be proactive • Give students clear expectations on day 1

21. THE POWER OF MOMENTS IN EDUCATION

22. Preceptor = Teacher A practicing pharmacist who gives personal instruction, training, and supervision to a pharmacy student Modeler Socializer Educator

24. BOOK TAKEAWAYS • Defining moments shape our lives • We don’t have to wait to make them happen • We can create them

25. KEY POINTS • Elevate the ordinary by creating peaks in the moment • Seek insight by seeking the truth and looking deep into the moment • Create pride by seeing the contributions of others in the moment • Develop connections by reflecting on the meaning of the moment

26. DEFINING MOMENTS • “Our lives are measured in moments, and defining moments are the ones that endure in our memories” • Recall moments based on peaks, pits, and transitions • Scientific reason for remembering these moments • Unique and extraordinarily unexpected • Four components (EPIC): Elevation, Pride, Insight, Connection HEATH, C AND DAN HEATH. THE POWER OF MOMENTS.

27. THINKING IN MOMENTS • “Transitions should be marked, milestones commemorated, and pits filled.” • If you want to lead people differently, you have to be aware of your ability to change the ordinary • Example: what if you treated the student’s first day of rotation like a first date? You worked hard to find out their interests, their goals, their learning style? • G.L.E.A.M tool • End of rotation “moments” (e.g. coffee, lunch, workplace announcement to highlight the student’s month, other?) • People crave unique experiences HEATH, C AND DAN HEATH. THE POWER OF MOMENTS.

28. G.L.E.A.M. TOOL • Goals: what are your goals and expectations for this rotation? What are your goals and expectations for your career? • Learning: How do you learn most effectively? What has helped you succeed in other rotations? What did you find challenging? How do you like to receive feedback? What is your learning style? • Experiences: What previous patient experiences have been meaningful to you? What have other clerkships been like? Which patient experiences/interactions have been most challenging for you? Are there particular patient groups or medical conditions that have been more challenging for you? Have the students share a story. If there have been no challenges so far, encourage them to talk with you when such challenges arise during your time together • Activities: what activities are you involved in outside of school? • More: what more do I need to know about you to make this an optimal learning experience? What have a forgotten to ask you? Do you have any questions for me? HEATH, C AND DAN HEATH. THE POWER OF MOMENTS.

29. BUILDING PEAKS • “To elevate a moment, do three things: First, boost sensory appeal. Second, raise the stakes. Third, break the script.” • Highschool students log more time in classrooms than anywhere else. Yet most adults will not recall learning experiences. What if we could design an academic experience that was as memorable as prom? • Consider designing instructional methods that drive emotional connection and memory to the experience in order to increase student retention of knowledge • Experiential rotations might be a key place to practice this concept • “Peaks don’t just happen. They take energy and effort.” HEATH, C AND DAN HEATH. THE POWER OF MOMENTS.

30. BREAK THE SCRIPT • “Breaking the script is a strategy” • We can create more peaks by disrupting routines • Must be a surprise, not an expectation • Example: if you give something away every Friday, it becomes routine, and when you stop doing it, it creates a disappointment • Spontaneity in every aspect of your life will create lasting moments at home, with friends, and at work • What area of your work could you ”break the script”? • ACH emergency department allows students to ride Angel One helicopter for a day HEATH, C AND DAN HEATH. THE POWER OF MOMENTS.

31. RECOGNIZE OTHERS • “Being grateful to others elevates your own spirits” • Educators have great influence on the direction of life and learning • ”Of all of the ways we can create moments of pride for others, the simplest is to offer them recognition.” • We need more strategies and development in order to increase our ability to create moments for students. • Surveys have found that “the top reason people leave their jobs is a lack of praise and recognition.” HEATH, C AND DAN HEATH. THE POWER OF MOMENTS.

32. MULTIPLY MILESTONES • ”A common trait you will observe in accomplished people is an obsession with completion. Once a project falls into their horizon, they crave almost compulsively to finish it.” • Multiply milestones (progress, success) by breaking larger tasks into smaller pieces. • When there is a BIG project, it is often difficult to see the incremental change; celebrate small successes to increase the power of moments. • People love milestones in their live. HEATH, C AND DAN HEATH. THE POWER OF MOMENTS.

33. PRACTICE COURAGE • “People almost always know the right thing to do. They just lack courage because they have not practiced or experienced the results of taking the risk to be brave.” • Have a plan and practice courage. • “Implementation intentions” Ex. “I am going to eat a cookie; if I crave a second cookie, I’m going to eat an apple” • Without implementation intentions, we end up defaulting to the path of least resistance because we didn’t have a plan. • Take small steps. • In didactic curriculum- we have OSCE simulations to practice real-world scenarios HEATH, C AND DAN HEATH. THE POWER OF MOMENTS.

34. CREATE SHARED MEANING • “If you want to be a part of a group that bonds like cement, take on a really demanding task that’s deeply meaningful. All of you will remember it the rest of your lives.” • If you expect customers (or students) to have great experiences, it begins with the employees having great experiences. • Create connections with people by doing it in person…you don’t feel ‘meaning’ in an email. • Discover your “why” HEATH, C AND DAN HEATH. THE POWER OF MOMENTS.

35. DEEPEN TIES • “If we can create the right kind of moment, we can change relationships in an instant.” • Be genuine in how you respond and give feedback. • Processes and checklists to determine the progress of others/students do not build genuine connections. HEATH, C AND DAN HEATH. THE POWER OF MOMENTS.

36. MAKING MOMENTS MATTER • “ A bit of attention and energy can transform an ordinary moment into an extraordinary one.” HEATH, C AND DAN HEATH. THE POWER OF MOMENTS.

37. THINGS TO THINK ABOUT… • What ordinary moments in your day (in the students day) could be extraordinary? • List ways that you can support others to build courage • Review your willingness to support others finding the importance in the moment • Describe how you utilize collaborative practice in order to make moments matter • List your strategies for recognizing others • Evaluate your own ability to deepen the purpose of work for others or yourself.

38. WHY SHOULD WE CARE ABOUT HEIGHTENED ‘MOMENTS’ IN EDUCATION AND A STUDENT’S CAREER? • Increased appreciation for the profession • Increased ownership in the profession • Increased student engagement • Improving shared meaning can increase personal connection regarding student interaction and engagement • These moments matter! We never forget them!

39. HOW CAN THE CONTRIBUTIONS OF OTHERS CREATE SATISFACTION IN STUDENTS? • When students and staff feel valued, respected, and supported their satisfaction increases. • This can be hard to do consciously demonstrate these matters • Create space and conditions for students to discover and wrestle with new ideas • Give them the opportunity to work through a problem and come up with a solution

40. CELEBRATE THE ORDINARY

41. ASSESSMENT QUESTIONS • How to play: • Go to https://kahoot.it • Enter in game PIN: 7983512 • Create your name

42. REFERENCES • Heath, C and Dan Heath. The Power of Moments. London, Transworld Publishers, 2017