Molding the Contemporary Pharmacist: Tips for Preceptors

1. Molding the Contemporary Pharmacist: Tips for Preceptors Rayanne Story, Pharm.D., Assistant Dean of Experiential Education, Harding University College of Pharmacy Arkansas Association of Health-System Pharmacists Fall Seminar October 6, 2017

2. Rayanne Story has nothing to disclose.

3. Pharmacist Learning Objectives • Identify reasons to serve as a pharmacy preceptor • Outline the characteristics of the millennial learner • Discuss the orientation process for the learner • Describe the steps of the Pharmacists’ Patient Care Process and discuss methods to incorporate it into pharmacy practice learning experiences • Explain the need for providing ongoing feedback to learners in pharmacy practice experiences • Identify strategies for dealing with the difficult learner

4. Technician Learning Objectives • Understand the importance of an orientation process for the learner. • Discover the need for providing ongoing feedback to learners. • Identify strategies for dealing with a difficult learn

5. Serving as a Preceptor • Rewarding professional responsibility • Current pharmacy curriculum require experiential education to be over 30% of student learning • IPPE 300 hours minimum concurrent with didactic training • APPE 1440 hours minimum • Student pharmacists serve as pharmacist extenders in patient care • Vital to the growth of the pharmacy profession

6. Mentoring • Involves ongoing engagement with mentee • Greater investment of time and commitment by both parties • Relationship based on trust and respect • Foster growth

7. Characteristics of the Millennial Generation • Born between 1981 and 2000 • Nurtured by omnipresent parents • Schedule everything • Feel enormous academic pressure • Prefer digital literacy • Prefer to work in teams; collaborative • Told over and over again that they are special • Crave constant and immediate feedback

8. Effective Preceptor-Learner Relationships • Structure a positive learning environment • Clearly define expectations, roles and responsibilities • Model behavior • Coach learners • Foster self-reflection

9. Student Orientation • Goals, objectives and expectations • Syllabus • Training Manuel • Schedule • Tour • Introduction to team members • Evaluation instruments • Competencies provided by schools • Grading rubrics

10. Delivering Effective Feedback

11. Competencies • Pressure to provide positive feedback • Duty to ensure one has demonstrated skills necessary • Passing a student that is not competent could put a patient at harm

12. Vickery AW, Lake FR. Med J Aust 2005; 183(5):267-268

13. Reprimand *Be specific & focus on the behavior *Wait until you are calm *Do it in a timely manner, don’t delay *Find a private place *Relay your feelings & give the person a second to sense you reaction *Inspire progress Praise *Be specific & timely with your praise *Relay your feelings & give the person a second to sense your reaction Inspire continual similar behavior Successful Constructive Feedback Figure 6-2, Cuellar, L. M., & Ginsburg, D. B. (2016). Preceptor's Handbook for Pharmacists. Bethesda: American Society of Health-System Pharmacists, Inc.. Page 100

14. The Sandwich Technique for Feedback Positive statements Negative Statement https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcRhIFj9aOvyxnR7VWGTjcuLPcBNhsv6Uwjws1AJyZyyvLW42JTt

15. Methods of Summative Evaluation: • Examination • Written • Oral • Practical • Evaluation Instruments • Mid-term evaluation • Final evaluation

16. Preceptor Tips: • Learners should be accessed on knowledge as well as communication and professionalism skills • At the midpoint, let learners know how they are progressing and make a plan to correct weaknesses you identify • Feedback should be given throughout the experience so that learners are not surprised by the outcome • Resist the temptation to reward or grade learners based only on improvement; learners need to demonstrate competency • Evaluate the learner objectively, avoiding error and bias

17. What’s new in Experiential Education at UAMS and Harding University?

19. CORE Benefits • Intuitive interface • Preceptor availability is gathered electronically on phone, tablet or computer • Evaluations may be completed on a variety of devices • More functionality and easier to use for: • Students • Preceptors • Meets more of the experiential office needs Seth Heldenbrand, UAMS College of Pharmacy 2017

20. Timeline for CORE Implementation • August 2017 —begin loading preceptor and student information • September-November 2017 –gather preceptor availability electronically • You will have logins, passwords and an instructional email on how to enter your availability for the 2018-2019 year • December 2017 – enter student preferences • January 2018 – optimize the schedule and then release for preceptor approval • May 2018 -- CORE launches as the only preceptor/student experiential software Seth Heldenbrand, UAMS College of Pharmacy 2017

21. The Pharmacists’ Patient Care Process (PPCP) Joint Commission Pharmacy Practicioners (JCPP)

22. The Pharmacists’ Patient Care Process https://jcpp.net/wp-content/uploads/2015/09/PatientCareProcess-298x300.jpg

23. Goals of PPCP: • Promote consistency across the profession • Provide a framework for delivering patient care in any practice setting • Contemporary and comprehensive approach to patient-centered care delivered in collaboration with other members of the health-care team • Applicable to a variety of patient care services delivered by pharmacists, including medication management

24. Rolling the “wheel” into practice… • Inpatient/Acute Care • Community Pharmacy • Ambulatory Care Clinic

25. The Difficult Learner

26. Struggling with professionalism issues: • Contact the Office of Experiential Education or Residency Director • Communicate with the learner about the problem as they may not be aware of it • Require self assessment of the situation • Discuss the problematic behavior • Why is it unacceptable? • Reinforce that it will not be tolerated in the future • Consider progressive discipline depending on the significance • Verbal warning • Written reprimand • Progressing to failure

27. APPE Competency Form Important Note: Student professionalism is considered a minimum standard of expectation. Therefore, a proficiency score of less than 3 on any of the following six questions will result in a reduced letter grade and trigger an automatic student review by the he Assistant Dean for Experiential Education. Please contact the ADEE for questions or concerns about student professionalism. __Maintains patient/site confidentiality __Recognizes knowledge limitations, asks questions, learns independently, and welcomes formative feedback __Places patients’ welfare above personal self interest __Performs duties in accordance with legal, ethical, social, economic, and professional guidelines __Appropriately uses personal technology (cell phone, tablet, social media, etc)

28. Struggling with time management issues: • Hold the learner accountable • Provide periodic checkpoints for bigger projects in an effort to break it down into smaller pieces • Set SMART (specific, measureable, attainable, realistic, and timely) goals • Identify tasks that are procrastinated • Discover the best environment and times for personal productivity • Plan a schedule of priorities

29. Unprepared Learners • Are there barriers to learning? • Ask questions to access clinical knowledge base • Does the learner struggle with time management? • Does the learner lack self-confidence? Introverted?

30. Entitled Learners • Some learners are accustomed to being rewarded for participation, not production • Concept of student as consumer; blame others for their failures or provide excuses • Expect high grades regardless of performance • Expect all learning to be delivered from the preceptor without significant effort on their part as the learner

31. Lead the learner from entitlement to empowerment • Be a good role model • Communicate deadlines and guidelines for assignments, do not compromise • Focus on consequences for not meeting expectations instead of discussing rules • Establish an environment where it is safe to fail

32. Disinterested Learners • Ask learners about previous experiences and what they look to learn on your experience • Connect with your learner over a break or lunch • Demonstrate how the skills they learn will be applicable to future practice • Be passionate about what you teach as learners will sense it http://proper-english-foundatio.yolasite.com/resources/Uninterested%20or%20disinterested.png

33. Resources for Preceptors

34. Continuing Education for Preceptors https://www.e-value.net/index.cfm

35. http://www.gotocei.org/ http://www.gotocei.org/

36. Helpful books for Preceptors https://store.ashp.org/default.aspx

37. Final thoughts for Preceptors

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39. ______ assessment monitors the learner in order to provide ongoing feedback. • A. Academic • B. Formative • C. Expressive • D. Summative • E. All of the above

40. _________ feedback should be given during the middle and end of the experience. • A. Academic • B. Formative • C. Expressive • D. Summative • E. All of the above

41. What is the name of the new experiential education learning management program adopted by UAMS and Harding? • A. E-Value • B. ExamSoft • C. Learning Space • D. CORE

42. References • Cuellar, L. M., & Ginsburg, D. B. (2016). Preceptor's Handbook for Pharmacists. Bethesda: American Society of Health-System Pharmacists, Inc. . • Soric, M. M. (2013). Maximize Your Rotations. Bethesda, MD: American Society of Health-System Pharmacists, Inc. • Soric, M. M., Schneider, S. R., & Wisneski, S. S. (2017). The Effective Pharmacy Preceptor. Bethesda, MD: American Society of Health-System Pharmacists, Inc. . • The Pharmacists' Patient Care Process. (2017, June 20). Retrieved from Joint Commission of Pharmacy Practitioners: https://jcpp.net/patient-care-process/ • Zlactic, T. D. (2010). Clinical Faculty Survival Guide. Lenexa, KS: American College of Clinical Pharmacy.