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Providing a Positive Learning Experience when Precepting Student Pharmacists AJ Greco, PharmD What is a Preceptor? A teacher, instructor, and coach who moves students from: Application to Integration into Classroom-based real-life patient

  1. Providing a Positive Learning Experience when Precepting Student Pharmacists AJ Greco, PharmD

  2. What is a Preceptor? A teacher, instructor, and coach who moves students from: Application to Integration into Classroom-based real-life patient clinical pharmacy Knowledge cases practice Doty R. Getting Started as a Pharmacy Preceptor. Washington, D.C. American Pharmacists Association; 2011.

  3. Preceptor “Hats” “Hat” Responsibility Teacher Teach students how to apply their knowledge in clinical and real- world settings Instructor Design activities to allow students to integrate their knowledge in a real-world patient care environment Coach Nurture student pharmacists’ professional growth by challenging and encouraging them Doty R. Getting Started as a Pharmacy Preceptor. Washington, D.C. American Pharmacists Association; 2011.

  4. Why Become a Preceptor? • To positively influence future pharmacists • To broaden your impact on patients • To give back to the profession Doty R. Getting Started as a Pharmacy Preceptor. Washington, DC. American Pharmacists Association; 2011.

  5. 4 Preceptor Roles Direct Modeling Coaching Facilitating Instruction Starring Roles: The four preceptor roles and when to use them. American Society of Health-System Pharmacists. http://www.ashpmedia.org/softchalk/softchalk_preceptorroles/soft chalk4preceptorroles_print.html. Accessed October 25, 2016.

  6. Direct Instruction This preceptor role is typically appropriate for the beginning of the rotation Teaching of foundational content • Orienting a student to the process at hand • Filling in any necessary knowledge gaps before skills can be applied • Starring Roles: The four preceptor roles and when to use them. American Society of Health-System Pharmacists. http://www.ashpmedia.org/softchalk/softchalk_preceptorroles/soft chalk4preceptorroles_print.html. Accessed October 25, 2016.

  7. Direct Instruction - Scenario Creating a medication action plan for a patient with diabetes • The student pharmacist first needs to understand the following: • Information about diabetes • Potential treatment options for diabetes • The latest research for diabetes Starring Roles: The four preceptor roles and when to use them. American Society of Health-System Pharmacists. http://www.ashpmedia.org/softchalk/softchalk_preceptorroles/soft chalk4preceptorroles_print.html. Accessed October 25, 2016.

  8. Modeling This is appropriate after the student understands/demonstrates the appropriate amount of background information • The preceptor demonstrates a task while “narrating” their actions out loud • This allows the student to witness the problem-solving process Starring Roles: The four preceptor roles and when to use them. American Society of Health-System Pharmacists. http://www.ashpmedia.org/softchalk/softchalk_preceptorroles/soft chalk4preceptorroles_print.html. Accessed October 25, 2016.

  9. Modeling - Scenario Creating a medication action plan for a patient with diabetes The student will observe the preceptor developing the medication • action plan while: The preceptor “thinks out loud” and states their thought process • The student will prepare to emulate the plan • Starring Roles: The four preceptor roles and when to use them. American Society of Health-System Pharmacists. http://www.ashpmedia.org/softchalk/softchalk_preceptorroles/soft chalk4preceptorroles_print.html. Accessed October 25, 2016.

  10. Coaching Appropriate when the student has observed modeling of the process • The student is to perform a task, while being shadowed by the preceptor • Preceptor provides ongoing feedback during this process • Allows student to fine-tune their skills and gain independence Starring Roles: The four preceptor roles and when to use them. American Society of Health-System Pharmacists. http://www.ashpmedia.org/softchalk/softchalk_preceptorroles/soft chalk4preceptorroles_print.html. Accessed October 25, 2016.

  11. Coaching - Scenario Creating a medication action plan for a patient with diabetes • The preceptor oversees the student as they develop the medication action plan • The student “thinks out loud” • The preceptor provides feedback during this process Starring Roles: The four preceptor roles and when to use them. American Society of Health-System Pharmacists. http://www.ashpmedia.org/softchalk/softchalk_preceptorroles/soft chalk4preceptorroles_print.html. Accessed October 25, 2016.

  12. Facilitation This role typically occurs towards the end of the rotation • Allowing the student to perform more independently • It is important that the preceptor remain readily available Starring Roles: The four preceptor roles and when to use them. American Society of Health-System Pharmacists. http://www.ashpmedia.org/softchalk/softchalk_preceptorroles/soft chalk4preceptorroles_print.html. Accessed October 25, 2016.

  13. Facilitation - Scenario Creating a medication action plan for a patient with diabetes • The student is now able to complete the medication action plan on their own, but still under direct supervision of a pharmacist Starring Roles: The four preceptor roles and when to use them. American Society of Health-System Pharmacists. http://www.ashpmedia.org/softchalk/softchalk_preceptorroles/soft chalk4preceptorroles_print.html. Accessed October 25, 2016.

  14. Student Learners Introductory Pharmacy Practice Advanced Pharmacy Practice Experiential (IPPE) Experiential (APPE) • Develop baseline competencies in • Preparation for entry-level the practice setting practice • Typically less work experience • Didactic curriculum completed • May require more supervision/assistance • Typically previous rotation and some work experience Doty R. Getting Started as a Pharmacy Preceptor. Washington, D.C. American Pharmacists Association; 2011.

  15. Student Perceptions of Preceptor Excellence • Major factors and characteristics: • Interest in teaching • Relate to the student as an individual • Encourage discussion • Accessible • Provide feedback • Serve as a practice role-model • Organized Young S, Vos S, Cantrell M, et al. Factors Associated with Students’ Perception of Preceptor Excellence. Am J Pharm Educ. 2014; 78 (3): Article 53.

  16. Preceptor Qualities that Foster Learning 1. Be a Role Model 2. Perform a Pre-rotation Assessment 3. Provide Structure 4. Give Meaningful Work 5. Share Your knowledge and Expertise Janet K. Astle. 10 Preceptor Qualities That Create a Great Learning Environment. Inside Pharmacy. August/September 2014. Volume 2, No. 4.

  17. Preceptor Qualities that Foster Learning 6. Be a Coach 7. Give Context to Future Practice 8. Provide Feedback 9. Spend Time with Your Students 10. Communicate Janet K. Astle. 10 Preceptor Qualities That Create a Great Learning Environment. Inside Pharmacy. August/September 2014. Volume 2, No. 4.

  18. Teaching Techniques • Direct Instruction – Fundamental Content • Assigned Readings • Lectures • Topic Discussions • Case-based Teaching Weitzel KW, Walters EA, Taylor J. Teaching clinical problem solving: a preceptor’s guide. Am J Health-Syst Pharm. 2012 Sept;69:1588-99.

  19. Teaching Techniques • Modeling - Problem Solving Process • Actual patient encounter • Preceptor “Thinking Out Loud” • “Priming” before an encounter • Execute the behavior being modeled • Discussion on what was accomplished Weitzel KW, Walters EA, Taylor J. Teaching clinical problem solving: a preceptor’s guide. Am J Health-Syst Pharm. 2012 Sept;69:1588-99.

  20. Teaching Techniques • Coaching – Preceptor Observation • Actual patient encounter • Student “Thinking Out Loud” • “Priming” before an encounter • Asking structured questions • Providing feedback Weitzel KW, Walters EA, Taylor J. Teaching clinical problem solving: a preceptor’s guide. Am J Health-Syst Pharm. 2012 Sept;69:1588-99.

  21. Teaching Techniques • Facilitation - Guidance • Allow students to work more independently • Remain available to de-brief • Teach students to evaluate their own work • Teach students how to facilitate their own learning Weitzel KW, Walters EA, Taylor J. Teaching clinical problem solving: a preceptor’s guide. Am J Health-Syst Pharm. 2012 Sept;69:1588-99.

  22. The One-Minute Preceptor 1. Get a Commitment 2. Probe for Supporting Evidence 3. Teach General Roles 4. Reinforce What was Done Right 5. Correct Errors Neher J et al. A five “micro-skills” model of clinical teaching. Journal of American Board of Family Practice. 1992; 5(4): 419-24.

  23. The One-Minute Preceptor 1. Get a Commitment • What do you think is going on with this patient? • What investigations do you feel are indicated? • What do you think needs to be accomplished on this visit? 2. Probe for Supporting Evidence • What are the major findings that lead to your conclusion? • What else did you consider? • What made you choose that particular treatment Neher J et al. A five “micro-skills” model of clinical teaching. Journal of American Board of Family Practice. 1992; 5(4): 419-24.

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