mentoring vs. coaching vs. precepting: what’s the difference? veronica vernon, pharmd, bcps, bcacp...

Mentoring vs. Coaching vs. Precepting: What’s the

Difference?

Veronica Vernon, PharmD, BCPS, BCACPClinical Pharmacy Specialist

IPA/CPI Annual Joint ConventionSeptember 19, 2014

Disclosure

The speaker has no actual or potential conflicts of interest in relation to

this presentation

Objectives

1. Compare and contrast the purpose and responsibilities associated with mentoring, coaching, and precepting.

2. Describe methods used to facilitate conversations as a mentor, coach, or preceptor. 

3. Identify communication strategies that can be employed in challenging situations.

Famous Mentors in the Media

http://www.cruxcatalyst.com/wp-content/uploads/yoda-luke.jpghttp://wandervogeldiary.files.wordpress.com/2014/05/mr-miyagi-the-karate-kid-630-75.jpg?w=655

What do these mentors have in common?

Mentoring

A Mentor Is…

“A trusted counselor guiding the professional development of an individual”

“Knowledgeable and competent professionals who are one or more steps ahead of a trainee”

Byyny RL. Pharos Alpha Omega Alpha Med Soc Winter 2012; 1-3Rose GL, et al.. Acad Med 2005; 80(4): 344-348

The Origins of the Mentor

The Odyssey

Athena appeared as Mentor to Telemachus

Provided encouragement

http://paesmem.stanford.edu

Smilor R. Entrepreneurship. Available at: http://www.entrepreneurship.org/en/resource-center/what-makes-yoda-so-good-how-to-be-an-effective-mentor.aspx

What are desirable qualities in a mentor?

What actions should a mentor take to ensure

a successful relationship with the

mentee?

Successful Actions of a Mentor

ListensProvides

constructive feedback

Supports and

challenges the mentee

Develops a personal

relationship

Designates time for the

mentee

White SJ. Hosp Pharm 2011; 46(5):332-335.Smilor R. Entrepreneurship. Available at:

http://www.entrepreneurship.org/en/resource-center/what-makes-yoda-so-good-how-to-be-an-effective-mentor.aspx

Principles of Mentoring

Focus on the needs of the mentee

Demonstrate perseverance

Mentors must give of themselves

Align passion and work

Model character

Smith RE. ACCP Academy Leadership and Management Newsletter 2007; 1(1): 1-3

What NOT to Do

Attempt to solve the mentee’s problems

Violate confidentiality

Force opinions on a mentee

Share “war stories”

Attempt to create a “clone”

Smilor R. Entrepreneurship. Available at: http://www.entrepreneurship.org/en/resource-center/what-makes-yoda-so-good-how-to-be-an-effective-mentor.aspx

Apprenticeship Model

I do itI do it

and you watch

You do it and I watch

You do it

Maxwell JC. Mentoring 101.

Collaboration

Mentor

Mentee

Zachy LJ. The Mentor’s Guide.

How do you ensure success in a mentoring

relationship?

The Mentoring Equation

Johnson W. The HBR Blog Network. Available at: http://blogs.hbr.org/johnson/2011/10/get-the-mentoring-equation-rig.html

Creating a Positive Experience

Set expectations Frequency of meetings Responsibilities of mentor and mentee

Evaluate, evaluate, evaluate

Coaching

A Coach Is…

“ Someone who helps another person reach higher effectiveness by creating a dialogue that leads to awareness and action.”

An individual who helps another come to their own decision

An observer, a guide

Emerson B, et al. A Manager’s Guide to Coaching: Simple and Effective Ways to Get the Best Out of Your EmployeesAtul G. The New Yorker. 2011 (October 3). Available at: http://www.newyorker.com/reporting/2011/10/03/111003fa_fact_gawande

Coaching

Assists an individual in reaching goals faster

Several types of coaching: Peer Career Performance Life Health

Whitworth L, et al.. Co-Active Coaching, New Skills for Coaching People Toward Success in Work and LifeTofade T. Am J Pharm Edu 2010; 74(3): Article 51.

Co-Active Coaching Model

Develop a connection

Listen/communicate effectively

Keep the end goal in sight

Ask powerful questions

Build self-awareness and self-esteem

Recognize their whole life

Whitworth L, et al.. Co-Active Coaching, New Skills for Coaching People Toward Success in Work and LifeTofade T. Am J Pharm Edu 2010; 74(3): Article 51.

Co-Active Coaching Model

Acknowledge efforts

Identify limits

Hold the individual accountable

Debrief learning

Celebrate accomplishments

Whitworth L, et al.. Co-Active Coaching, New Skills for Coaching People Toward Success in Work and LifeTofade T. Am J Pharm Edu 2010; 74(3): Article 51.

Precepting

What are attributes of a “good” preceptor?

A Preceptor…

Sets Expectations Provides Feedback

Displays Passion Is Confident, yet Humble

Challenges the Learner

Seeks Learning Activities

Cuellar LM, Ginsburg DB. Preceptor's handbook for pharmacists.Beck DE, Boh LE, PS O'Sullivan. Am J Pharm Educ. 1995; 59: 236– 46.

The One Minute Preceptor

Have the student commit to an assessment/plan

Require evidence

Teach concepts that can be applied elsewhere

Provide positive feedback

Give constructive feedback

Furney SL, et al.  J Gen Intern Med.  2001; 16: 620– 4.

The Learning Pyramid

Direct instruction

Facilitating

Modeling

Nimmo CM, Guerrero R, Greene SA, Taylor JT, eds. Staff development for pharmacy practice. Bethesda, MD: ASHP; 2000

Culminating Integration

Practical Application

Foundational Skills and

Knowledge

Coaching

How do you incorporate direct instruction, modeling,

coaching, and facilitation into your precepting?

Four Facets of Precepting

Setting expectations Structured and informal learning activities

Topic discussions Journal clubs

Providing the learner autonomy

Mentoring, Coaching, Precepting: Similarities and Differences

Mentoring

• Involves sharing of knowledge

• Longer time investment

• Facilitates decisions

• Focused on the mentee

Coaching• Involves

questioning and assessing

• Limited investment

• Reflective listening

• Focused on tasks

Precepting

• Involves teaching and evaluation

• Limited time investment

• Focused on the learner and tasks

Atul G. The New Yorker. 2011 (October 3). Available at: http://www.newyorker.com/reporting/2011/10/03/111003fa_fact_gawande

Communication

Communicating as a Preceptor/Mentor/Coach

Regular contact is essential

Set clear expectations early

Ask open-ended questions

Maintain open lines of communication

Utilize active listening

Be vigilant of body language

APhA and NACDS. Available at: http://www.therapeuticresearch.com/ce/documents/custom/apha_nacds.pdfUniversity of Pittsburgh Institute for Clinical Research Education. Available at: http://www.icre.pitt.edu/mentoring/effective.html

The Importance of Feedback

Vital to the learning experience

Preceptors may not meet learner needs

Meant to improve a targeted skill or behavior of the recipient

It is not an evaluation

Novices vs. experts respond differently

Sonthisombat P. Am J Pharm Educ. 2007;72:1–6. Finkelstein SR, et al. J Consum Res 39; 22-38.

Purpose of Feedback

Actual performance

Desired performance

Actual performance

Desired performance

Cantillon P, et al. BMJ 2008;337:a1961.

Feedback Techniques

Feedback Sandwich

Pendleton Model

Reflective Feedback Conversation

Cantillon P, et al. BMJ 2008;337:a1961.

Feedback Techniques

Feedback Sandwich

• Reinforcing statement• Corrective statement• Reinforcing statement

Cantillon P, et al. BMJ 2008;337:a1961.

Feedback Techniques

Pendleton Model

• Learner states what was good• Teacher agrees and elaborates• Learner states areas for improvement• Teacher states areas for improvement

Cantillon P, et al. BMJ 2008;337:a1961.Pendleton D, et al. The consultation: an approach to learning and teaching. .

Feedback Techniques

Reflective Feedback Conversation

• Teacher asks about concerns• Learner shares concerns and what could

have been improved• Teacher provides opinion and support• Teacher asks learner what may improve

the situation• Learner responds• Teacher elaborates on learner’s response

Cantillon P, et al. BMJ 2008;337:a1961.

Feedback/Evaluation Example

Video

Effective Feedback

Timely Scheduled

Specific Straightforward

Collaborative

Beck DE, et al. Am J Pharm Educ. 1995;59:236–46.Koons K, et al. J Am Pharm Assoc 2012;52: e273-e276.

Ende J. Feedback in clinical medical education. JAMA 1983;250: 777-81.

Providing Effective Feedback

1• Prepare learner prior to

the activity

2• Provide descriptive,

relevant, and objective feedback frequently

3• Avoid overloading the

learner with feedback

4• Follow-up on action

plansBeck DE, et al. Am J Pharm Educ. 1995;59:236–46.

Koons K, et al. J Am Pharm Assoc 2012;52: e273-e276.Ende J. Feedback in clinical medical education. JAMA 1983;250: 777-81.

Providing Positive vs. Negative Feedback

Positive Negative

Weitzel KW, et al. Am J Health Syst Pharm 2012 69:1588-1599

Common Pitfalls to Avoid

Judgmental feedback

Insufficient “wait time”

Lecturing inappropriately

Close-ended questions

Challenging learner past abilities

“Sugar-coating”

Not focusing on the learner

Quilligan S.. Clin Teach 2007;4:100-105.Maynard, R. Preceptor CE: Giving effective feedback to students and residents. Pharmacist’s Letter PL CE Live

2012.

GROW Model

G •Goal

R •Reality

O •Options

W •Way Forward

Personal Development Plans (PDPs)

Plan and tracks progress against goals SMART goals

Professional and personal goals

Important to update and assess progress with goals at regular time intervals

PDP ExampleName:

Short Term Goal(s) (completion in 1-2 years):

Long Term Goal(s) (completion in 5+ years):Skill

sAssessme

ntActivities to

improve

Goal Date

Mentor signature and date

Structural Tension Chart

Action Steps Date Completed

Fritz R. The Path of Least Resistance for Managers.

Current Reality

Goal/Future

Questions to Facilitate Meetings

1. What do you really want to do?

2. What do you do well that allows you to reach your goal?

3. What is preventing you from reaching your goals?

4. What will you do differently tomorrow?

5. How can I help?

Tjan AK. HBR Blog Network. Available at: http://blogs.hbr.org/tjan/2009/03/five-questions-every-mentor-mu.html

Components of Successful Meetings

Scheduled time at intervals determined by the mentor or mentee

Assist the mentee in developing SMART goals

… But What About Those Challenging Situations?

Video

Learner Scenarios

Scenario #1

TR is a final-year student pharmacist on his eighth APPE rotation

He was 10-15 minutes late on the first week of his rotation

He was on time during the second week

TR is now late again on the 1st day of the third week of his rotation and is unprepared for his topic discussion today

Scenario #2

DE and GL are two final-year student pharmacists on a community pharmacy rotation together

Throughout the first week, you notice that DE appears to take more initiative and is more prepared for the rotation than GL

Scenario #3

You will be precepting multiple learners in your clinic JJ, an IPPE student RS, an APPE student PL, a PGY1 resident

How will you ensure each learner has a meaningful experience?

Scenario #4You are an enthusiastic, innovative

pharmacist who desires to advance pharmacy practice at your site. Management fully supports new initiatives to improve patient care and further incorporate the pharmacists into a team.

JR is one of your colleagues who does not see the benefit of these changes and wants to maintain the status quo.

How would you approach this situation?

What other challenging precepting situations

have you encountered?

Summary

The roles of preceptor, mentor, and coach often overlap

Clear and open communication is key

Feedback is essential to the development of a student/resident/mentee

Various feedback methods exist

Tailor the approach to the student/resident

Resources

Stoddard DA. The Heart of Mentoring. 1st ed. Colorado Springs, CO: NavPress; 2003.

Zachy LJ. The Mentor’s Guide. 2nd ed. San Francisco, CA: Jossey-Bass; 2012.

Maxwell JC. Mentoring 101. 1st ed. Nashville, TN: Thomas Nelson; 2008.

Resources Continued

Adams M. Change Your Questions, Change Your Life: 10 Powerful Tools for Life and Work. 2nd ed. San Francisco, CA: Berrett-Koehler Publishers; 2009.

Bradberry T, Greaves J. Emotional Intelligence 2.0. 1st ed. San Diego, CA: TalentSmart; 2009.

Mentoring vs. Coaching vs. Precepting: What’s the

Difference?

Veronica Vernon, PharmD, BCPS, BCACPClinical Pharmacy Specialist

IPA/CPI Annual Joint ConventionSeptember 20, 2014