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Precepting with a passion: Positive behaviors that make a difference

Marian Gaviola, PharmD, BCCCPMeredith Howard, PharmD, BCPSUNT System College of Pharmacy

Pharmacist Learning Objectives

1. Discuss the various frameworks surrounding teaching effectiveness

and teacher passion

2. Identify positive attributes and behaviors that improve student

experiences during experiential learning

3. Incorporate preceptor passion into student learning experiences,

including within the assessment and feedback process

Technician Learning Objectives

1. List components of preceptor passion

2. Identify methods of displaying positivity and enthusiasm in

precepting

3. Incorporate ways to provide motivating feedback to learners

Think about…

• Preceptors that have made a difference in your career

• What did they do differently?• What did they avoid doing?• How would you describe their attitude?

ACPE Standards 2016

ACPE. Standards 2016. https://www.acpe-accredit.org/pdf/Standards2016FINAL.pdf.

Standard 20

PreceptorsCriteria, education, and development

•Recruitment

•Orientation

•Performance

•Evaluation

Aptitude and attributes

•Aptitude for teaching

•Attributes of preceptors

Attributes of Preceptors

ACPE. Guidance for Standards 2016. https://www.acpe-accredit.org/pdf/GuidanceforStandards2016FINAL.pdf.

Practices ethically and with

compassion

Accepts personal responsibility

Professional education,

experience, and competence

Evidence-based practice

Desires to educate others

Advocate Creative thinkingAptitude to

facilitate learning

Assesses student performance

Continuous professional development

Collaborative Committed

Being a Pharmacist and Preceptor

Pharmacist

Patient care

Administrative duties

Managing operations

Precepting and teaching

Think about…

• Preceptors that have made a difference in your career

• What did they do differently?• What did they avoid doing?• How would you describe their attitude?

• Attitudes and attributes that would make a difference in your student’s career

Teaching Behaviors

Young S. Am J Pharm Educ. 2014;78(3):Article 53.

Factors associated with preceptor excellence

Interested in teaching this rotation

Related to me as an individual

Encouraged active participation

Readily available to answer questions and concerns

Provides good direction and feedback

Served as role model

Rotation activities were well-organized and structured

Spent time discussing patient care and practice-related issues

Teaching Behaviors

Role modeling

Positive attitude

Very knowledgeable

Enthusiasm and passion for patient care

Works well with others

Advocates and has enthusiasm for profession

Teaching-coaching

Interested in student learning and success

Makes time for student

Clear in expectations

Solicits input from students

Facilitative behaviors

Flexible, organized and accommodating

Willing to provide a variety of experiences

Creates great working environment

Provided independence

O’Sullivan TA. Am J Pharm Educ. 2016;79(10):Article 151.

UNTHSC Preceptor Positivity

Positivity in Precepeting

Themes

Feedback provision and clear

expectations

Enthusiasm and passion for teaching

KnowledgeableAttitude: patient, non-judgmental, caring

Positive role model

Teaching with a Passion

“…the best teachers are people who are passionate about their subject AND passionate about sharing that subject with others.”

“Teaching without passion is merely information delivery.” - James Wangberg

Constructs

• Positivity, passion, enthusiasm, attitudes

• What is it?• Does it matter?• Should I do it?

Passion

• an intense desire or enthusiasm for something

• a strong inclination towards an activity (e.g. one’s job, teaching) that one likes

(or even loves) and finds important and in which one invests time and energy

Carbonneau N. J Educ Psych. 2008; 100(4):977-987.

Teacher Passion

Wangberg JK. Am Entomologist. 1996; 199-200.

• ContagiousEnthusiasm

• Shows that you really love this stuff

• There might be more to this than students think

Immersion in the subject

• Spirit of experimentation

• Risk vs reward

Creative and innovative approaches

• Good teachers continue to be students

• Brings what they learn to their teachingTeacher as learner

O’Sullivan TA. Am J Pharm Educ. 2016;79(10):Article 151.

Teacher Passion

• Motivator• Can be seen as behavior• Relates to internal emotions

Passion (Love) vs Teacher Passion (Learning)

Roeger E. 2012. University of Illinois at Urbana-Champaign. EdD dissertation.

Intimacy

Love

Passion

Learning intimacy

Love of self, career, learning

Passion as motivator

Hastings JK. Am J Pharm Educ. 2005;69(2):Article 38.MS Medina. Am J Health-Syst Pharm. 2011;68:230-231.

Teacher Passion and Motivation

• Mastery orientation = desire to develop competence

• Performance orientation = desire to demonstrate competence

• Academic alienation = no desire to develop nor demonstrate competence

• Internal vs external

• Value creates value

• Enthusiasm adds credibility

• Expectancy x Value = Motivation• Expectancy = expected success• Value = what you get out of it

Hastings JK. Am J Pharm Educ. 2005;69(2):Article 38.MS Medina. Am J Health-Syst Pharm. 2011;68:230-231.

Teacher Passion and Motivation

• Mastery orientation = desire to develop competence

• Performance orientation = desire to demonstrate competence

• Academic alienation = no desire to develop nor demonstrate competence

• Internal vs external

• Value creates value

• Enthusiasm adds credibility

• Expectancy x Value = Motivation• Expectancy = expected success• Value = what you get out of it

Teacher Passion and Motivation

• Behaviors• Immersion in subject

• Direct communication of expectancy and value

• Internal emotions• “I want to do a good job.”

• “I want my students to do a good job.”

Role modeling

Positive attitude

Very knowledgeable

Enthusiasm and passion for patient care

Works well with others

Advocates and has enthusiasm for profession

Teaching-coaching

Interested in student learning and success

Makes time for student

Clear in expectations

Solicits input from students

Facilitative behaviors

Flexible, organized and accommodating

Willing to provide a variety of experiences

Creates great working environment

Provided independence

Teacher Passion and Motivation

Teacher Passion and Love

• Love of self and what you’re doing• “Catch passion” – emotional contagion

• “If someone is ascribing emotion, then this must be important.”• Strong feelings strong memories

• Positive intentions > positive interaction

Roeger E. 2012. University of Illinois at Urbana-Champaign. EdD dissertation.

How do you show that you’re passionate about what you do?

What do you do when there’s a mismatch between you and the student?

Roeger E. 2012. University of Illinois at Urbana-Champaign. EdD dissertation.

Teacher Passion and Intimacy

• Intimacy: caring, quality of instruction, discipline expertise

• Creates trust credibility contagion• Students mimic how you portray yourself if trust is present• Expert in the field vs partners in learning

Role modeling

Positive attitude

Very knowledgeable

Enthusiasm and passion for patient care

Works well with others

Advocates and has enthusiasm for profession

Teaching-coaching

Interested in student learning and success

Makes time for student

Clear in expectations

Solicits input from students

Facilitative behaviors

Flexible, organized and accommodating

Willing to provide a variety of experiences

Creates great working environment

Provided independence

Teacher Passion and Intimacy

Roeger E. 2012. University of Illinois at Urbana-Champaign. EdD dissertation.

Effects of Teacher Passion

• To learner outcomes• Enthusiasm improves memory• Caring improves motivation• Intimacy improves autonomy

• To self• Passion improves motivation, may decrease burnout• Intimacy improves relatedness with students

Practical Questions to Consider• Start as you mean to go

• What thoughts and attitudes do you have about students? Precepting? Pharmacy? Your job?

• Set expectations• How motivated are you and how motivated do you expect your students to be?

• There’s never enough time• What is your priority at work? What is your priority for your students? How do you

make time for both?• How willing are you to make (potentially risky) changes to what you’re currently

doing?

Putting it into Practice

UNTHSC Preceptor Positivity

Positivity in Precepeting

Themes

Feedback provision and clear

expectations

Enthusiasm and passion for teaching

KnowledgeableAttitude: patient, non-judgmental, caring

Positive role model

Establishing a Positive Environment from Day 1

Orientation

Growth mindset

Expectations

Feedback

Case Study: Orientation Day

Your student is set to arrive at 9:30AM after you have looked at your patients and/or clinical duties for the day. When they arrive you will go over the rotation calendar, day-to-day activities, and your expectations. It is a busy day for patient care, but by 9AM you are on track for the morning.

At 9:10, you get a call from your clinical manager that your help is needed covering clinical consults as one of your colleagues is out, adding a significant amount to your workload. At 9:15 your student arrives in the pharmacy, early, to start rotation.

How do you greet them to start the day?

Maintaining Positivity During Busy Times

Reminder: it isn’t always what you say but how you say it

Tying Passion and Positivity into Expectations

• Reviewing clear expectations on day 1• Patient care related• Attitude related• Learning related• Positive spin?• Verbalize thresholds

• Demonstrating expectations for self -- and verbalizing them• Framing feedback to align with expectations

“High but achievable expectations”

Establishing a Growth Mindset as a Preceptor

• Growth mindset• Human brain is pliable and ready for continuous learning• 7th graders taught this improved math grades

• Praise telling kids they are smart encourages a fixed mindset vs. praising effort fosters growth mindset

• Personal learning philosophy as a pharmacist?• How do you share or exemplify these• How do you incorporate this into your feedback and expectations

Rattan, et al. J Exp Soc Psychol. 2012; 48(3):731-37.Blackwell, et al. Child Dev. 2007 Jan-Feb;78(1):246-63.

Feedback Methods to Encourage Positivity and Growth

• Self-assessment• “What motivates you?”

• Sandwiching• Incorporate student self-assessment first• Caution: losing the filling

• Feedback Fridays

Sharing your Enthusiasm

• Sharing background, stories, etc…• New frontiers – highlighting what’s new and exciting• Emphasize rare events and learning opportunities• Excitement for planned rotation activities• 1 thing learned

Partnership in Learning

Establishing your practice

Establishing self as the “expert”

Creating boundaries

• It’s okay to show vulnerability• It’s okay to be relatable

• Balance, balance, balance….

What not to do….

Audibly sigh Roll eyesRefer to

students as “student”

Complain in front of students

Gossip

What if it isn’t you?

Negative pharmacy staff?Negative providers?

Address situations as needed Align expectations Department support

Case Study: Pharmacy Staff

Your hospital has been taking an increasing number of pharmacy students and you have created a student area which is underneath storage shelves that technicians need to access only about once or twice per day. One day in the middle of rotation one of your students asks you if there is a better place for students to work as one of the technicians has been heard walking away from the storage areas audibly saying “Ugh, these students are always in the way now.”

How do you respond to the student? Do you do anything else?

Encouraging a Culture of Positivity and Learning

What if it’s your student?

Student negative or not receptive to learning environment?

• Pharmacy is a profession with learnable and adaptable skills across practice settings• Students will always need to figure out why a med is on a patients

profile, etc., regardless of it’s an IV drip or a HTN maintenance medication

• Not teaching content but skills• Build scaffolding of expectations for future practice

Limitations of Positive Precepting

• Do you fake it until you make it? • Authenticity?

Be the best version of yourself!

Changing Culture

• Start today• Did you have any changes in perspective, beliefs, or perceptions?

• Did you identify anything you were doing that was reinforced?

• Did you identify any opportunities for improvement?

• What are your next steps to advance you preceptorship?

• With each student• Orientation and expectations

• First impressions

• Realistic “protection”

Changing Students’ Future Perspectives

• Invest in helping shape student attitudes, beliefs, and perspectives

• Consistently display the behaviors you expect students to mimic

• Incorporate your own teaching and learning style

Post-Test 1

True or false: One construct for teacher passion, as defined by

Wangberg, includes enthusiasm, immersion in the subject, innovation,

and teacher as learner.

A. True

B. False

Post-Test 2

Teacher passion can improve student motivation by:

A. Creating value for the student that is associated to the task at hand

B. Increasing trust and credibility between the preceptor and student

C. Helping set expectancy for success among students

D. All of the above

Post-Test 3

Which of the following feedback would encourage a growth mindset for

continued learning?

A. “You’re doing a great job on the rotation, keep up the good work.”

B. “You’re one of the brightest students I’ve precepted.”

C. “I can tell you are working very hard, continue to do XYZ.”

D. All of the above encourage growth

Post-Test 4

Which of the following is NOT a method of incorporating positive

expectations into a student’s learning experience?

A. Describing the attitude that is expected

B. Listing out paths to rotation failure

C. Using enthusiasm as a motivator

D. Framing with positivity