maria miller 847 ppt
TRANSCRIPT
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Cognitive Apprenticeship in a Long-Term Care
Pharmacy
Maria MillerClemson University
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Green Pharmacy dispenses prescriptions to residents of long-term care facilities
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Problem: packaging mistakes leading to potentially harmful or fatal patient outcomes
– Wrong medication
– Wrong strength
– Wrong quantity
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Adverse outcomes to medication errors can produce serious results
Sub-theraputic or overdosing Patient harm or death
Legal action Fines
Loss of licensure
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Green Pharmacy went on a Performance Improvement/Root Cause Analysis journey to determine the cause of packaging errors
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The analysis determined that the performance gap was due to training issues
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Pharmacy technicians spend 9 months in a classroom-based vocational training program
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New technicians begin work without much hands-on experience
They learn the trade by being paired with an experienced technician
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The Apprenticeship Model
• Modeling: the instructor demonstrates and narrates how to perform a task
• Coaching: the student performs the task while the instructor watches and coaches
• Scaffolding: as the student becomes increasingly more competent, the instructor pulls away support
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• Instructors would explain how to perform tasks, but not necessarily why a task needed to be performed a particular way
• The work was not organized in a way conducive to training a new technician
• Having multiple instructors made it difficult for trainees to see the ‘big picture’ view
• Sometimes trainees picked up bad habits
The downside to the apprenticeship model
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The Cognitive Apprenticeship Model
Adds these features
• Articulation: the trainer questions the student and also stimulates the student to ask questions
• Reflection: encouraging the student to be aware of his/her own strengths and weaknesses
• Exploration: encouraging students to formulate and
pursue learning goals
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The cognitive apprenticeship model bridges the gap between schooling and work by helping students use the information learned in school within the context of the work setting
Knowledge + Appropriate Training = Success
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Conclusion
Green Pharmacy has adopted the cognitive apprenticeship model to training new pharmacy technicians with the expectation that better trained technicians will make fewer errors