Maximize Your Preceptor Interaction!

Strategies for Precepting Different Level Learners

Natalie R. Buening, PharmD, BCPSHealth Sciences Assistant Clinical ProfessorDirector – South Bay Experiential Program

University of California, San FranciscoSchool of Pharmacy

Disclosure

The speaker has no actual or potential Conflict of Interest in relation to this presentation.

Discuss current pharmacy preceptor demand

Review differences between precepting student vs. resident learners

List advantages and challenges of precepting different level learners

Discuss approaches to effectively precept different level learners

Learning Objectives

Demand/residency program design

ASHP requirements

Lack of literature

Real differences

Advantages

Challenges

Why?

Numbers

Expectations◦ Present◦ Future

Experiences

Practice models

Demand

Brown DL. Am J Pharm Educ. 2013;77(5):Article 90Smith KM et al. Pharmacotherapy. 2010;30(12): 490e – 510e

ASHP. Am J Health Syst Pharm. 2007;64(12):1320-30

Discuss with your neighbor some key differences between student and resident learners in regards to career paths, interaction with preceptors, training locations, etc.

Think – Pair – Share

DifferencesStudents ResidentsWide variety of career paths, interests and abilities

Higher performers, career goals that match the practice site

Volume of preceptors that lack connection

Smaller group of colleague preceptors

Geographic spread Same practice setting

Competing expectations Focused training program

Volunteer vs. fee - for - service Incorporated in job responsibilities

Smith KA. Accessed 6/10/15 http://www.ashp.org/Doclibrary/MemberCenter/Webinars/ASHP-Residency-Preceptors-Webinar.aspx

Preceptor◦ Experience◦ Multiple precepting roles◦ Multiple interactions

Learner◦ Experience◦ Collaboration◦ Connection◦ Interactive learning◦ Feedback

Advantages

Schwenk TL. Accessed 6/10/15 www.crlt.umich.edu/publinks/occ1.pdfPinder-Grover T and Groscurth CR. Accessed 6/10/15 http://www.crlt.umich.edu/sites/default/files/resource_files/CRLT_no26.pdf

Preceptor◦ Time◦ Multiple learning styles◦ Multiple goals/objectives◦ Less structured learning environment

Learner◦ Mismatched learners◦ Mismatched learning styles◦ Multiple goals/objectives◦ Multiple preceptors◦ Less structured learning environment

Challenges

Schwenk TL. Accessed 6/10/15 www.crlt.umich.edu/publinks/occ1.pdfPinder-Grover T and Groscurth CR. Accessed 6/10/15 http://www.crlt.umich.edu/sites/default/files/resource_files/CRLT_no26.pdf

Discuss with your neighbor different approaches to address the challenges of precepting different level learners simultaneously.

Think – Pair – Share

Analyze situational Factors

Develop activities for specific goals and objectives

Plan feedback and evaluation

Plan interactive learning activities

Check for alignment of all components of the learning experience

Evaluate the experience and make changes

Solutions

Collins J. RadioGraphics 2007;27:1511-1517

Learner pre-rotation evaluation form

Goal sheet

Learner portfolio review

Learning style evaluations/preceptor development topic

Analyze Situational Factors - Learner

Collins J. RadioGraphics 2007;27:1511-1517

Rotation syllabi

Targeted rotation expectations

Future strategy: preceptor teaching philosophy

Analyze Situational Factors - Preceptor

Collins J. RadioGraphics 2007;27:1511-1517

Activities for Goals and Objectives Focus

◦ Goal: global learning outcome

◦ Objective: learner performance

◦ Activity: learner exercise

Strategies◦ School of pharmacy competencies/expectations

◦ Assign specific goals, objectives and activities for each rotation experience

◦ Development plans

ASHP. Accessed 9/9/15. http://www.ashp.org/doclibrary/accreditation/newly-approved-pgy1-standard-september-2014.pdf Collins J. RadioGraphics 2007;27:1511-1517

Student Rotation Syllabus

Student Rotation Syllabus

Rounds

Patient profiles

Documentation

Discussions

Meetings

Education activities

Student Activities and Responsibilities

Student Activities and Responsibilities

Student Activities and Responsibilities

PGY1 Learning Experience Description

Goal: Application of knowledge and skills to the practice setting

Objective/competency◦ Describe the pathology of diseases◦ Describe the mechanism of action of medications (efficacy/toxicity)

◦ Apply mathematical principles in pharmacy practice

Activities: What will the student do to meet this goal and corresponding objectives?

Example: Student rotation syllabus

PGY1 Learning Experience Description

PGY1 Learning Experience Description

Preceptor Interaction PGY1

The resident and preceptor will meet at a minimum for pre-rounds each day to touch base about patients and daily in the afternoon. The preceptor may or may not be present with the resident during rounds or conference. It is expected that the resident and preceptor will meet at least two times per week for in depth formal topic discussions as well.

PGY2The resident and preceptor will meet at a minimum of once a day to touch base about patients. The preceptor may or may not be present with the resident during round or conference. It is expected that the resident and preceptor will meet at least one to two times per week for in-depth formal topic discussions as well.

Expected Progression: Week 1&2 PGY1

The resident will be assigned50-100% of the Burn team.The resident will meet withThe preceptor daily for prerounds. The resident may be looking for validation oftherapeutic plans for both corecommon and less commondisease states at this time.The preceptor will attend roundsand model team and patientinteractions

PGY2The resident will be assigned allpatients on the Burn team. The resident will meet with thepreceptor at least once daily todiscuss patients. The resident maybe looking for validation oftherapeutic plans for both corecommon and less common diseasestates at this time. The preceptor will attend rounds and model team and patientinteractions as needed.

Expected Progression: Week 3&4 PGY1

The resident will be assigned allpatients on the Burn team. The resident should meet with thepreceptors daily for pre-rounds. The resident may be looking for validation of the therapeuticplan for uncommon diseasestates. The preceptor will attendrounds at a minimum of one totwo days per week.

PGY2The resident will continue tofollow all patients on the Burnteam. The resident should meet with the preceptor at least oncedaily to discuss patients. The resident may be looking forvalidation of the therapeutic plan for uncommon disease states. The preceptor will try to limit interactions to allow the resident to develop autonomy.

Targeted Expectations

Plan Feedback and Evaluation Focus

◦ Feedback

◦ Evaluation

Strategies◦ Preceptor development topic◦ Snapshots◦ Daily documentation form

◦ Midpoint evaluations◦ Customized evaluations◦ Summative evaluations

◦ Targeted preceptor evaluations◦ Student reflections◦ Daily documentation form

Collins J. RadioGraphics 2007;27:1511-1517

Plan Interactive Learning Activities Focus

◦ Active learning

◦ Activities should be aligned with goals, objectives and evaluation

Strategies◦ Group discussions◦ Learner lead discussions◦ Preceptor lead discussions◦ Group rounds◦ Simulations◦ Case based presentations

Collins J. RadioGraphics 2007;27:1511-1517

Group approach◦ Learning activities◦ Evaluations◦ Resident preceptor involvement

“One Minute Preceptor” model

Four preceptor roles

Additional Solutions

Check for alignment of all components of the learning experience

Make appropriate changes

Evaluate and Make Improvements

Utilize available resources and documents

Set expectations

Determine the need for additional guidance

Be realistic

Give up “total control”

In Summary

Which of the following are tools that can aid in the assessment of learner expectations when designing a rotation experience?

A. Pre-rotation assessment forms

B. Targeted rotation expectations

C. Resident intro-evaluations

D. A and C

E. All of the above

Answer: D

Learning Assessment Question #1

Which of the following focus areas can be used to set expectations between different level learners?

A. Preceptor interaction

B. Learning experience activities

C. Expected progression

D. A and C

E. All of the above

Answer: E

Learning Assessment Question #2

Which of the following is an active learning activity that can incorporate different level learners?

A. Group patient care rounds

B. A student patient case presentation to the group utilizing power point slides

C. A resident presenting a handout to the students on warfarin discharge counseling

D. The preceptor providing a journal article to the group for review Answer: A

Learning Assessment Question #3

Brown DL. A looming joblessness crisis for new pharmacy graduates and the implications its holds for the academy. Am J Pharm Educ. 2013;77(5):Article 90.

Smith KM et al. Value of conducting pharmacy residency training – an organization perspective. Pharmacotherapy. 2010;30(12): 490e - 510e.

ASHP. Long range vision for the pharmacy workforce in hospitals and health systems: ensuring the best use of medicines in hospitals and health systems. Am J Health Syst Pharm. 2007;64(12):1320 - 30.

Smith KA. Practical approaches to developing residency preceptors. http://www.ashp.org/Doclibrary/MemberCenter/Webinars/ASHP-Residency-Preceptors-Webinar.aspx Accessed 6/10/15.

Schwenk TL. Center for research on learning and teaching occasional paper No.1: clinical teaching. www.crlt.umich.edu/publinks/occ1.pdf Accessed 6/10/15.

Pinder-Grinder T and Groscurth CR. Center for research on learning and teaching occasional paper No. 26: principles for teaching the millennial generation: innovative practices for UM faculty. http://www.crlt.umich.edu/sites/default/files/resource_files/CRLT_no26.pdf Accessed 6/10/15

ASHP. Accreditation standard for post graduate year one (PGY1) pharmacy residency programs 2014.http://www.ashp.org/doclibrary/accreditation/newly-approved-pgy1-standard-september-2014.pdf. Accessed 9/8/15.

Collins J. Designing learning experience. RadioGraphics. 2007;27:1511 - 1517.

References

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