Enhancement of an Experiential - PowerPoint Presentation

Enhancement of an Experiential Education Rotation Utilizing the Methods of Excellent Preceptors Presented by Regina Tabor, RPh. and Dr. Nicole Farrell October 27, 2017 at the F eik school of pharmacy preceptor CE conference

Disclaimer The speakers do not have a vested interest in or affiliation with any corporate organization offering financial support or grant monies for this continuing education program, or any affiliation with an organization whose philosophy could potentially bias the presentation

Learning Objectives Recognize the characteristics of excellent preceptors in experiential education.Recognize the importance of an effective orientation process and an organized rotation experience.Identify your student’s professional goals and be familiar with their prior rotations and work experience.Recognize the importance of scheduling formal feedback and assessment time for constructive feedback to affect future learning.

Characteristics of Excellent Preceptors Regina Tabor RPh.

Characteristics of excellent preceptors Display a genuine interest in student learning and successRelating to the student as an individual, the characteristic most highly associated with excellent preceptors.Stimulated dialogue that encouraged critical thinking and aided in problem-solving.Consistently available for student questions and guidance.Provide useful feedback and clear expectations.Effectively organized appropriate learning activities.Dedicated time and energy to teaching student.Student-valued measurable teaching behaviors of award-winning pharmacy preceptors by TA O’Sullivan, et al. AJPE, 79.10, Dec 2015

Structuring Your Rotation Orientation-integrate learner into the practice setting Learning by doing-provide learners opportunities to engage in the practiceFeedback-ongoing informal feedback in addition to the midpoint and final evaluation-perspectives on performance and suggestions for improvement.WIFM-What’s In it for Me? Ways you can benefit personally from the presence of a student. Create learning opportunities for students that also meet the preceptor’s needs.Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg, 2016, page 6

Core Values for preceptors Professionalism: exhibit professional behavior and encourage students to become active members in organizationsDesire to educate and share knowledge and experiences: draw on your personal experiences.Help understand why something is importantWillingness to advise, mentor, and provide valuable feedback and direction: guide the student to become competent, independent and committed professional colleague.Willingness to commit the time necessary for precepting: preceptors must devote the extra time to effectively teach their learners in addition to their workload.Respect for others-being a positive role model: engaging colleagues, other health professionals and patients is critical to a student development.Willingness to work with a diverse student population: recognize and respect the differences in today’s students. Ethnic and gender diversity, students may have worked in another field, possess advanced degrees. Must be competent in your area of practice to precept the student. Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016, page 7

Advantages of having students on rotation site Infusion on site of intelligent practitioners who help keep the pharmacy knowledge base sharpened Journal clubs and formal presentations with up-to-date pharmacy information.Symbiotic learningPreceptors can influence future practitioners, influence the future of the profession for many years to come. Ultimately patient care is improved-the reason we practice pharmacy.Pharmacist extenders for internal projects and programs Pharmacy students utilized in hospital emergency rooms for medication reconciliationPharmacy students utilized for patient counseling and provision of immunizations in community pharmaciesPreceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016

Effective Orientation Nicole Farrell, PharmD.

Orientation: Why is it Necessary? Critical Foundational StepFirst ImpressionsRoad map for the rotationSets the tone for the rest of the internshipStrengthen preceptor & student relationshipPreceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016, page 108

Orientation: Pre-Rotation Initial Conversations (Preparatory information for rotation)Directions to the siteParking informationArrival timeMeeting placeItems to bringSite specific pre-rotation requirements (training, paperwork, pre-readings etc.)Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016, page 13

Orientation: What to Include Meet & GreetStudent background, pharmacy experience, career goalsPreceptor background, pharmacy experience, career goalsSiteTour of the department & facilityMap Mission, vision and history of company/organizationPersonnelPreceptors & Pharmacy StaffOrganization chart for the pharmacy department/key personnelDirectory (or key contacts)Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016, page 13

Orientation: What to Include Continued… SafetyPolicies and proceduresLicensure confirmation (student and preceptor)Contact information in case of an emergency or safety issueResourcesList of inventory (especially “fast movers”)Introduction to Information systemsIntroduction to pharmacy technologyPaper & electronic referencesPreceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016, page 109

Orientation: What to Include Continued… Calendar/Schedule:Assignments & deadlines (Journal club, case presentation, readings, topic discussions, etc.)Examples from years pastExample formatsActivities (counseling, shadowing, health screenings, medication reconciliation, etc.)Duties & responsibilities for which the student will be held accountableAssessments (e.g. CORE ELMS Rxpreceptor for Feik School of Pharmacy)QuizzesProblem setsFeedbackPreceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016, page 108

Building the schedule Include time for preceptor teaching and feedbackTime for students to reflect on their patient encountersProject completion timeShadowing opportunitiesUnplanned events that enhance an experienceInclude dates for midterm and final evaluations Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016.

SAMPLE SCHEDULE: Houston Methodist Monday Tuesday Wednesday Thursday Friday Week 1 9/26 9/27 9/28 9/29 9/30 Student 1 Training Training Training Med History Pyxis Feedback Student 2 Training Training Training Pyxis Med History Feedback Week 2 10/3 10/4 10/5 10/6 10/7 Student 1 Purchaser 9AM/Robot 10:30 AM Research Pharmacy 9:00 AM Nuclear Pharmacy 9:30 AM Call Center 10:00 AM Outpatient Care Feedback Student 2 Purchaser 9AM/Robot 10:30 AM Call Center 10:00 AM Nuclear Pharmacy 9:30 AM Research Pharmacy 9:00 AM Controlled substances Feedback

SAMPLE SCHEDULE: WeekDate Time Area Contact Person/Location 1 8/15 13:00-16:30 Meet Preceptor/Review rotation Objective Dr. John Smith   8/16 08:00-16:30 Central Pharmacy-Shadow Triage Pharmacist Dr. Ann Jones   8/17 08:00-10:00 10:00-16:00 Project Time Invest Drug Service-Central Rx Dr. Ann Jones   8/18 08:00-10:00 10:00-16:00 Project Time Invest Drug Service-Central Rx Dr. Ann Jones   8/19 08:00-16:00 Preceptor’s Floor /Week 1 Feedback Dr. John Smith 2 8/22 08:00-16:30 Clinical Pharmacist/Clinic Dr. Paul Smith   8/23 08:00-12:00 13:00-16:00 Clinical Pharmacist/Gen Medicine Project Time Dr. Mary Jones   8/24 08:00-16:00 Clinical Pharmacist/ Heart Failure and Transplant Dr. Susan Smith   8/25 08:00-16:00 Heart and Vascular Pharmacy/Staff Rx Dr. Linda Lee   8/26 08:00-12:00 Preceptor’s Floor/ Week 2 Feedback Dr. John Smith

Setting Rotation Goals Regina Tabor RPh.

Taking time with your intern Preceptors must keep in mind that more than anything else students want to spend quality time talking with and learning from their preceptor. Allow students to attend departmental meetings related to their experience. Use the students experiences, goals and interest to help tailor rotations to individual students.The first meeting with your student sets the tone for the entire training encounter.Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016.

Goal Setting for Rotation Utilize the IPPE and APPE Syllabi Found in RxPreceptor Document Library SectionIncludes Professional OutcomesRequired Activities for the Specific RotationTexas State Board of Pharmacy Objectives (Competencies 1-22)Intern Grading RubricProfessionalismClinical SkillsKnowledgeCommunication

Goal Setting for the Rotation Define Student Goals:What motivates them:Determining the students goals for the rotation and showing an interest in them as an individualBeing able to practice pharmacist skills with a preceptor before they are practicing soloWorking with a preceptor that treats them with respect as a colleague in trainingBuilding their professional confidence Having opportunities to witness a positive change from their activities is beneficial

Preceptor Goals for Student Utilization of the S.M.A.R.T. Method Specific-address the five W’s… who, what, when, where and whyMeasurable-define quantityAchievable-be within your control and influenceRelevant-instrumental to the mission of the department (pharmacy)Time-bound-identify a definite target date for completionwww.projectsmart.co.uk/smart-goals.php, accessed 10/17/16

Giving Effective Feedback Nicole Farrell, PharmD.

“We all need people who will give us feedback. That’s how we improve.” http://listabuzz.com/wp-content/uploads/2015/10/Bill-Gates-1.jpg

Feedback: Why is it Necessary? Feedback and evaluation are essential for:LearningImproving performanceReinforcing appropriate behaviorCorrecting deficiencies and promoting confidenceSilence can be destructiveProviding Effective Feedback by Lourdes Cuellar, July 26, 2016Tugend A. You’ve been doing a fantastic job. Just one thing… New York Times. April 5, 2013: http://www.nytimes.com/2013/04/06/your-money/how-to-give-effective-feedback-both-positive-and-negative.html?_r=0. Accessed October 2016.

Feedback: Tips Timely/ScheduledEnd of rotation = too late!PrivateSpecific Avoid: ‘That’s really good or that’s really bad”Separate emotional from technicalNegative feedback ≠ harsh/detrimental CollaborativePreceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016.Tugend A. You’ve been doing a fantastic job. Just one thing… New York Times. April 5, 2013: http://www.nytimes.com/2013/04/06/your-money/how-to-give-effective-feedback-both-positive-and-negative.html?_r=0. Accessed October 2016.

Feedback: Tips Begin with genuine praise and honest appreciationPositive feedback ≠ empty flatteryWord choice mattersPixar & “plussing”“What if” & “and” versus “but”I am really proud of your customer service, but your sales numbers are really abysmalI am really proud of your customer service, and with your continued efforts your sales numbers should rise. What if you tried XYZ…Be relatable & approachableReal life experiences (struggles and successes: Lifetime learning habits, job application, interviewing skills, etc.)Carnegie D.  If you must find fault, this is the way to begin. In:   Pell AR,  ed.   How to win friends & influence people.    New  York,  NY:   Gallery Books;   1981:193-198.   Tugend A. You’ve been doing a fantastic job. Just one thing… New York Times. April 5, 2013: http://www.nytimes.com/2013/04/06/your-money/how-to-give-effective-feedback-both-positive-and-negative.html?_ r=0. Accessed October 2016. Carnegie D.    How to criticize and not be hated for it. In :   Pell AR,  ed.   How to win friends & influence people.    New  York,  NY:   Gallery Books;   1981:199-202.  

Learning Prescription [Insert your facility]For Date 2 things student did well: 1. 2. 2 things student should work on or future learning issue: 1. 2. May Substitute May Not Substitute R.Ph . Refill ______ Times in ______ Months Used with permission from Todd Canada,PharmD , BCNSP, FASHP, University of Texas MD Anderson Cancer Center

Feedback: Understand your students generation Millennials are very comfortable with technology and can be impatient with more traditional communication methods.They like and want praise. UpbringingBeginners vs. Seasoned veteransThey need more personalized feedback, coaching and mentoring.Providing effective Feedback by Lourdes Cuellar, July 26, 2016Finkelstein SR, Fishbach A. Tell Me What I Did Wrong: Experts Seek and Respond to Negative Feedback. Journal of Consumer Research. 2012;39:22-37. 

Resources

Available Preceptor References: Books Cuellar L, Ginsburg D. Preceptors Handbook for Pharmacists. 3rd ed. Bethesda, MD: American Society of Health-System Pharmacists;2016. Dotey RE. Getting Started as a Pharmacy Preceptor. Washington, DC: American Pharmacists Association;2011. Soric MM. Maximize Your Rotations: ASHP’s Student Guide to IPPEs, APPEs, and Beyond. Bethesda, MD: American Society of Health-System Pharmacists;2013. Peripheral Brain for the Pharmacist. 5th ed. Washington, DC: American Pharmacists Association;2016.

Available Preceptor References: Books http://store.ashp.org/Default.aspx?TabId=216&ProductId=34546482. Accessed Oct. 2016http://www.amazon.com/Getting-Started-As-Pharmacy-Preceptor/dp/158212146X. Accessed Oct. 2016 http://www.pharmacist.com/apha-releases-new-edition-popular-reference-material-peripheral-brain-pharmacist. Accessed Oct. 2016 http://store.ashp.org/Default.aspx?TabId=216&ProductId=4221. Accessed Oct. 2016

Preceptor Resources: Miscellaneous Other preceptors may be willing to share materials (orientation checklist, calendars, syllabi).TCEP Toolkit on CORE ELMS (Rxpreceptor) account home page Document Library Preceptor Toolkit Grading Rubrics folder (Click on blue button to Open File )IPPE and APPE Syllabi on CORE ELMS (Rxpreceptor) account home page Document Library Folder for APPE Syllabi and folder for IPPE Documents (Click on blue button to Open File)

QUESTIONS?

Post-Test Questions Which of the following is NOT a characteristic of an excellent preceptor? (Objective #1)Relating to the student as an individualProviding useful feedback and clear expectationsEffectively organizing appropriate learning activitiesConsistently available for student questions.Keeping to your 8 hour schedule and not having time for student inquiries The structure of the experiential rotation does not matter; the student can absorb the information be observing a busy pharmacy. (Objective #2) True False

Post-Test Questions Your student’s professional goals and their work experience can be determined by which of the following methods. (Objective #3)Meeting with your pharmacy intern to discuss their goals and experience in pharmacyObtaining your student’s CVReviewing your student’s portfolioReviewing your student’s introductory email prior to the start of the rotation experienceAll of the aboveConstructive feedback can contribute to improved performance and develop self-confidence. (Objective # 4)TrueFalse