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Presented by Regina Tabor, RPh. and Dr. Nicole Farrell

Enhancement of an Experiential E ducation Rotation U tilizing the Methods of Excellent P receptors. Presented by Regina Tabor, RPh. and Dr. Nicole Farrell October 27, 2017 at the F eik school of pharmacy preceptor CE conference. Disclaimer.

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Presented by Regina Tabor, RPh. and Dr. Nicole Farrell

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  1. 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 Feik school of pharmacy preceptor CE conference

  2. 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

  3. 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.

  4. Characteristics of Excellent Preceptors Regina Tabor RPh.

  5. Characteristics of excellent preceptors Student-valued measurable teaching behaviors of award-winning pharmacy preceptors by TA O’Sullivan, et al. AJPE, 79.10, Dec 2015 • Display a genuine interest in student learning and success • Relating 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.

  6. Structuring Your Rotation • Orientation-integrate learner into the practice setting • Learning by doing-provide learners opportunities to engage in the practice • Feedback-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

  7. Core Values for preceptors • Professionalism: exhibit professional behavior and encourage students to become active members in organizations • Desire to educate and share knowledge and experiences: draw on your personal experiences. • Help understand why something is important • Willingness 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

  8. 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 learning • Preceptors 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 reconciliation • Pharmacy students utilized for patient counseling and provision of immunizations in community pharmacies Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016

  9. Effective Orientation Nicole Farrell, PharmD.

  10. Orientation: Why is it Necessary? • Critical Foundational Step • First Impressions • Road map for the rotation • Sets the tone for the rest of the internship • Strengthen preceptor & student relationship Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016, page 108

  11. Orientation: Pre-Rotation • Initial Conversations (Preparatory information for rotation) • Directions to the site • Parking information • Arrival time • Meeting place • Items to bring • Site specific pre-rotation requirements (training, paperwork, pre-readings etc.) • Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016, page 13

  12. Orientation: What to Include • Meet & Greet • Student background, pharmacy experience, career goals • Preceptor background, pharmacy experience, career goals • Site • Tour of the department & facility • Map • Mission, vision and history of company/organization • Personnel • Preceptors & Pharmacy Staff • Organization chart for the pharmacy department/key personnel • Directory (or key contacts) • Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016, page 13

  13. Orientation: What to Include Continued… • Safety • Policies and procedures • Licensure confirmation (student and preceptor) • Contact information in case of an emergency or safety issue • Resources • List of inventory (especially “fast movers”) • Introduction to Information systems • Introduction to pharmacy technology • Paper & electronic references Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016, page 109

  14. Orientation: What to Include Continued… • Calendar/Schedule: • Assignments & deadlines (Journal club, case presentation, readings, topic discussions, etc.) • Examples from years past • Example formats • Activities (counseling, shadowing, health screenings, medication reconciliation, etc.) • Duties & responsibilities for which the student will be held accountable • Assessments (e.g. CORE ELMS Rxpreceptor for Feik School of Pharmacy) • Quizzes • Problem sets • Feedback Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016, page 108

  15. Building the schedule • Include time for preceptor teaching and feedback • Time for students to reflect on their patient encounters • Project completion time • Shadowing opportunities • Unplanned events that enhance an experience • Include dates for midterm and final evaluations Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016.

  16. SAMPLE SCHEDULE: Houston Methodist

  17. SAMPLE SCHEDULE:

  18. Setting Rotation Goals Regina Tabor RPh.

  19. 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.

  20. Goal Setting for Rotation • Utilize the IPPE and APPE Syllabi • Found in RxPreceptor Document Library Section • Includes Professional Outcomes • Required Activities for the Specific Rotation • Texas State Board of Pharmacy Objectives (Competencies 1-22) • Intern Grading Rubric • Professionalism • Clinical Skills • Knowledge • Communication

  21. 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 individual • Being able to practice pharmacist skills with a preceptor before they are practicing solo • Working with a preceptor that treats them with respect as a colleague in training • Building their professional confidence • Having opportunities to witness a positive change from their activities is beneficial

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

  23. Giving Effective Feedback Nicole Farrell, PharmD.

  24. “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

  25. Feedback: Why is it Necessary? 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 and evaluation are essential for: • Learning • Improving performance • Reinforcing appropriate behavior • Correcting deficiencies and promoting confidence • Silence can be destructive Providing Effective Feedback by Lourdes Cuellar, July 26, 2016

  26. Feedback: Tips 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. Preceptor’s Handbook for Pharmacists-3rd edition Cuellar and Ginsburg 2016. • Timely/Scheduled • End of rotation = too late! • Private • Specific • Avoid: ‘That’s really good or that’s really bad” • Separate emotional from technical • Negative feedback ≠ harsh/detrimental • Collaborative

  27. Feedback: Tips 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. 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. • Begin with genuine praise and honest appreciation • Positive feedback ≠ empty flattery • Word choice matters • Pixar & “plussing” • “What if” & “and” versus “but” • I am really proud of your customer service, but your sales numbers are really abysmal • I am really proud of your customer service, and with your continued efforts your sales numbers should rise. What if you tried XYZ… • Be relatable & approachable • Real 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.

  28. 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

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

  30. Resources

  31. 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.

  32. Available Preceptor References: Books http://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 http://store.ashp.org/Default.aspx?TabId=216&ProductId=34546482. Accessed Oct. 2016

  33. 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)

  34. QUESTIONS?

  35. Post-Test Questions • Which of the following is NOT a characteristic of an excellent preceptor? (Objective #1) • Relating to the student as an individual • Providing useful feedback and clear expectations • Effectively organizing appropriate learning activities • Consistently 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

  36. 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 pharmacy • Obtaining your student’s CV • Reviewing your student’s portfolio • Reviewing your student’s introductory email prior to the start of the rotation experience • All of the above • Constructive feedback can contribute to improved performance and develop self-confidence. (Objective # 4) • True • False

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