Developing Preceptor Development Kyle A Gustafson, PharmD, BCPS, BCCCP PGY-1 Residence Program Director Southwest General Hospital

Objectives Identify current weaknesses in preceptor development nationally Develop a system to encourage and track individual preceptor development Institute departmental practices that allow for preceptor development

Why Preceptor Development? Simply: because ASHP requires it Reduces areas of partial compliance 4.4 RPDs have responsibility for… C: implementing use of criteria for appointment and reappointment of preceptors D: evaluation, skills assessment, and development of preceptors in the program E: creating and implementing a preceptor development plan for the residency program 4.7 Preceptors must… D: demonstrate practice expertise, preceptor skill, and strive to continuously improve 4.8 Preceptor qualifications A: …by use of clinical teaching roles (instructing, modeling, coaching, facilitating) at the level required by the resident F: ongoing professionalism, including a personal commitment to advancing the profession ASHP Accreditation Standard For Postgraduate Year One Pharmacy Residency Programs (2016)

Why Preceptor Development? Precepting is a difficult skill to master Many preceptors are clinically trained Less are educationally trained Open opportunity to interact with other preceptors Idea exchange and practice development Encourages preceptor consistency across key points Evaluation style Evaluation definitions Learning experience write-ups

So... How Are We Doing Not that well… (2005 Standards) Standard % Citied NC or PC 5.9 Preceptors do not meet 4/7 criteria for commitment and contribution to pharmacy (PGY-2 Standard) 77% 4.4e The RPD serves as the organizationally authorized leader of the residency program and has responsibility for creating and implementing a preceptor development plan for the residency program 45% ASHP Communique Fall 2016

So… How Are We Doing? 2014 Standards Standard % Citied NC or PC 3.4.c At the end of each learning experience, residents receive, and discuss with preceptors, verbal and written assessment on the extent of their progress toward achievement of assigned educational goals and objectives, with reference to specific criteria 88% 4.8.f Preceptors demonstrate ongoing professionalism, including a personal commitment to advancing the profession 57% 3.3.c Learning experiences include expectations of residents ASHP Communique Spring 2017

Raising the Bar New guidance documents by ASHP (April 2018) Tighter definitions of 4.8e (recognition) “Preceptors must have one of the following” Board certification Multidisciplinary certification (DE, CHC, etc) Fellow status Advanced degree Formal recognition from peers (Awards) Credentialing and privileging >30% fail to meet, will impact duration of accreditation https://www.ashp.org/professional-development/residency-information/residency-program-directors/residency-accreditation/accreditation-standards-for-pgy1-pharmacy-residencies

Raising the Bar 4.8.f “ongoing professionalism, including a personal commitment to advancing the profession” Increase from 1 activity to 3 activities in past 5 years Serve as a reviewer Presentation/poster/publication Co-author with student or resident at a professional meeting Active service in professional organization Evaluator at regional residency conference Routine in-service presentations to pharmacy or other providers Primary preceptor for pharmacy students Pharmacy technician educator Preceptor development on site Public health activities Publication of original research Publication or presentation of case reports Didactic education of pharmacy or professional students (non-precepting) https://www.ashp.org/professional-development/residency-information/residency-program-directors/residency-accreditation/accreditation-standards-for-pgy1-pharmacy-residencies

What Makes A Preceptor Eligibility (4.6) (Critical Factor) ASHP accredited PGY-1 residency followed by a minimum of one year of experience ASHP accredited PGY-2 residency followed by six months of experience Three or more years of pharmacy practice experience

What Makes A Preceptor Qualification (4.8) (Critical Factor) Demonstrate the ability to precept a residents learning experiences by meeting one or more qualifying characteristics in all of the following six areas Demonstrating the ability to precept residents’ learning experiences by use of clinical teaching roles (instructing, modeling, coaching, facilitating) at the level required by residents The ability to assess residents’ performance Recognition in the area of pharmacy practice for which they serve as preceptors An established, active practice in the area they serve as preceptors Maintenance of continuity of practice during the time of residents’ learning experience Ongoing professionalism, including a personal commitment to advancing the profession

3 Keys To Compliance Documentation Organization Preceptor engagement

Documentation Standardized formatting to meet ASHP criteria Academic and professional record (APR) Replaces curriculum vitae Addresses the old 2005 standards (4/7) Doesn’t address several key preceptor qualification Demonstrate ability to precept residents’ experience by using learning roles Ability to assess residents’ performance Maintenance of continuity of practice during the time of residents’ learning experiences Southwest uses a “Preceptor Application” to ensure preceptors have appropriate qualifications

Documentation Preceptor development tracking In addition to updated APR Must track preceptor growth over time Must demonstrate competence in areas where APR is lacking Southwest has opted for an every two year preceptor model Coincides with RPD/Preceptor meeting Ensures follow-up with: Learning experience updates Evaluation timing and quality Professional growth and contribution Keep attendance records for specific events RAC meeting minutes

Organization ”Doable” and repeatable Complicated or aggressive policies are difficult to enforce RAC should help with the development Standing meetings and agenda items Limited number of documents Kept in the same place Schedule “preceptor development” activities well in advance Post activities online for those who can’t attend live Take advantage of existing resources Pharmacist Letter Colleges of pharmacy (student precepting) Regional and national preceptor conferences Leverage what you are already doing Pearls, student presentations, skills fairs

Preceptor Engagement Many preceptors but only 1 RPD Shift responsibility for development to the preceptors Documentation should fall on the preceptors Encourage preceptors to “lead” on-site development sessions Tackle key areas of partial compliance Allows preceptors to become more familiar with ASHP standards RAC involvement in creation and enforcement of the standards

What Are Your Best Practices?