The “Whys” and “Hows” of a Comprehensive Preceptor Development Program Toyin Tofade, MS, PharmD, BCPS, CPCC

Objectives  Discuss the 2016 ACPE Standards that relate to preceptor development  List essential and optional components of a comprehensive preceptor development program  Identify common themes in preceptor development programs relevant to pharmacy education  Compare and contrast select preceptor development programs

No Conflicts of Interest

Insert Poll Do you require preceptors to complete a particular preceptor development program or module? Yes or No

Introduction  ACPE 2016 Standards released – Feb 2015 Standards 2016Standards 2007 Standard 20: Preceptors Standard 24: Faculty and Staff – Quantitative Factors Standard 25: Faculty and Staff – Qualitative Factors Standard 26: Faculty and Staff Continuing Profession Development

Preceptor education and development(Standard 20.3) 1. Preceptors are oriented to the program’s mission, the specific learning expectations for the experience outlined in the syllabus, and effective performance evaluation techniques before accepting students. 2. The college or school fosters the professional development of its preceptors commensurate with their educational responsibilities to the program.

Additional Guidance (20f)  Orientation to the college or school’s mission, goals, and values  Review of the college or school’s curriculum and teaching methods  Review of the specific objectives for the pharmacy practice experiences  Guidance regarding the assessment of students’ prior knowledge and experience relative to the rotation’s objectives.

Additional Guidance (20f)  Orientation to systems in place to assist preceptors in dealing with serious student problems and/or unprofessional student behaviors  Review of the college or school’s performance assessment and grading systems, and policies to address behavioral problems or misconduct

Why develop preceptors?  It is the school’s/college’s responsibility to ensure the quality and integrity of the experiential education program – Quality assurance focusing on individual preceptor and site needs – Adequate orientation and development of preceptors  Challenges include multiple preceptors, sites and rotation types and level of experience

The Facts At least 50% or more of the experiential education learning opportunities are taught by outside pharmacist preceptors >82% of schools/colleges use faculty who are jointly funded with practice sites Approximately 60% of the total APPE rotations are provided by adjunct or volunteer faculty.

More Facts Need for qualified preceptors is growing with new schools/colleges, expansion in existing programs, and expansion of experiential load Preceptors who receive formal preceptor training generally respond that they are more confident

AACP Task Force Findings 2002  40/90 Programs responded-44%  36 had preceptor development programs  A total of 250 objectives Objective CategoryPercent(%) Motivation and Teaching Skills24 Providing Feedback21 Precepting practice18 Setting expectations16 Policy and procedures11 Other10 Cynthia J. Boyle, Sian Carr-Lopez, Nancy E. Kawahara, Mara A. Kieser, Carla J. See, and Geralynn B. Smith. Am. J. Pharm. Educ., 66, 42S-43S(2002)

Who Develops the Programs?  Experiential office/directors – 52.8%  Experiential + pharmacy practice – 14%  Experiential + pharmacy practice + preceptors – 14% Cynthia J. Boyle, Sian Carr-Lopez, Nancy E. Kawahara, Mara A. Kieser, Carla J. See, and Geralynn B. Smith. Am. J. Pharm. Educ., 66, 42S-43S(2002)

Program Details  ACPE Hours range from 0-40 hrs  Live programs constitute 75% of offerings  Average Attendance – New preceptors 48.6% (3-100%) – Experienced preceptors 32.6% (5- 98%) Cynthia J. Boyle, Sian Carr-Lopez, Nancy E. Kawahara, Mara A. Kieser, Carla J. See, and Geralynn B. Smith. Am. J. Pharm. Educ., 66, 42S-43S(2002)

National Preceptor Survey 2008  9 Programs and 4,396 sites involved  300 IPPE and 1,440 APPE hr stipulation  41 questions – Time spent with student and quality of instruction – Forms of compensation – APPE requests – 20% did not feel they spend enough time with the student to provide a quality experience Maryann Z. Skrabal, Rhonda M. Jones, Ruth E. Nemire, Cynthia J. Boyle, et. Al. AJPE 2008; 72 (5) Article 112.

Suggestions for development  Appropriate time allotted for student supervision – varies based on site and rotation type  Potential student activities on rotation  Develop workload balance issues for sites and preceptors  Designing quality interactions that facilitate self directed learning and action  Practitioner vs Teacher Maryann Z. Skrabal, Rhonda M. Jones, Ruth E. Nemire, Cynthia J. Boyle, et. Al. AJPE 2008; 72 (5) Article 112.

Development needs of Volunteer Preceptors – 2011  N=576, 40.9% response  48.1% indicated students helped complete the task  29.5% agreed that students helped decrease overall workload – 48.1% helped complete daily tasks – 67.8% extended patient care Assemi M, Corelli RL, Ambrose PJ. Development needs of volunteer pharmacy practice preceptors. Am J Pharm Educ. 2011; 75(1):Article 10.

Insert POLL Slide What do you think was the most popular topic for the preceptors during the study? 1. Engaging and motivating students 2. Update on teaching/precepting strategies 3. Questioning students effectively 4. Communicating effectively with students 5. Working effectively with different adult learning styles

Most Popular Areas for Preceptor Development/Education 1. Engaging and motivating students (69%) 2. Update on teaching/precepting strategies (60%) 3. Questioning students effectively (59%) 4. Communicating effectively with students (49%) 5. Working effectively with different adult learning styles (49%) 6. Assessing student performance (47%) 7. Effectively integrating students into day to day workplace activities (42%) Assemi M, Corelli RL, Ambrose PJ. Development needs of volunteer pharmacy practice preceptors. Am J Pharm Educ. 2011; 75(1):Article 10.

The “Hows” of Preceptor Development  Ideally preceptor development should be self-directed, a professional responsibility and a life long process.  Hence the term “Continuing Professional Development” (CPD)  Unfortunately, some professionals fall short hence the need for schools to monitor closely

Goals of CPD  Enhance preceptors’ knowledge, skills, professional attitudes and behaviors, and values  Education and development should be – Individual and site specific – Outcomes based  Framework for lifelong learning

CPD Model

Reflect – Needs Assessment Does your program have a benchmark for success? How will you prioritize issues? Based on your assessment data, plan your focus – Site specific issues or preceptor specific – Orientation versus development – First time or seasoned preceptor – Individual versus group development Know your preceptor demographic – Single versus multiple learners on rotations

PLAN-S.M.A.R.T Goals  Specific  Measurable  Achievable  Relevant  Timed  Goals and objectives that are SMART are more likely to be accomplished

PLAN – Identify Development Topics Orientation to school/college and EE program Providing effective and timely feedback through formal and informal evaluations Setting expectations for the rotation Motivating students for success Dealing with difficult students Dealing with different learners on rotation Transitioning from preceptor to mentor

Self Reflection Exercise What are you currently doing for preceptor development – Reflect What circumstances or issues concerned you this past year about your preceptors or sites? What information was notable for you during your site visits? (What is working and what is not?) Please use the text/messaging section on the webinar platform

More Self Reflection- Homework What themes did you notice from student evaluations of preceptors this past year? (What they liked and what could be different) What were the main frustrations in interacting with preceptors this past year? (office perspective)

Preceptor Training Essential Components Orientation to the college’s or school’s mission, goals, and values Review of the college’s/school’s curriculum and teaching methodologies Review of the specific objectives for the pharmacy practice experiences Guidance regarding the assessment of student pharmacists’ prior knowledge and experience relative to the rotation’s objectives Review of the college’s or school’s performance assessment and grading systems.

Additional Topics to Consider Putting together a learning contract for your rotation Evaluating the student Providing feedback How to precept the student in practice Modeling the way Student learning styles Generational differences in learning and teaching Inspiring professionalism in practice

Self/Group Activity Where would you like to go? – Plan Write out one SMART goal for your program today. Please use the text/messaging tool on the webinar platform

Other Questions to Consider Where do you see the needs for preceptors in your program? What successes could be transferred to other sites or preceptors? How might you turn those concerns, frustrations or successes into teachable or development topics?

SMART Goals  Specific  Measurable  Achievable  Relevant  Timed

Executing the Program LEARN – ACT Individual preceptor or group development – Multiple preceptors at one site – May be a combination of group presentation and individual short sessions First time versus more experienced preceptors – In depth review of program and assessment for all first time preceptors with continual refreshers and updates

Executing the Program Case based scenarios versus general topic discussion Education delivery – School/college – Live, live or pre- recorded webinars, phone – Outside – Pharmacist’s letter, CEI, – National resources – ASHP, APhA – Education Scholar Program – AACP – Statewide and regional resources – Consortia, associations – Other health professions

Evaluating the program  Depends on the type of program – Workshop – Webinar – Webcast – Live lecture – Home study

CPD Model

Insert Poll How often do you conduct Live sessions?  Annually  One a month  Once a quarter  Every other month  Once every other year

Insert Poll On average, how many people attend each live session?  <15       >150

Maryland Schools  Collaborate at State Association Meetings providing Preceptor Development (MPhA, MSHP)  Offer individual on-line (webinars, Pharmacists Letter) and school specific preceptor orientation and live training  Executed a live Preceptor Development Program to all preceptors in the state  Collaborate with Mid Atlantic Experiential Consortium (MEC) resources

MEC Members DCMDVAWVA 1. Howard University 2. Notre Dame of Maryland Univ 5. Appalachian College of Pharmacy 9. Marshall Univ 3. Univ of Maryland6. Hampton Univ10. Univ of Charleston 4. Univ of Maryland Eastern Shore 7. Shenandoah Univ 11. West Virginia Univ 8. Virginia Commonwealth Univ

Common Processes in MEC Schools  Review feedback from preceptors and students – This type of assessment includes the preceptor’s ability to: (ACPE Guideline 20g) – (1) facilitate learning, – (2) communicate effectively, – (3) serve as a professional role model and mentor, and – (4) positively represent and advance the profession.

Common Processes in MEC Schools  Conduct site visits for personal development  Collaborate at statewide associations and endeavors  Provide live preceptor development sessions at least annually  Supplement with periodic sessions via webinars, webcasts or alternative training options, pharmacists letter, etc.

Insert Poll Which modality have you found to be the most successful for preceptor development?  Webinars  Webcasts  Live sessions  Printed materials delivered to preceptors by mail or electronically  External vendors – pharmacists letter, CEI, ASHP or APhA resources

Compare and Contrast Select Preceptor Development Programs James D. Scott, PharmD, M.Ed., FCCP, FASHP, FCSHP Associate Dean for Experiential and Professional Affairs Western University of Health Sciences College of Pharmacy Gina M. Baugh, Pharm.D. Clinical Associate Professor Director, Introductory Pharmacy Practice Experiences WVU School of Pharmacy

Case Example - WesternU  Western University of Health Sciences  First class started in 1996  Private, non-profit  Health sciences focused university, no large health center  Faculty account for 20-25% of APPE rotations

Case Example - WesternU  Preceptor development prior to 2010 – Site visits, dinner meetings – Cover some educational expenses – Pharmacist Letter Preceptor Network – Hospital Pharmacist Monthly

Case Example - WesternU  Preceptor development after 2010 – Continued prior initiatives – Increased site visits – Collaborative Education Institute Accessible through E*Value Free preceptor development online CE Orientation to WesternU available

Case Example - WesternU  Preceptor development after 2010 – Live CE programs on precepting Typically, a 2-hr live program is given 3-4 times annually – Los Angeles, Orange County, San Diego, campus Partner with local professional chapters to increase attendees (and recruit new preceptors)

Case Example - WesternU  Preceptor development after 2010 – On-site preceptor development CEs Typically 1-hr lunch CE programs – Shorter versions of 2-hr programs Site should expect >10 pharmacists to attend – Occasional focused workshops MTM, EBM, Physical Assessment

Case Example - WVU  West Virginia University School of Pharmacy  Centennial celebration in 2015  Public school  Part of academic health sciences center  Faculty account for 25-30% of APPE rotations  Require 2 hours of preceptor development CE every 2 years

Case Example - WVU  Preceptor development – Annual Preceptor Development Conference – Six hours of live continuing education 3 hours of didactic sessions 3 hours of active learning sessions Meets WV live CE requirements – Didactic sessions are recorded for on- line completion – Encore session held at remote campus location (3 didactic hours)

Case Example - WVU  Preceptor development – Annual live “homecoming” continuing education session – Typically hour session – Held Friday afternoon of homecoming weekend during the fall semester Additional alumni activities scheduled immediately following CE

Case Example - WVU  Preceptor development – State pharmacists conferences Partner with 2 other SOPs in WV Rotate “lead” school – Regional pharmacists conferences Presented by Office of Experiential Learning Regional Coordinators Encore session of state conference

Case Example - WVU  Preceptor development – Online Programs Recorded sessions by the Office of Experiential Learning Pharmacists Letter

Summary  Discussed the 2016 ACPE Standards that relate to preceptor development  Listed essential and optional components of a comprehensive preceptor development program  Identified common themes in preceptor development programs relevant to pharmacy education  Compared select preceptor development programs

Thank you for your attention and participation