1. Pharm 428 Preceptor Course Review Experiential Education Program Faculty of Pharmacy, UofA Marlene Gukert; mgukert@ualberta.camgukert@ualberta.ca Course Coordinator Michelle MacDonald: michelle.macdonald@albertahealthservices.camichelle.macdonald@albertahealthservices.ca AHS/Faculty Liaison APRIL 2015 1

2. Agenda What’s New? Course Information Student Information Faculty Expectations Preceptor Responsibilities Course Activities & Assignments Assessment Information Course Policies and Guide Preceptor Resources 2

3. What’s New? …not too much…. Pharm 428; new course number (community placement now called Pharm 426) Cheryl Cox has retired.. well kind of… Manual; format changed to better align with other courses; “Course Syllabus” now as well as Policies & Procedures Guide Assessments shortened again Radio buttons instead of drop downs on assessment forms; quicker & easier No longer need to ask students for Criminal Record Checks, Immunization Records or Signed Privacy Confidentiality Certificate; collected by Faculty before placement Using ACP # as unique identifier for “onboarding” You will be receiving a “Preceptor Quick Reference Guide”: about 1 month prior to start 3

4. Pharm 428 – What is it? 4 th year of study; electives & placements 8 weeks; course preceded or followed by Pharm 426 Advanced clinical placement; “next to” ready to practice - Entry to Practice competence Able to provide collaborative & comprehensive patient care; increasingly efficient Opportunity to: - accept pharmacist accountabilities & professional responsibilities - apply clinical & ethical judgment - develop critical thinking & decision making Provide opportunities for students to problem solve and see the “grayness” of practice. Students tend to be black and white thinkers. 4

5. Faculty Expectations Roles & responsibilities of institutional practice; guide the student through the course Supervision - guiding principle: ensure patient safety - student observes preceptor  student assists preceptor  student performs while preceptor observes  student performs independently - discuss steps involved in activity before doing - student should be prepared & share their plan with you Provide regular feedback to coach student on their skills; debriefing sessions after activities is key to learning Provide other healthcare opportunities; i.e. IP Review documentation: care plans, chart notes Assess the student; formally & informally Contact us if needed You exceeded expectations!! student survey comments; extremely positive 5

6. Pre-Placement Planning Ensure you can log into RxPreceptor; contact Gaenor: phexed@ualberta.ca with login or viewing difficultiesphexed@ualberta.ca Syllabus posted on RxPreceptor (Documents Library) & Faculty website http://pharm.ualberta.ca/preceptors/course-information Students instructed to post their picture, profile & resume on RxPreceptor one month prior to placement Preceptors emailed with instructions to confirm review of student’s resume/profile in RxPreceptor - also provide information they need to know for their placement 6

7. Pre-placement Planning... Netcare arranging access Develop schedule template Coordinate activities with team, co-preceptor (if applicable) & other HCPs 1 mth prior to placement preceptors emailed “Course Quick Reference Guide” - orientation checklist, activity & discussion summaries & schedules, assessment information, etc. - forms also be posted in RxP & QRG will be posted on Preceptor webpage Orientation - expectations: yours & student’s - introduce co-preceptors (if applicable) - information about facility & practice (unit) - Student Self Assessment – informed to complete bring printed copy - review schedule: activities & assignments - review assessments: forms, process, timelines 7

8. Co-Precepting Often we are not precepting alone & work together with co- precepting team of 1-2 preceptors for 2 week placement Important to consider: Planning- meet as a team prior to placement to plan. Try to schedule preceptors in time blocks vs changing daily Communication- establish how you will communicate as precepting team; especially in transition between preceptors (email, phone call, meet in person). Communicate regularly progress of student. Expectations - discuss having consistent expectations of each other as preceptors & of student; daily routines/workflow, documentation format, deadlines, feedback,etc Assessment- determine who will complete early & final assessments & RxPreceptor access. Have communication plan for each to contribute to assessment. If student is struggling, collaborate on action plan Debrief- after placement, what went well? improvements? 8

9. RxPreceptor allows only 1 primary preceptor to be assigned to student. Options we have seen teams do to address this: ◦ Primary preceptor logs in for other preceptor to review RxP (student profile/ resume & assessment). Enter their comments & assessment ◦ Primary Preceptor shares their RxPreceptor password with team so each has access. PWord can be changed after placement to maintain access privacy ◦ Print assessment forms; share with other preceptors to write comments & submit back to primary preceptor. (comments could be also be emailed) NOTE: Your RxPreceptor password can be changed before & after placement. Preceptors can set up ‘temporary password’ to maintain own password integrity & privacy. Student Performance Assessments 9

10. Skills Labs Second year skills labs: students had sessions on; Allergy Assessment Medication Reconciliation Discharge Counseling Shared Decision Making Informal case presentation to another health care professional Critical appraisal of journal article Third year skills labs: students had sessions on; Injection Training Death & dying Mental health patients Motivational interviewing Chronic Disease Management Minor ailments During orientations students receive Advanced Netcare training & DI refresher. Prior to 315 they had Antimicrobial Stewardship session with review of precautions. 10

11. Pharm 428: The Course Focus: introduction to institutional practice - building basic clinical skills; start to see need for clinical judgment & experience decision making - developed & organized around 7 outcomes Advanced Placement: practice & preceptor informs the activities Core Skills Professionalism - ethical behaviours, appropriate appearance, punctual - patient accountabilities - demonstrates initiative Communication - written; charting, documentation - verbal presentations; patients, in-service, patient presentation: formal & informal 11

12. Care Provider ACTIVITY: Minimum of 12 CDM patients (include Med Rec) - should be able to care for minimum 4 patients daily by week 3 - direct & and indirect supervision - use Patient Care Plan Process (website & Preceptor Guide) - worksheet is template for Patient Care Plans – “Preceptor Checklist” in syllabus, posted in RxPreceptor, in Quick Reference Guide - can use site specific forms - documentation should be comprehensive, well organized - review with you, all elements of plan should be included - assistance should be minimal & decreasing as placement proceeds -care for >1 patient with same condition allows for depth of understanding Reminder: Patient Care Process eModules are on Faculty webpage http://pharm.ualberta.ca/preceptors/training-and-resources 12

13. Care Provider ACTIVITY: Clinical Judgment - during patient care discussions - ASSIGNMENT: provide 1 example that demonstrates clinical decision making skills, interpretation of labs or TDM levels, microbiology reports; C and S, etc. - students write about what skills they found beneficial? challenging? What documentation was required & outcome ACTIVITY: Patient Care Presentation - suggested format in syllabus; based on AHS formats - includes PICO question - use of practice site format OK - new evaluation form in syllabus Discussion Activities: expanded scope of practice, patient care strategies Other Activities: injections, education & counselling, discharge planning & counselling, seamless care, etc. 13

14. Tips and Suggestions! Activities may require differing degrees of supervision; need for supervision should decrease as placement progresses Your preceptor role will be more coaching & facilitation as placement progresses Documentation should be discussed (except reflection) Students should be familiar with Pharmaceutical Care Plan (PCP) worksheet Use of site specific forms can be implemented when you feel student is ready Documentation (i.e. chart notes); may require practice, should have clear intent & include only relevant information Presentations (patient, in-services) should be submitted to give time for review & revisions by you; clear deadlines should be given Important for preceptors to share their expectations regarding activities with the student 14

15. 15

16. Collaborator ACTIVITY: Inter-Professional Collaboration: spend time with at least 1 other HCP who is caring for one of their patients or from their unit (as deemed appropriate) i.e. assisting while providing care ASSIGNMENT: Reflection of Experience; insights about skills that impacted them, not about what they did - should discuss expectations with you to prepare - should debrief with you after - should use the UP Student Shadowing Cards (rectangular, green perforated card) -Provide as many IP opportunities as possible; rounds, conferences, interactions with other HC students 16

17. Scholar Activities - provide DI as needed for patient care & upon request - mini projects - In-service - UofA Library tutorial – upon request - assigned topics to present to preceptor or discuss Advocate Activity: discuss pharmacist’s role in health promotion (vaccinations, smoking cessation, lifestyle) or disease programs/clinics available through the institution - Advocacy responsibilities: special access drug, committees, DUR 17

18. Manager Differences in practice; participation varies Discuss or participate - pr imary steps of basic drug distribution process - process used to ensure safe & effective drug distribution - quality assurance programs - med admin policies - incident & ADR reporting policies & procedures - AHS Adverse Events & Patient Safety Website Medication Safety Activity (Discussion) & Assignment - students review ACP: Systems Approach to Quality Assurance for Pharmacy Practice; Mitigating Risk - choose a topic (Drug Shortages or Patient Assessment) - discuss your current process; brief assignment 18

19. Assessments You roared ….. we heard Shortened them again Thank you for the feedback! We are also learning Assessments posted in RxPreceptor; check them out! Radio buttons now Forms can be printed Remember to SAVE; can return & complete later Viewable by student after submitted 19

20. Assessment Process RxPreceptor (RxP ); primary preceptor has login ID; completes assessment or list co-preceptors who completed assessment - ensure comments are shared between preceptors; slide 9 comments Important to discuss & review with student - acknowledgement on each form indicating discussion occurred Comment Boxes: provide feedback – as much as you can! Assessment Instructions will be emailed in Quick Reference Guide - review assessments to be familiar with what you are assessing student on Different forms submitted at different times; week 1, week 4 & end RxPreceptor questions: contact Gaenor; phexed@ualberta.caphexed@ualberta.ca 20

21. Assessments Preceptors Complete End of Week 1: Early Assessment of Student - quick check (10min) End of Week 4: Midpoint Student Performance Assessment (1hr) - assess behaviours/skills - identification of expectations & areas for focus for balance of placement - no grade (Pass or Fail) given End of Week 8: Final Student Performance Assessment (1 hr) - placement grade given; pass or fail - behaviours/skills assessed same as midpoint Preceptor Survey: sent post placement; comments appreciated! (30 mins) - anonymous but can request Faculty to contact you 21

22. Student Performance Assessments 7 Learning Outcomes are assessed; Professional, Communicator, Care Provider, Collaborator, Scholar, Advocate, Manager Provided descriptors for each outcome to assist you Preceptors provide overall mark for that outcome: - Not Meeting an Acceptable Level of Performance - Needs Improvement - Meets Acceptable Level of Performance - Exceeds an Acceptable Level of Performance To student must achieve at least “Meets Acceptable Level of Performance” on all 7 outcomes at the final 22

23. 23

24. Assessment Tips Needs Improvement OK at MIDPOINT: not at FINAL - may be contacted by me; just to be sure things are OK Not Meeting an Acceptable Level of Performance: indicates major concerns, Faculty must be notified by midpoint at the latest - if it is questionable whether student may pass notify Faculty ASAP; either Michelle or Marlene - IMPT to discuss difficulties with students, concerns should not be a surprise; specific feedback helpful for student - student should be encouraged to contact Faculty; phexed@ualberta.ca - Faculty has experience with these situations; each is different - documentation important: comment boxes on forms; be specific - develop a plan & work together: Faculty, preceptors & student

25. Assessment Tips Midpoint Identification of Goals : after midpoint assessment important to discuss an “action plan” with goals for areas that need improvement Important that you review student performance assessments prior to placement starting; know what you will be assessing student on Comment boxes on performance assessment forms, please be specific, comments helpful for students Discourage use of “Exceeds” at midpoint unless student is “outstanding” Preceptors provide “Placement Grade” Faculty provides “Course Grade” based on assessment & assignment review Remember to review Student Self Assessments with Student Performance Assessments; good comparator 25

26. Assessments Students Complete Student Self Assessments - students advised to complete, print, bring to site - discuss at orientation - compare with midpoint & final Preceptor Student Performance assessments Early Assessment of Preceptor; quick - end of Week 1 Midpoint and Final Assessments of Preceptor & Site - discuss with preceptor Two surveys completed post placement by student - overall placement experience - course 26

27. ExEd Policies and Procedures Guide Posted RxPreceptor, outlines student responsibilities, policies & procedures - requirements, Netcare, Needlestick Incidents Students advised to review prior to placement Scheduling - 40 hours/week; 5 x 8 hour days - evenings & weekends OK; complete assignments etc - sickness, bereavement 1 day OK; > 1 day time must be made up - changes to accommodate personal holidays not allowed - change of schedule outside of stated timelines must be approved by course coordinator in advance of change - routine medical/dental visits should be scheduled outside of course time Professional Opportunities: 1 day (PDW, UofA Flu Clinics (Nov): Banff CSHP Conference (March) Job Interviews/MOCK PEBCs: not acceptable reasons for missing time 27

28. Preceptor Resources http://pharm.ualberta.ca/preceptors Course Information: syllabi & Policies Guide Newsletters Preceptor Faculty appointments Preceptor award recipients Preceptor workshops Training & Resources: http://pharm.ualberta.ca/preceptors/training- and-resourceshttp://pharm.ualberta.ca/preceptors/training- and-resources Preceptor Guide Patient Care Process Module Podcasts UBC Etips Library Resources; Library Homepage; databases & resources - Library Access Form; 120 days UofA library access - other on-line precepting resources New in 2015, AHS/Covenant: Preceptor Connection & Online Communities of Support for New Models of Precepting- Every 2 months. Invites sent out via LYNC 28

29. What To Do? If you think you have a problem - you usually do!!! Call Faculty early Michelle.macdonald@albertahealthservices.ca; 403-561-6278 Michelle.macdonald@albertahealthservices.ca mgukert@ualberta.ca; 403-254-6449 mgukert@ualberta.ca - you might not have experienced the issue before but we likely have! Contacts listed in policy guide/preceptor guide, website or contact Gaenor; triage - phexed@ualberta.ca - 780.492.9780 29