2. Maximize Your Preceptor Interaction! Strategies for Precepting Different Level Learners Natalie R. Buening, PharmD, BCPS Health Sciences Assistant Clinical Professor Director – South Bay Experiential Program University of California, San Francisco School of Pharmacy

3. Disclosure The speaker has no actual or potential Conflict of Interest in relation to this presentation.

4. Discuss current pharmacy preceptor demand Review differences between precepting student vs. resident learners List advantages and challenges of precepting different level learners Discuss approaches to effectively precept different level learners Learning Objectives

5. Demand/residency program design ASHP requirements Lack of literature Real differences Advantages Challenges Why?

6. Numbers Expectations ◦ Present ◦ Future Experiences Practice models Demand Brown DL. Am J Pharm Educ. 2013;77(5):Article 90 Smith KM et al. Pharmacotherapy. 2010;30(12): 490e – 510e ASHP. Am J Health Syst Pharm. 2007;64(12):1320-30

7. Discuss with your neighbor some key differences between student and resident learners in regards to career paths, interaction with preceptors, training locations, etc. Think – Pair – Share

8. Differences StudentsResidents Wide variety of career paths, interests and abilities Higher performers, career goals that match the practice site Volume of preceptors that lack connection Smaller group of colleague preceptors Geographic spreadSame practice setting Competing expectationsFocused training program Volunteer vs. fee - for - serviceIncorporated in job responsibilities Smith KA. Accessed 6/10/15 http://www.ashp.org/Doclibrary/MemberCenter/Webinars/ASHP-Residency-Preceptors-Webinar.aspxhttp://www.ashp.org/Doclibrary/MemberCenter/Webinars/ASHP-Residency-Preceptors-Webinar.aspx

9. Preceptor ◦ Experience ◦ Multiple precepting roles ◦ Multiple interactions Learner ◦ Experience ◦ Collaboration ◦ Connection ◦ Interactive learning ◦ Feedback Advantages Schwenk TL. Accessed 6/10/15 www.crlt.umich.edu/publinks/occ1.pdfwww.crlt.umich.edu/publinks/occ1.pdf Pinder-Grover T and Groscurth CR. Accessed 6/10/15 http://www.crlt.umich.edu/sites/default/files/resource_files/CRLT_no26.pdfhttp://www.crlt.umich.edu/sites/default/files/resource_files/CRLT_no26.pdf

10. Preceptor ◦ Time ◦ Multiple learning styles ◦ Multiple goals/objectives ◦ Less structured learning environment Learner ◦ Mismatched learners ◦ Mismatched learning styles ◦ Multiple goals/objectives ◦ Multiple preceptors ◦ Less structured learning environment Challenges Schwenk TL. Accessed 6/10/15 www.crlt.umich.edu/publinks/occ1.pdfwww.crlt.umich.edu/publinks/occ1.pdf Pinder-Grover T and Groscurth CR. Accessed 6/10/15 http://www.crlt.umich.edu/sites/default/files/resource_files/CRLT_no26.pdfhttp://www.crlt.umich.edu/sites/default/files/resource_files/CRLT_no26.pdf

11. Discuss with your neighbor different approaches to address the challenges of precepting different level learners simultaneously. Think – Pair – Share

12. Analyze situational Factors Develop activities for specific goals and objectives Plan feedback and evaluation Plan interactive learning activities Check for alignment of all components of the learning experience Evaluate the experience and make changes Solutions Collins J. RadioGraphics 2007;27:1511-1517

13. Learner pre-rotation evaluation form Goal sheet Learner portfolio review Learning style evaluations/preceptor development topic Analyze Situational Factors - Learner Collins J. RadioGraphics 2007;27:1511-1517

14. Rotation syllabi Targeted rotation expectations Future strategy: preceptor teaching philosophy Analyze Situational Factors - Preceptor Collins J. RadioGraphics 2007;27:1511-1517

15. Activities for Goals and Objectives Focus ◦ Goal: global learning outcome ◦ Objective: learner performance ◦ Activity: learner exercise Strategies ◦School of pharmacy competencies/expectations ◦Assign specific goals, objectives and activities for each rotation experience ◦Development plans ASHP. Accessed 9/9/15. http://www.ashp.org/doclibrary/accreditation/newly-approved-pgy1-standard-september-2014.pdfhttp://www.ashp.org/doclibrary/accreditation/newly-approved-pgy1-standard-september-2014.pdf Collins J. RadioGraphics 2007;27:1511-1517

16. Student Rotation Syllabus

18. Rounds Patient profiles Documentation Discussions Meetings Education activities Student Activities and Responsibilities

21. PGY1 Learning Experience Description

22. Goal: Application of knowledge and skills to the practice setting Objective/competency ◦ Describe the pathology of diseases ◦ Describe the mechanism of action of medications (efficacy/toxicity) ◦ Apply mathematical principles in pharmacy practice Activities: What will the student do to meet this goal and corresponding objectives? Example: Student rotation syllabus

23. PGY1 Learning Experience Description

25. Preceptor Interaction PGY1 The resident and preceptor will meet at a minimum for pre-rounds each day to touch base about patients and daily in the afternoon. The preceptor may or may not be present with the resident during rounds or conference. It is expected that the resident and preceptor will meet at least two times per week for in depth formal topic discussions as well. PGY2 The resident and preceptor will meet at a minimum of once a day to touch base about patients. The preceptor may or may not be present with the resident during round or conference. It is expected that the resident and preceptor will meet at least one to two times per week for in-depth formal topic discussions as well.

26. Expected Progression: Week 1&2 PGY1 The resident will be assigned 50-100% of the Burn team. The resident will meet with The preceptor daily for pre rounds. The resident may be looking for validation of therapeutic plans for both core common and less common disease states at this time. The preceptor will attend rounds and model team and patient interactions PGY2 The resident will be assigned all patients on the Burn team. The resident will meet with the preceptor at least once daily to discuss patients. The resident may be looking for validation of therapeutic plans for both core common and less common disease states at this time. The preceptor will attend rounds and model team and patient interactions as needed.

27. Expected Progression: Week 3&4 PGY1 The resident will be assigned all patients on the Burn team. The resident should meet with the preceptors daily for pre-rounds. The resident may be looking for validation of the therapeutic plan for uncommon disease states. The preceptor will attend rounds at a minimum of one to two days per week. PGY2 The resident will continue to follow all patients on the Burn team. The resident should meet with the preceptor at least once daily to discuss patients. The resident may be looking for validation of the therapeutic plan for uncommon disease states. The preceptor will try to limit interactions to allow the resident to develop autonomy.

28. Targeted Expectations

29. Plan Feedback and Evaluation Focus ◦ Feedback ◦ Evaluation Strategies ◦Preceptor development topic ◦Snapshots ◦Daily documentation form ◦Midpoint evaluations ◦Customized evaluations ◦Summative evaluations ◦Targeted preceptor evaluations ◦Student reflections ◦Daily documentation form Collins J. RadioGraphics 2007;27:1511-1517

30. Plan Interactive Learning Activities Focus ◦ Active learning ◦ Activities should be aligned with goals, objectives and evaluation Strategies ◦Group discussions ◦Learner lead discussions ◦Preceptor lead discussions ◦Group rounds ◦Simulations ◦Case based presentations Collins J. RadioGraphics 2007;27:1511-1517

31. Group approach ◦ Learning activities ◦ Evaluations ◦ Resident preceptor involvement “One Minute Preceptor” model Four preceptor roles Additional Solutions

32. Check for alignment of all components of the learning experience Make appropriate changes Evaluate and Make Improvements

33. Utilize available resources and documents Set expectations Determine the need for additional guidance Be realistic Give up “total control” In Summary

34. Which of the following are tools that can aid in the assessment of learner expectations when designing a rotation experience? A. Pre-rotation assessment forms B. Targeted rotation expectations C. Resident intro-evaluations D. A and C E. All of the above Answer: D Learning Assessment Question #1

35. Which of the following focus areas can be used to set expectations between different level learners? A. Preceptor interaction B. Learning experience activities C. Expected progression D. A and C E. All of the above Answer: E Learning Assessment Question #2

36. Which of the following is an active learning activity that can incorporate different level learners? A. Group patient care rounds B. A student patient case presentation to the group utilizing power point slides C. A resident presenting a handout to the students on warfarin discharge counseling D. The preceptor providing a journal article to the group for review Answer: A Learning Assessment Question #3

37. Brown DL. A looming joblessness crisis for new pharmacy graduates and the implications its holds for the academy. Am J Pharm Educ. 2013;77(5):Article 90. Smith KM et al. Value of conducting pharmacy residency training – an organization perspective. Pharmacotherapy. 2010;30(12): 490e - 510e. ASHP. Long range vision for the pharmacy workforce in hospitals and health systems: ensuring the best use of medicines in hospitals and health systems. Am J Health Syst Pharm. 2007;64(12):1320 - 30. Smith KA. Practical approaches to developing residency preceptors. http://www.ashp.org/Doclibrary/MemberCenter/Webinars/ASHP- Residency-Preceptors-Webinar.aspx Accessed 6/10/15.http://www.ashp.org/Doclibrary/MemberCenter/Webinars/ASHP- Residency-Preceptors-Webinar.aspx Schwenk TL. Center for research on learning and teaching occasional paper No.1: clinical teaching. www.crlt.umich.edu/publinks/occ1.pdf Accessed 6/10/15. www.crlt.umich.edu/publinks/occ1.pdf Pinder-Grinder T and Groscurth CR. Center for research on learning and teaching occasional paper No. 26: principles for teaching the millennial generation: innovative practices for UM faculty. http://www.crlt.umich.edu/sites/default/files/resource_files/CRLT_no26.pdf Accessed 6/10/15http://www.crlt.umich.edu/sites/default/files/resource_files/CRLT_no26.pdf ASHP. Accreditation standard for post graduate year one (PGY1) pharmacy residency programs 2014.http://www.ashp.org/doclibrary/accreditation/newly-approved-pgy1-standard-september-2014.pdf. Accessed 9/8/15.http://www.ashp.org/doclibrary/accreditation/newly-approved-pgy1-standard-september-2014.pdf Collins J. Designing learning experience. RadioGraphics. 2007;27:1511 - 1517. References

38. Thank you for attending! Please write down your CE secret code. All ACPE credit must be claimed online no later than November 20, 2015. See Seminar Program Book for details.