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Demys&fying  Precep&ng  in  the  PharmD  for  Prac&cing  Pharmacists  Program

 

Experien&al  Educa&on  Course  Coordina&on  

Sheila  Walter  Pharm  511,  512,  513  and  514  Email:  swalter@ualberta.ca  

Phone:  780  492-­‐5513  

Office  days:  Monday  to  Thursday  

Tara  Leslie  Pharm  515  Email:  tleslie1@ualberta.ca  

Office  days:  Wednesday  to  Friday  

 

The  program  focuses  on  enhancing  pharmacists’  ability  to:    

•  confidently  take  responsibility  for  and  manage  drug  therapy  

•  manage  complexity  and  uncertainty  

•  self-­‐assess  &  direct  ones’  learning  to  support  CPD    •  provide  educaSon  to  students,  paSents  and  other  HCP  

 

Pharm  D  For  Prac&cing  Pharmacists  –  Experien&al  Educa&on  Goals   Pre  Placements  

•  Pharm  501:  CriScal  Analysis  of  Evidence  in  PracSce  •  Pharm  502:  Advanced  PaSent  Care  Skills  and  Health  Assessment  •  Pharm  503:  Advanced  Pharmacotherapy  •  Pharm  504:  Frameworks  for  Teams,  CollaboraSon  and  EducaSon    Concurrent  with  Placements  •  Pharm  505:  Seminars    How  they  are  taught  •  emphasis  on  acSve  &  self  directed  learning  through  problem  solving,  

applicaSon  to  paSent  scenarios  to  acquire  and  develop  knowledge  &  skills  

 

Course  Work  

•  Apply  the  principles  of  evidence-­‐based  medicine  (EBM)  in  clinical  pracSce.  

•  Formulate  an  answerable,  focused  quesSon  •  Demonstrate  an  advanced  ability  to  search  on-­‐line  databases  

including  synthesized  sources  for  the  best  evidence.  •  CriScally  appraise  various  types  of  evidence  for  validity,  clinical  

relevance,  and  applicability  •  Apply  evidence  to  clinical  situaSons  while  individualizing  

recommendaSons  based  on  clinical  experSse  and  paSent  values.  

Cri&cal  Analysis  of  Evidence  in  Prac&ce  

•  Demonstrate  a  systemaSc  approach  to  paSent  assessment  •   Apply  physical  assessment  findings  to  medicaSon  assessment  and  

monitoring  •  Assess  various  symptoms  of  paSents  with  respect  to  history,  

physical  and  laboratory  findings,  and  potenSal  drug  and  disease  causes.  

•  Explain  the  role  and  uSlity  of  specialty  assessments  in  paSent  care  (geriatric  assessment,  mental  health)  

 

Advanced  Pa&ent  Care  Skills  and  Health  Assessment  

   

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Developed  knowledge  and/or  skills  in  the  following  key  areas:  •  breadth  and  depth  of  therapeuSc  knowledge  in  core  disease  states    •  decision  making  within  the  paSent  care  process    •  managing  medicaSon  therapy    •  communicaSon  and  collaboraSon:  paSent  care  team    •  evidence  based  medicine:  criScal  appraisal  and  translaSon  to  

paSent  care  •  biopsychosocial  model  of  care    •  pharmacokineScs    

Advance  Pharmacotherapy  

•  Discuss  issues  related  to  preceptorship  •  Develop  an  educaSon  plan  for  diverse  audiences  including  professionals,  public,  paSents  and  groups  of  paSents  

•  Describe  elements  of  group  development,  group  dynamics,  and  group  effecSveness  

•  Evaluate  a  group  experience    

Frameworks  for  Teams,  Collabora&on  and  Educa&on  

•  PHARM  511  -­‐  PaSent  Care  in  a  CollaboraSve  Team  •  AddiSonal  emphasis  on  interprofessional  collaboraSon  

•  PHARM  512  –  PaSent  Care  in  Acute  Care  

•  PHARM  513  –  PaSent  Care  in  Community  PracSce  or  Ambulatory  Care  

•  PHARM  514  –  Repeat  of  PHARM  511,  512,  513  

•  PHARM  515  –  Specialty  ElecSves    •  PaSent  care,  non-­‐paSent  care,  or  combinaSon  

 

Experien&al  Courses  

PharmD  Student’s  perceived  strengths*  

•  Time  management  skills  •  MoSvaSon  to  learn  •  CriScal  appraisal  skills  •  PaSent  assessment  process  (head  to  toe/ROS)  •  Process  when  they  don’t  know  what  to  do  

 

       *Taken  from  a  PharmD  focus  group  discussion    

 

What  is  a  PharmD  Student  

•  Student’s  baseline  abiliSes  will  vary;  expect  growth  throughout  placement  

•  Organize  Sme  to  fulfill  all  placement  commitments  •  Complete  acSviSes  under  indirect  supervision  •  Show  iniSaSve  and  acSvely  parScipate  all  learning  opportuniSes.  •  Assume  responsibility  and  accountability  for  paSent  care    •  Develop  care  plans  that  address  complexity  &  ambiguity  in  pracSce  

 

Preceptor’s  Expecta&ons  of  Student  

•  Responsible  for  their  decisions  and  acSon  •  Fulfill  the  pharmacist’s  role  over  the  course  of  the  placement  (they  would  like  to  free  you  up)  

•  Responsible  for  maintaining  the  record  of  care  

•  ParScipate  in  relevant  site  programs  and  staff  acSviSes  

 

Preceptor’s  Expecta&ons  of  Student  

   

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•  RxPorcolio  (replaces  student  profile)  •  Accessible  through  RxPreceptor  •  CV  including  work  history  &  samples  of  work  

•  Placement  Learning  Plan  •  Emailed  to  preceptor  1  week  in  advance  

•  Afend  PharmD  seminars  

 

Addi&onal  Student  Responsibili&es  Supervision  

•  ACP  requirements  •  May  perform  all  acSviSes  under  indirect  supervision  •  Appropriate  supervision  to  ensure  paSent  safety  is  upheld  

•  Supervision  should  vary  based  on  student  &  paSent  factors.  •  Consider  the  student’s  previous  experience,  place  in  the  program  &  the  complexity  of  the  pracSce  segng  

•  Students  are  licensed  pharmacist  that  want  to  be  accountable  &  responsible  

 

•  How  to  be  a  good  pracSSoner  •  How  to  see  shades  of  grey  instead  of  black  and  white  •  How  to  be  a  good  preceptor  •  How  to  acquire  knowledge  &  funcSon  in  a  new  

environment  •  Gained  confidence  faster  with  each  placement  •  MoSvated  to  try  different  approached  

 

What  Students  Have  Learned  from  Preceptors  

•  Possess  a  commitment  to  teaching  •  Teach  by  quesSoning  &  providing  guidance  •  Engage  in  learning  with  the  student  •  Form  professional  relaSonships  with  the  student  •  Good  Communicator  •  Model  professional  behaviours,  skills  and  agtudes  •  Provide  opportuniSes  to  engage  in  paSent  care  and  

other  team  members  •  NO  ADVANCED  DEGREES  REQUIRED  J  

 

What  Makes  a  Good  Preceptor    

•  Pharmacists  are  working  with  paSents  &  providing  direct  paSent  care  

•  Students  are  able  to  implement  care  plans  •  Students  are  allowed  to  collaborate  with  the  care  team  

(centralized  or  decentralized)  •  OpportuniSes  to  teach  as  well  as  learn  •  Students  are  given  projects/duSes  that  benefit  the  

team  or  segng.      

 

What  Makes  A  Good  Prac&ce  Environment  

Quotes  from  Alberta  Preceptors:  •  “PrecepSng  enhances  my  own  pracSce;  through  guiding  and  learning  

with  others”  •  "I  want  to  give  back  to  the  pharmacy  profession  and  hope  that  my  

students  get  the  same  experience  that  I  did”  

•  "I  enjoy  having  students  because  they  challenge  me  and  help  me  improve  my  pracSce.“  

•  "Learning  is  ongoing.  My  students  learn  from  me  and  I  learn  from  them.  It  is  a  wonderful  opportunity  from  which  preceptor  and  students  benefit  from.  It  is  a  symbioSc  relaSonship.“  

•  "I  find  it  very  rewarding  to  help  students  develop  skills  and  reach  their  potenSal  in  their  future  pharmacy  career.  

 

The  Benefits  of  Precep&ng  

   

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Con&nuous  Professional  Development  Learning  Records  for:  •  Preceptor  training  courses;  PrecepSng;  Discussion  with  colleague  •  Did  the  acSvity  result  in  acquiring  in  new  knowledge  or  confirmaSon  of  knowledge  

•  Target  –  transfer  knowledge  or  improve  own  pracSce    Implementa&on  Record  •  Placement  plans  •  Discussion  outlines    hVp://pharm.ualberta.ca/preceptors/training-­‐and-­‐resources/con&nuing-­‐competence-­‐program-­‐resource  

The  Benefits  of  Precep&ng   Components  of  a  Placement  

•  ExperienSal  EducaSon  Manual  •  SecSon  3:  Preceptor  ResponsibiliSes  

•  Course  Syllabus  &  Summary  •  Placement  Outline  •  RxPorcolio  •  Learning  Plan  •  Assessment  forms  

 

 

Pa&ent  Care  Courses  

•  Learning  AcSviSes:    •  Provide  paSent  care  &  parScipate  in  meeSngs/rounds  •  Work  collaboraSvely  with  paSents  and  team  members  •  Manage  their  pracSce  by  prioriSzing  •  ParScipate  in  &  lead  educaSon  

•  Assignments  •  Learning  Plan  •  Two  Assignments  negoSated  between  student  and  preceptor.    

•  Assessments:  •  ObservaSon  of  acSviSes  and  performance  on  assignments  inform  your  raSngs  on  the  assessments    

 

Placement  Outlines  

•  DescripSon  of  PracSce  Site  &  Services  •  Type  of  pracSce,  paSent  populaSon,  •  Clinical  services  &  regular  acSviSes  •  Professional  relaSonships  

•  AcSviSes  &  ExpectaSons  of  Students  •  Clinical  services  &  duSes  the  student  will  perform  •  Learning  opportuniSes  &  potenSal  assignments  •  Student  responsibiliSes  (teaching,  independence)  

 

 

Learning  Plan  Template   Clinical  Assignment  •  Example  of  Clinical  Assignments:  

•  Journal  Club  •  Case  •  PaSent  EducaSon  Tool  •  In-­‐service  

•  Assessment  of  Assignments  (OpSonal):  •  PresentaSon,  journal  club,  case  presentaSon  •  Found  in  the  document  library  under  PharmD  resources  •  Student  to  upload  preceptor’s  evaluaSon  or  summary  as  a  field  encounter  

 

   

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Role   Descrip&on   When/how  to  use   Other  Direct  InstrucSon  

Readings,  lectures,  discussions    Refer  students  to  relevant  resources  &  check  understanding  

For  foundaSonal  content  required  to  perform  a  skill  Novice  learners  or  beginning  of  a  placement  

Differs  from  classroom  learning  preceptor  can  place  responsibility  for  content  on  the  student.  Use  to  verify  learning  later  in  a  placement  

Modeling   DemonstraSng  a  process  while  thinking  out  loud  

Used  when  learner  has  the  appropriate  background  &  is  ready  to  begin  learning  to  perform  the  skill  

Student  both  observes  behaviour  &  hears  the  thought  process  

Coaching   Student  performs  the  task  while  being  observed  &  feedback  is  provided  during  the  thinks  out  loud  

Used  when  learner  has  knowledge  &  has  observed  the  process.  Fine  tuning  of  a  skill  

Used  unSl  correcSve  feedback  is  not  longer  required  Learner  should  be  able  to  describe  what  to  conSnue  doing  &  how  to  improve  

FacilitaSng   Learner  performs  the  acSvity  independently.    The  preceptor  debriefs  &  is  available  if  required    

Previously  coached  Student  &  preceptor  have  confidence  in  ability  

Use  pre-­‐brief  to  assess  student’s  approach  and  preparedness  

Preceptor  Roles       4Th  Year  Student   PharmD  Student  Direct  instrucSon  

Fill  knowledge  gap  when  encountering  unique  populaSons,  disease  states  Discussion  can  allow  preceptor  to  verify  student’s  base  line  knowledge  

Fill  knowledge  gap  when  encountering  unique  populaSons,  disease  states  Discussion  can  allow  preceptor  to  verify  student’s  base  line  knowledge  

Modeling   Frequently  starSng  role  Clarifying  expectaSons  

Introducing  new  skill/new  populaSon  Clarifying  expectaSons  

Coaching   Primary  role  early  in  the  placement  Skill  development  Verify  self  assessment  of  abiliSes;  determine  student’s  level  of  performance  

Early  in  the  placement  for  fine  tuning  Verify  self  assessment  of  abiliSes;  allows  preceptor  to  determine  student’s  level  of  performance  

FacilitaSng     Used  for  simple  cases  iniSally,  with  progression  to  more  complex  cases  as  student  ability  and  competence  builds.    This  allows  student  to  build  independence  and  role  definiSon.  

Primary  Preceptor  Role  Increase  use  as  the  placement  progresses  Start  with  less  complex  scenarios  (increasing  complexity  to  challenge)  

Pharm  511-­‐514  Assessment  •  Faculty  developed  assessment  in  RxPreceptor  

•  Professional  •  Communicator  •  Care  Provider  •  Scholar  •  Advocate  •  Manager  

•  Meets,  Exceeds  or  Needs  Improvement  to  meet  ExpectaSons  •  Recommend  placement  mark  –  Pass/Fail    AddiSonal  InformaSon  -­‐    ExperienSal  EducaSon  Student  Performance  Assessments      

 

Document   Time point   Completed by   Purpose  Early Assessment of Student  

End of week 1 (40h); must be submitted within 3 days  

Preceptor   Feedback for learning  •  Clarify expectations  •  Share learning and

teaching styles  •  Finalize learning plan

(511-514)  •  Identify and address

concerns  •  Promote feedback

and discussion  

Early Assessment of Preceptor  

Student  

Midpoint Student Performance Assessment  

Midpoint of placement (120h) must be submitted within 3 days    

Student & preceptor   Feedback for learning  •  Communicate

student progress  •  Indicate areas for

improvement  •  Set learning goals

and expectations for balance of placement  

Student Evaluation of Preceptor and Site  

Midpoint (120h) must be submitted within 3 days    

Student   •  Identify preceptor and placement strengths and suggest areas for improvement  

Final Student Performance Assessment  

End of placement (240h) must be submitted within 3 days  

Preceptor   •  Assess learning objectives  

•  Recommend placement mark  

Program  Informa&on  

 

www.pharm.ualberta.ca

   

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Preceptor  Requirements  

•  Preceptor  enrolment  form  •  Complete  introductory  Preceptor  Training  

•  Segng  your  student  up  for  success  or  •  UBC  e-­‐Sps  or  •  Former  AHS  preceptor  development  workshop  

•  Review  the  PrecepSng  the  PaSent  Care  Process  Modules  •  Placement  outline  •  Apply  for  library  resources  or  CAC  appointment  

 

Keep  In  Mind  

•  Students  can  use  their  own  laptop/technology  

•  There  is  Faculty  support  to  assist  you  with:  •  Training  to  Precept  •  Developing  your  placement  outline  •  Ideas  to  help  you  integrate  the  student  into  your  workflow  •  Providing  feedback  and  understanding  assessment  

•  You  have  colleagues  that  are  experienced  preceptors.  

 

Resources  

•  Website:  hfp://pharm.ualberta.ca/preceptors  

•  Course  Review  –  (Course  InformaSon  Page)  

•  Understanding  Assessment    

•  hfp://pharm.ualberta.ca/preceptors/training-­‐and-­‐resources/student-­‐assessment-­‐resources  

 

Ques&ons  

Thank  you  for  your  Sme  and  support  of  experienSal  training!    

   Sheila  Walter  

(Ph)  780  492-­‐5513  (E)  swalter@ualberta.ca  Office  days:  Mon  –  Thurs  

Tara  Leslie  (Ph)  403-­‐818-­‐7490  

(E)  tleslie1@ualberta.ca  Office  days  Wed  -­‐  Fri