PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR
pharmacy.presby.edu | 864.938.3900
September – December 2016
Introducing the Master Preceptor Many of the preceptors at PCSP go above and beyond what is required of them and we want to recognize their efforts. The Office of Experiential Education and Experiential Program Review Committee (EPRC) have created a credentialing process to increase the recognition of our exceptional preceptors. To become eligible for the Master Preceptor level, the preceptor should submit all materials and CV to the OEE by November 1 each year. Master Preceptors will be recommended for adjunct faculty status in January and recognized at the White Coat Ceremony in August. We hope many of you will take advantage of this opportunity!
For more information about becoming a Master Preceptor, Contact Kate Moore Executive Director of Experiential Education kgmoore@presby.edu 864-938-3860
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
September – December 2016
PRECEPTOR There’s a lot in the literature about trends and improvements in experiential education. So we’ve created an easy way for you to keep up: The Journal Monitor. In each preceptor newsletter, we’ll provide you a brief look at some current articles. And we’ll provide the source information as well so you can take a look at the whole article yourself.
Variables Affecting Pharmacy Students’ Patient Care Interventions during Advanced Pharmacy Practice Experiences American Journal of Pharmaceutical Education 2016; 80 (7) Article 116
INTRODUCTION: Typically on APPEs, preceptors direct students to identify medication-related problems (MRPs) and appropriate interventions. They might expect that student will self-initiate interventions more frequently by the end of the APPE or later in the APPE year. The purpose of this study was to find differences in the pharmacy students’ self-initiation of interventions across APPEs. METHODS: The study incorporated acute care APPEs in critical care, infectious disease, internal medicine, and pediatrics. Students documented interventions and indicated how they were initiated (self, pharmacist preceptor, physician, or nurse). RESULTS: A majority of student pharmacists’ interventions were self-initiated and most were accepted by the medical staff Students were less likely to self-initiate interventions on pediatrics or infectious disease rotations, relative to internal medicine rotations (-1.14, p<0.01) Students who expressed interest in postgraduation residency were less likely to self-initiate interventions (-0.79, p<0.05) No significant differences were found across APPE temporality (whether it was at the beginning of the APPE year or at the end) CONCLUSIONS: Preceptors should determine a threshold of what percentage of interventions should be self-initiated. Once determine, student-initiated interventions could be used as an objective marker of competency and student success on the APPE. SAMPLE STUDENT INTERVENTION LOG:
Student
Rotation Week #
Initiator
Service
Type of Intervention
Primary Medication
Rotation #
Recommendation
Accepted? (Y/N)
Expanding care through a layered learning practice model Am J Health-Syst Pharm Volume 73 Number 22 November 15, 2016
INTRODUCTION: Layered Learning practice model (LLPM) allows for expansion of direct patient services. The LLPM team is assigned to care for all the medication needs of patients on a medical service and works together to ensure proper medication management at all transitions of care. METHODS: The LLPM team consisted of a PGY-1 or PGY-2, an APPE student, a clinical generalist pharmacist, and an attending pharmacist. The team’s mission was to provide discharge medication reconciliation and counseling to every patient discharged from the hospital and each team member had a dedicated role. RESULTS: 51% of all patients discharged during the study period received personalized education a discharge from the pharmacy team. Prior to this, the percentage was 0%. An overall mean of 1.12 medication related problems were identified per patient and all were reconciled prior to discharge. CONCLUSIONS: Sustainability of pharmacist care services is an important consideration with learner scheduling and team member availability. The provision of pharmacy education requires a different educational strategy in which the learner team is supported to provide care services in knowledge and ability. To meet the educational needs of students at all learning levels, the school of pharmacy must be supportive of the education through the delivery of patient care services.
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR What we’ve been up to…. Site Visits Palmetto Health Richland, Columbia, SC Newberry Hosptial, Newberry, SC Agape Senior/LTC Health Solutions, Columbia, SC AnMed Rehabiliation Hospital, Anderson, SC Greenville Memorial (GHS), Greenvile, SC
Fall Preceptor Workshop The Fall Preceptor Workshop was held on Friday, September 16th at The Commerce Club in Greenville, SC. Dr. Melissa Medina, Ed.D. (The University of Oklahoma College of Pharmacy) presented great information about the use of rubrics and objective grading. Dr. Medina also presented to the PCSP faculty during her trip to South Carolina for a Lunch and Learn about co-curricular requirements in the ACPE 2016 Standards. “From the workshop we all just attended, it reinforced my love of rubrics! When I used to use a point system for my SOAP note assessment, the “A and P” portion was 70%, but so subjective from the amount of points you graded. So the scale is much, much better.” – Dr. Ashley Gulyas, Preceptor
pharmacy.presby.edu | 864.938.3900
September – December 2016
Recap from AACP Encore Institute Drs. Kate Moore, Mary Douglass Smith, and Jaime Foushee traveled to Dulles, Virginia, to participate in the American Association of Colleges of Pharmacy (AACP) Encore Institute to learn about transformational change in experiential education from expert speakers. These institutes, put on by AACP, are designed to deliver background information on focus areas followed by “team time” for the individuals from each school to develop action plans and materials to take home to their schools to implement. This particular institute focused on quality assurance and assessment as well as interprofessional education in experiential education. Our team was very productive during our time at the institute. We designed an entire blueprint for assessment of our experiential process including student, curricular, and preceptor/site assessments as well as assessments for our departmental procedures. We spent considerable time ensuring that all assessment tools line up with ACPE standards as well as the overall assessment plan of the Presbyterian College School of Pharmacy (PCSP). We also identified needed changes to our existing evaluation tools. Although this is a large undertaking, we are excited about implementing these changes and the resulting improvements in data that will guide both students and preceptors. The PCSP Experiential Program Review Committee will create new preceptor and student evaluation tools for both IPPEs and APPEs which we will share at our spring preceptor workshop to be held on March 3, 2017, at the PCSP. If you would like more information or would like to be involved in the process, please contact Kate Moore (kgmoore@presby.edu or 864938-3860). We are grateful to Dr. Jaime Foushee (chair of the PCSP Assessment Committee) for her time and contributions to our office and this process.
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR
pharmacy.presby.edu | 864.938.3900
September – December 2016
E*Value Tip: Requirement Status and Letter of Good Standing When you see your schedule on E*Value now, you may have noticed that there are two new columns: Requirement Status and Letter of Good Standing. E*Value automatically added these options to ease with pre-rotation requirements. However, we already have a process in place where we send personalized packages to each site, so we are not planning on using these generated letters.
Preceptor Listservs Do you wonder if another preceptor is doing something really innovative that you could duplicate at your site? Do you have a great rubric that you’d love to share with similar preceptors? Do you struggle with developing a meaningful assignment to evaluate a student’s “Ethical & Legal Judgement” and would love to see what other preceptors are doing? We have developed listservs for our preceptors to utilize to share ideas, ask questions, collect information, and network! The listservs are specific for each type of rotation offered:
Community Preceptors Acute Care Preceptors Ambulatory Care Preceptors If you would like to be added to a listserv and join the conversation, drop an email to Mary Douglass (mdsmith@presby.edu)
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR
pharmacy.presby.edu | 864.938.3900
September â&#x20AC;&#x201C; December 2016
Preceptor Spotlight: Ashley N. Castelvecchi, PharmD, BCGP
Clinical Pharmacy Specialist, Home-Based Primary Care Greenville VA Outpatient Clinic, Greenville, SC
Ashley is originally from Kentucky where she graduated from the University of Kentucky. She completed a PGY-1 residency at the Lexington VA Medical Center. There she realized her passion towards geriatrics and home-based primary care. She then moved to South Carolina with her husband, where she currently works at the Greenville VA Outpatient Clinic. Ashley is a Board Certified Geriatric Pharmacist (BCGP) and serves as preceptor for an ambulatory care experience with a focus on providing comprehensive medication management and care to primarily geriatric home-bound veterans. 1. What are the most difficult aspects of being a preceptor? And how do you overcome these barriers? It can be difficult adapting the rotation requirements to meet each individual's needs. To help overcome this, I provide a self-assessment on the first day, giving the student time to analyze a patient case, make clinical recommendations, and then discuss the case with me. This allows me to gauge the student's thought process and application of their knowledge to a patient, and then I am able to tailor the rotation to help them get the most out of the month. 2. What do you value most about being a preceptor? I value getting to work with different types of students who each bring new ideas to the rotation. Their enthusiasm to learn helps me maintain my own excitement to precept, share my knowledge, and provide a unique rotation opportunity. 3. How do you judge a student's success on your rotation? A student has been successful on my rotation if they are able to adapt to working with a primarily geriatric population, in which the typical guidelines may not always apply. I assess students on their ability to improve during the month, work with veterans towards individualized goals, and providing education to patient and caregivers in a compassionate manner. If they have learned this they will be successful no matter where their career leads.
Greenville VA Outpatient Clinic Preceptors Dr. Ashley Castelvecchi Dr. Lamonica Crump Dr. Svetlana Starikova Dr. Rochelle Sullivan
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR
pharmacy.presby.edu | 864.938.3900
September – December 2016
Student Spotlight: Evan Bryson Evan Bryson is a current P3 student and commutes to Clinton from Easley, SC, where he has lived for most of his life. His professional interests have shifted over the course of his pharmacy school career. He has recently become interested in Ambulatory Care and hopes to complete a PGY1 residency with a focus in Ambulatory Care. He has been actively involved during pharmacy school, participating in multiple committees, acquiring a position as a Junior Board Member with SCSHP, and serving as the class’s vice president. He also worked at CVS pharmacy over the past year. Evan’s research has been published in International Journal of Pharmacy Compounding (IJPC).
1. What has been your most valuable rotation so far and why? I have been very fortunate with regard to my rotation schedule and have really had great rotations thus far. However, I recently completed an IPPE rotation at the VA Outpatient Clinic in Greenville, SC and I would have to say it was the most valuable of my rotations to date. My interactions with patients, including experiences such as one-on-one counseling on medications and proper inhaler technique to using telepharmacy to conduct thorough medication reconciliations, really gave me the opportunities to apply the knowledge that I have acquired through the didactic portion of my education and, also, to learn new skills in the process. My preceptor, Dr. Svetlana Starikova, also played a large role in the success of the rotation, challenging me to think outside of the box and asking me questions that I didn’t always have the answers to. Instead of simply giving me the answers, she encouraged me to use drug information resources to find reliable information and then, using information from multiple sources, formulate a complete and thorough recommendation to answer her question. Utilizing drug information resources is a skill that is taught in our pharmacy curriculum, but being able to utilize this skill in the real world was an invaluable experience, one which I feel will benefit me enormously in my future professional practice. My preceptor also provided constructive feedback during and after the rotation, which helped me identify areas for improvement. I sincerely believe that this particular rotation has helped me become a more competent and knowledgeable future pharmacist and acquire skills that will enable me to be successful during future professional experiences. 2. How do you balance the demands of your rotations with your school work? I feel that this issue is a conundrum for most pharmacy students at some point during their rotations. I have found that balancing multiple responsibilities requires both organization and flexibility. It is imperative to be organized in order to avoid missing deadlines and to be prepared for quizzes and exams. While different methods of organization work different students, I have found that using a Google calendar with reminders works very well for me. I simply add an event and set a reminder for 24 hours in advance to ensure I am on track and prepared for any upcoming assignments. Flexibility is also key. My schedule changes almost daily and so I have to be flexible to move things around in my calendar in order to accomplish all of my tasks efficiently. Keeping track of assignments from both school and rotations is challenging, for sure, but staying organized and being flexible have enabled me to keep up with my assignments and retain my sanity. 3. What is something you have learned about yourself on rotation? Each one of my rotations has provided many opportunities for self-reflection. One of the things I have learned about myself is that, at least for me, recalling pertinent information for an exam is drastically different than recalling that same information with a preceptor standing right in front of me. I have been asked questions that I knew the answers to, yet, in the heat of the moment, I could not remember them. However, I have also noticed that I have progressed in this area over the course of time, leading me to believe that this is a problem that can be overcome with practice. For this reason, I am extremely grateful for the opportunity to complete each rotation and for the understanding and patience of our amazing preceptors.
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR
pharmacy.presby.edu | 864.938.3900
September – December 2016
Alumni Spotlight:
Meissa O’Dell, PharmD Pharmacist, Patrick B. Harris Psychiatric Hospital
Meissa graduated cum laude from PCSP in May 2014. She currently serve as the Assistant Director of Pharmacy at Patrick B. Harris Psychiatric Hospital where she has both clinical and staff pharmacist responsibilities. She also precepts pharmacy students and works with the psychiatric medical residents. She lives in Fountain Inn, SC with her husband, Cody, and 6 month old daughter, Kaylee. When she is not trying to catch up on sleep, she enjoys spending time with family, traveling, and shopping! 1. What have been the most difficult parts of being a new practitioner? And what do you do to overcome these barriers? The most difficult parts of being a new practitioner are time management and confidence. I love to read, do research and learn. However, fulfilling my duties of a full-time pharmacist, wife and mother make finding time to do these things a challenge. I stay as organized as possible and schedule my days in advance to allow me the time I need to accomplish my learning goals. Also, I found making clinical recommendations to more experienced medical professionals initially intimidating. However, as I expand my clinical knowledge and gain more experience, my confidence grows. I also stay motivated to overcome my apprehension by keeping my patients’ best interests at the forefront of my mind. 2. What rotation experiences inspired your current career? Patrick B. Harris Psychiatric Hospital was my last fourth year APPE with Dr. Jim Pitts, our current Director of Pharmacy. I had never considered a career outside of community pharmacy, but Dr. Pitts and Harris Hospital quickly changed my mind. The mission of Harris Hospital and the execution of our mission through our exceptional patient care are truly inspiring. The culture of Harris Hospital is one that draws you in and inspires you to become a better practitioner. I quickly identified this on my APPE and worked toward attaining a pharmacist position here.
3. Describe one of your favorite moments in patient care. All of my patients are dear to me, especially at my current practice site. It is impossible for me to choose one moment in patient care as my favorite. I get the greatest satisfaction when I am able to make a recommendation that positively impacts my patient’s care and overall well-being; even if my patient does not realize my level of involvement. My current position at Harris Hospital allows me the greatest opportunity to achieve this by working closely with our medical staff.
“I had never considered a career outside of community pharmacy, but Dr. Pitts and Harris Hospital quickly changed my mind.”