PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR
pharmacy.presby.edu | 864.938.3900
September – December 2017
Learning Stages of Students Preceptors interact with students at various points of competency, especially as they are learning new skills and putting them into practice at the rotation site. The Conscious Competence Ladder was first developed in the 1970s and incorporates the two factors involved when a student learns a new skill: competence (ability to complete the skill) and consciousness (student’s self-awareness). Whether it be an ambitious P1 student or a P4 student that struggles with constructive feedback, preceptors must evaluate the student’s competence as well as their self-awareness of this competence in order to provide a better learning experience.
By helping the student evaluate where his/her learning stage is at the time of the rotation, feedback can be better tailored to the student. • Unconscious incompetent: Explain the importance of learning new skills, model lifelong learning, show the student how much he/she will learn during pharmacy school and rotations. • Conscious incompetent: Give encouragement and support to improve self-confidence when the student feels discouraged and frustrated while trying to perfect new skills. • Conscious competent: Allow opportunities for the student to improve on skills and build on previous learning experiences. Give activities that require new skills or higher levels of competency and allow the student to teach less experienced learners. • Unconscious competent: Avoid complacency and find ways to keep up to date. Practice patience with those learners who are at a lower stage. "Learning a New Skill is Easier Said than Done". Gordon Training International.
Save the date! Spring Preceptor Workshop March 22, 2018 Newberry Firehouse Conference Center Newberry, South Carolina
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR
pharmacy.presby.edu | 864.938.3900
September – December 2017
Experiential Program Review Committee The Experiential Program Review Committee (EPRC) is a school committee made up of faculty, students, experiential office members, and preceptors from diverse practice settings. This year has been busy as we worked on the following charges: • Establish criteria for new and current preceptors including a checklist of items that must be completed prior to taking students. • Determine quality benchmarks for preceptors and establish what points signal the need for targeted development. • Evaluate onsite visit form and provide feedback on planning of site visits including how frequent to make visits, what prompts a quicker visit, and content of visits made. • Determine quality benchmarks for rotation sites and establish plan for cessation of site usage if quality unable to be assured. The EPRC has been responsible for previous projects, such as the IPPE workbook, Master Preceptor recognition, and piloting new student evaluations.
Master Preceptor
Our preceptors have the opportunity to be recognized for their dedication to teaching pharmacy students with the Master Preceptor program. Two preceptors – Dr. Lee Dailey and Dr. Ashley Castelvecchi – have been awarded this distinction this year. Requirements are due each year by November 1, so now is the time to start looking at the requirements and begin working to complete them by next year’s deadline. For questions about the process or requirements, contact Kate Moore, Executive Director of Experiential Education (kgmoore@presby.edu, 864-938-3860)
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
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.
Fail Fast American Journal of Pharmaceutical Education 2013; 77 (8) Article 159
Joseph T. DiPiro, PharmD, and Marie A. Chisholm-Burns, PharmD, MPH, MBA
• “Fail fast,” “fail cheap,” and “fail smart” are all common concepts in information technology businesses. The idea of sharing failures and near-misses is utilized to improve upon systems and prevent continued malfunctions. • The concept of sharing failures has appeared in higher education, but is not readily accepted as a part of growth, especially in pharmacy education. This can lead to resistance to change and innovation, and a mindset of “this is the way we’ve always done it.” • Failure is not the opposite of success. Failure can simply be part of the learning process that creates better patient care, improved processes, and sustained success. • How does this apply to preceptors? • Preceptors can share their own failures and near misses with the student. Reflecting on missteps and the lessons learned while in pharmacy school or practice can illustrate to the student how continued growth leads to professionalism. • Invite the student to investigate the failures or near misses at the rotation site (such as frequent misfills of a medication or hindrances in transitions of care). Allow the student to use creativity, problem solving, and critical thinking to develop solutions. • Also see: Johannes Haushofer’s “CV of Failures”
pharmacy.presby.edu | 864.938.3900
September – December 2017 Pharmacy student experiences in small and rural hospitals American Journal of Health-System Pharmacy 2017, 74 (19) 1524-1526
INTRODUCTION: With the expansion of pharmacy schools, more pharmacy students are able to have experiential exposure in small and rural hospitals. This learning environment presents unique opportunities for involvement in various parts of the health system and pharmacists’ role in each. PHARMACY STUDENT EXPERIENCES: Nursing care Students can be introduced to medication distribution and administration and initial patient evaluations. Anesthesia practices Students are able to realize the impacts of bolus and rate changes of anesthesia and readily apply the knowledge of receptor targets and mechanisms of action . Nuclear medicine Many sites offer exposure to how nuclear medicine is prepared, distributed, and utilized. This experience fills in gaps from material unable to be taught and simulated in school. Hospital administration Small and rural hospitals can have increased access to the hospital administration team that can influence the students’ future career interests. Medical staff Students have increased access to the medical team and can experience closer relationships with providers. Ambulance services An underutilized opportunity for learning, a student can work with the ambulance services and experience the acute management of emergencies and the resulting transitions of care. Respiratory therapy With the advent of several new and innovative respiratory therapies, a student can improve both patient counseling and empathy while assisting respiratory services.
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR What we’ve been up to…. Site Visits Lunch and Learn on preceptor development for technicians and pharmacists at AnMed Health Medical Center, Anderson, SC Bryant Pharmacy & Supply, Anderson, SC Wingard’s Pharmacy, Greenwood, SC Fred’s Pharmacy, Ware Shoals, SC CVS Pharmacy, Honea Path, SC Walmart Pharmacy, Simpsonville, SC Greenville Health System Sterile IV Compounding Pharmacy, Greenville, SC Bon Secours St. Francis Health System, Greenville, SC Greenville VA Outpatient Clinic, Greenville, SC Prosperity Drug, Prosperity, SC RozCo, Inc., Rock Hill, SC Piedmont Medical Center, Rock Hill, SC Anderson VA Outpatient Clinic, Anderson, SC
Student evaluations on the way! Student evaluations of preceptors (both APPE and IPPE) will be released in January. These will include evaluations that students completed from May– December 2017. As a new professional requirement, students are required to complete at least 90% of their evaluations, so we are expecting larger numbers of evaluations for our preceptors than we’ve had in the past. We hope you will continue to use this information to improve and refine your teaching. The 2017 Fall Preceptor Workshop included strategies for self reflection and professional development using student evaluations. If you were not able to attend this workshop, you can find the recording of it on pcspoee.com (Courses – Preceptor Workshop Series – Fall Preceptor Workshop 2017)
pharmacy.presby.edu | 864.938.3900
September – December 2017
New (and Experienced) Preceptor Orientation The Preceptor Learning Portal contains 9 learning modules all preceptors should complete. Whether you’re brand new to precepting or have been precepting students for several years, the modules will orient you to the specific curriculum at Presbyterian College and assessments and evaluations unique to our program. The modules take about 90 minutes total and can be paused at any time. Topics include: • Module 1: Why You Teach (Desire to teach and a preceptor’s role) • Module 2: Preceptor Prep (What PCSP is all about) • Module 3: Our Support to You • Module 4: Model Preceptor (Attributes of a Preceptor) • Module 5: Presbyterian College Curriculum • Module 6: IPPE and APPE Objectives • Module 7: Serious Student Problems and Unprofessionalism • Module 8: Assessment, Evaluations, and Grades • Module 9: Preceptor Assessments
www.pcspoee.com
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
September – December 2017 PRECEPTOR E*Value Tip:
Resources available to preceptors There is no reason for preceptors to have to reinvent the wheel for assignments for both IPPE and APPE students. There are a variety of resources available on the E*Value home page and preceptors are encouraged to utilize and edit them for their own rotations. Examples include: • Blood pressure assessment form (to grade students’ techniques in measuring patient’s blood pressure) • SOAP note template (available as a Microsoft Word document to edit for the specific institution) • Journal Club evaluation (includes point breakdowns for more objective grading) • Law Quiz (part of the P1 workbook, but can be utilized for any student)
There are also links to Preceptor Development and the Pharmacist’s Letter for continuing education and our library resource page, including drug information resources.
2018-2019 APPE schedule release Thank you to our preceptors who entered availability for the 2018-19 APPE year!
Students have entered their preferences and we anticipate that finalized schedules will be released in February 2018. Around that same time, IPPE Availability for 2018-19 will be sent out, so that preceptors can indicate when they can precept IPPE students based on the APPE schedules.
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR
pharmacy.presby.edu | 864.938.3900
September – December 2017
Preceptor Spotlight: Katie Bastug, PharmD
Pharmacist, Barney’s Pharmacy-Peach Orchard Augusta, Georgia Katie Bastug is a 2015 graduate of the South Carolina College of PharmacyGreenville Campus. As a pharmacist at Barney’s Pharmacy-Peach Orchard, she focuses on compounding, long term care, retail pharmacy, durable medical equipment, and specialty pharmacy. She specifically precepts for community/independent APPEs. Barney’s also offers a community residency program through UGA and SCCP. The students gain experience in all of the departments as well as insight into what it takes to own and manage an independent pharmacy with the owner. The highlight for most students is the completion of a clinical service project focusing on an area of their choice. Dr. Bastug’s areas of focus include compounding and leading the Barney's Smoking Cessation Program. As the compounding pharmacist, her passion lies in bioidentical hormone replacement therapy consultations. Dr. Bastug has been with Barney’s for 3 years and says she absolutely loves the work and her coworkers. She lives in Augusta with her “fur children,” Colby (a Boston Terrier) and Avett (Tabby cat) and is getting married in February to her fiancé who is also a pharmacist.
1. What are the most difficult aspects of being a preceptor? And how do you overcome these barriers? One of the most challenging aspects of precepting is time management between my responsibilities at work and my responsibility to my students. By remaining organized and making individualized student schedules, I am able to overcome this obstacle. Another challenge is not always knowing the answers to my student’s questions. I am always working to expand my personal knowledge through research and am able to call upon coworkers with different experience to help answer any and all questions! 2. What do you value most about being a preceptor? There are many things I value about being a preceptor, but one of my favorites is being able to pay it forward. I did a rotation at Barney’s pharmacy as a student and it completely changed my career. My preceptor was engaging and made everything personalized to my interests. I love sharing all the clinical services we offer and allowing students to tap into what they are passionate about. 3. How do you judge a student's success on your rotation? I always base my student’s success on his/her progress. Everyone comes in at different points in the 4th year and also with different goals and backgrounds. I like to have an in-depth discussion at the beginning of a rotation to assess a student’s personal goals and focus on his/her progress in accomplishing those goals. Barney’s is a very high-speed pharmacy with a hands-on approach to patient care. It usually takes a few days to get the feel and pace of the pharmacy down, but I love guiding my students those first few days until they are independent problem-solvers!
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR
pharmacy.presby.edu | 864.938.3900
September – December 2017
Student Spotlight: Missouri Moultrie Missouri was born in Maryland but grew up in Cottageville, SC. She received her undergraduate degree from Winthrop University in 2013 and began working as a pharmacy technician and now an intern at CVS Pharmacy. While at PCSP, she enjoys being part of an integral team of professionals. She is very involved in student organizations, serving as president-elect of Student Society of Health-System Pharmacists, a member of American Pharmacists Association, and a PCSP Student Ambassador who assists with recruiting and tours of prospective new members. She is interested in pursuing a professional career in the emerging field of pharmacogenomics and its impact on the future of targeted drug therapy.
1. What has been your most valuable rotation so far and why? My most valuable rotation so far is Greenville Memorial Hospital with preceptor Dr. John Pearson. I enjoyed the wide variety of departments in hospital pharmacy that I was able to experience such as medication reconciliation and education, emergency department pharmacy, and clinical pharmacy. I appreciated knowing and experiencing the vital part that a pharmacist plays in an inter-professional team. 2. How do you balance the demands of your rotations with your school work? Balancing my time between rotations and school work can be challenging occasionally. The balance is achieved by strategically planning out my day-to-day activities and being sure to plan a sufficient amount of time to complete school work and study. I enjoy having the balance between the two because it prevents me from burning out on one task. 3. What is something you have learned about yourself on rotation? While on rotations, I am intrigued by how much I actually learned in my classes and am able to apply what was taught in courses to the practice of pharmacy.
PRESBYTERIAN COLLEGE SCHOOL OF PHARMACY
PRECEPTOR
pharmacy.presby.edu | 864.938.3900
September – December 2017
Alumni Spotlight:
Paige Street, PharmD
PGY-2 Resident, Pain Management and Palliative Care University of Florida Health, Jacksonville, Florida Paige Street is from Drexel, North Carolina, and received her Bachelorsof Science in chemistry from UNC-Wilmington in 2012. She graduated with honors from Presbyterian College School of Pharmacy in 2016. She completed her PGY-1 at the Malcom Randall VA in Gainesville, Florida, and is currently completing her PGY-2 in Pain Management and Palliative Care at UF Health Jacksonville. Her professional interests include acute pain management, substance abuse, and psychiatry. She is pursuing a career at an academic medical center in either acute pain management or pain stewardship. 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 part of becoming a new practitioner has been becoming an independent practitioner. It has been difficult to not have a preceptor looking over my shoulder and ensuring that I am doing the correct things to manage my patients. It was very scary verifying my first orders, knowing that I was solely responsible for making sure it was the correct medication, dose, and route. One way I overcame this fear has been looking up information that I am unfamiliar with. I carry around a notebook to write down questions I don’t know the answers to or new information that I learn on rounds. I have taken this information and made short references that I keep in my pocket to use when I am on rounds or talking with patients. I have used my preceptors as a references to guide me to appropriate resources to use and how situations are handled in the hospital system. All of my preceptors have assured me that I am not alone while at work but want to enforce the idea of independence. 2. What rotation experiences inspired your current career? When I started pharmacy school I was originally interested in substance abuse. I went to the University of Utah School on Alcoholism and Other Drug Dependencies after my P1 year. At this conference I heard a physician speak about how he utilizes his pharmacists to assess patients’ risk for abuse and their pain and recommending alternative medications to control their pain while minimizing opioids. This really opened my eyes to how pharmacists can be used to prevent addiction and better manage patients. After this experience, I had a rotation at a methadone clinic as well as a VA pain management rotation where I saw pharmacists make recommendations on ways to minimize opioid use while maximizing the patient’s pain control. This really opened my eyes to innovative ways to manage pain appropriately. 3. Describe one of your favorite moments in patient care. It is really hard to pick a specific favorite moment that stands out in my patient care experiences, but there are two very similar situations that I have had recently. Both patients had a recent craniotomy and both were complaining of severe headaches. One patient was being managed with Fioricet and the other was being managed with oxycodone. Their headaches continued to worsen over several days to the point that they were using the maximum amount of medication but still without any pain relief. I was able to provide education to these patients about the medication they were using and how both medications have a high risk of worsening their headaches when frequently used. After this discussion, they were willing to have their medications tapered off and initiate scheduled acetaminophen. Once they were weaned off of their original medications and only on acetaminophen, they had significant improvement in their headaches. These situations really stood out to me because they were two of the many examples where opioids are not always the answer and a medication as simple as acetaminophen could solve the problem.