SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
Fall 2018
Welcome Alyson Wilder, PharmD, BCCCP, BCPS Executive Director of Experiential Education Dr. Alyson Wilder, PharmD, BCCCP, BCPS, began her new position as Executive Director of Experiential Education in July 2018. Dr. Wilder started her academia career in 2017 at PCSP as a member of the pharmacy practice department. She brings a unique experience of over 10 years as a critical care pharmacist and preceptor. She is keenly aware of the issues facing pharmacy preceptors and has a vision to connect with preceptors while improving their teaching skills and continuous professional development. Dr. Wilder will be traveling the state this year to meet many preceptors in person, so feel free to reach out to her to introduce yourself!
As you may already know, Dr. Kate Moore left Presbyterian College School of Pharmacy this summer when her family was relocated to Winston-Salem, NC, with her husband’s work. The Office of Experiential Education is extremely grateful to Dr. Moore’s leadership over the past two years and the momentum she created in constantly improving the rotation experiences for our students!
What made you decide to pursue a career in experiential education? I chose this career path because I feel that experiential education plays a huge part in the development of a student into a confident, knowledgeable, effective pharmacy practitioner. It is during pharmacy practice experiences that students see it all come together and are able to apply their knowledge to real patients. As preceptors, we have an extremely influential role on the development of the future of our profession.
What is your vision for experiential education at PCSP? I have been the new preceptor fresh out of residency who experiences the “growing pains” of developing an effective student rotation. I have been the preceptor that has had to precept students through the development of a new practice site. I have also been that “seasoned” preceptor that is just fresh out of new ideas. I want build upon our current resources to provide the tools needed for preceptors during any phase of their precepting career. I want to investigate new and innovative ways to offer preceptor development. Additionally, I want to work with our preceptors to develop a “step up” rotation plan to further challenge our students when they take the same rotation type for a second time.
What are your goals for the preceptors and students? My goal for both preceptors and students is for them to feel supported by the experiential department. We are just a phone call or office visit away!
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
Fall 2018
Fall Preceptor Workshop The Fall Preceptor Workshop, held in October 2018, was one of the best attended and most engaging workshops we’ve had!
Dr. Lindsay Davis, PharmD, BCPS, ASH-CHC, TTS, FAzPA, visited South Carolina from Midwestern University College of Pharmacy – Glendale (Glendale, Arizona) and presented “Habits of Preceptors” and “Teaching Critical Thinking” to over 60 attendees. She challenged preceptors to reflect on their own precepting habits, set SMART goals, and practice the Socratic Method of questioning with students during the sessions.
Thank you to these student volunteers who came to help preceptors refine their Socratic Method questioning!
Some of the resources shared during the workshop: o Costa AL, Kallick B. Learning and leading with habits of mind: 16 essential characteristics for success. Alexandria, VA: ASCD, 2008. Print. o Dweck CS. Mindset: the new psychology of success. New York: Ballantine Books, 2008. Print. o Elder L, Paul R. The thinker’s guide to the art of asking essential questions. 5th ed. Foundations for Critical Thinking Press, 2010. www.criticalthinking.org o Hawkins DR, Paul R, Elder L. The thinker’s guide to clinical reasoning. Dillon, CA: Foundation for Critical Thinking, 2010. Print. o Oh RC, Reamy BV. The Socratic method and pimping: optimizing the use of stress and fear in instruction. Virtual Mentor. 2014;16(3):182‐6. PMID 24646846 [Free full text] o Paul R, Elder L. The thinker’s guide to the art of Socratic questioning. Foundation for Critical Thinking Press, 2007. www.criticalthinking.org o Lewis DP. Using the Socratic method in office based teaching. Fam Med. 2004;36(3):162‐3. PMID 14999569 [Free full text] o Weitzel KW, Walters EA, Taylor J. Teaching clinical problem solving: a preceptor’s guide. Am J Health‐Syst Pharm. 2012;69:1588‐99. PMID: 22935942 o Habits of Mind assessments: http://www.habitsofmindinstitute.org/resources/assessments/
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
Fall 2018
Simulation Week IPPE During the “Fall Week” IPPE segment in August, P3 students convened at the pharmacy school to complete an intensive, simulated IPPE. Faculty members served as preceptors and simulated several different acute care situations with the high-fidelity mannequins, including a code scenario. Students gained experience in rounding, making recommendations, navigating patient charts, and following a patient’s progress over several days.
Other activities during the week included: o Patient counseling (with standardized patient actors) o Sterile compounding o Order verification and checking o Drug information requests o Vaccine administration
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Objectives of IPPE Sim Week Provide direct patient care Participate in interprofessional interaction and practice Dispense medication, participate in medication distribution and administration and manage the pharmacy aspect of the health-care system Demonstrate professionalism in all areas of the rotation
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
Fall 2018 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 entire article yourself.
Efficient and effective precepting of pharmacy students in acute and ambulatory care rotations: A Delphi expert panel study Am J Health-Syst Pharm. 2017;74:1570-8 Ignoffo, Robert, et al.
• PURPOSE: A panel of experienced preceptors described the best practices to increase preceptor efficiency and effectiveness.. • STRATEGES IDENTIFIED • Thorough orientation to logistics, expectations, and scheduling of activities • Utilizing appropriately trained residents in student training • Opportunities for critical thinking and therapeutic decision-making • Giving frequent, quality feedback on clinical activities • Giving feedback to learners on a regular basis • THE ONE MINUTE PRECEPTOR MODEL ALSO IMPROVED BOTH EFFICIENCY AND EFFECTIVENESS • INTERPROFESSIONAL COLLABORATIVE TRAINING IS ALSO RECOMMENDED • ACTIVITIES RESIDENTS CAN PERFORM (CONSENSUS): • Patient case presentations by students • Rounding with students • Providing didactic discussions • Teaching critical thinking • Assisting with orientation • Helping students with projects • Helping preceptor with assessments • Providing feedback to students
Strategies for Improving Learner Metacognition in Health Professional Education American Journal of Pharmaceutical Education 2017; 81 (4)
WHAT IS METACOGNITION? Metacognition is the individual’s ability to regulate his/her thinking and learning and includes self-assessment skills (planning, monitoring and evaluation). In short, it is “you know what you know.” HOW CAN YOU TEACH METACOGNITION? Emphasizing mastery goal setting, using questions techniques that promote metacognitive awareness, utilizing feedback about the learner’s efforts, request explanations when student gives clinical recommendations, and layer different learners into the rotation. METACOGNITION AND CLINICAL DECISION MAKING: Metacognitive skills allow learners to supervise, adjust, and control their thinking processes. These skills can be influenced by both internal and external factors, including: External Instructor Academic environment Family background Culture Internal Motivation Self-regulation Critical thinking Creativity Learning strategies
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
Fall 2018
Precepting Tips to Prevent Burnout At the ASHP National Pharmacy Preceptor Conference in October, Dr. Mary Douglass Smith, PharmD, Director of Experiential Education, presented, "Fueling your Fire: Identifying and Managing Preceptor Burnout." One activity during the session included attendees sharing their best tips for preventing preceptor burnout. These activities were collected and organized into major themes. We hope you will be able to share this list with your colleagues and find more to add to it.
Team Precepting Increase depth of preceptor pool Share onboarding responsibilities Shared journal club/topic discussions Delegate, redistribute students utilizing a workload analysis Shadow other providers outside the pharmacy
Protected Time Schedule defined/capped periods of time for learning or discussions, so learners don’t have unending access to preceptors Have protected time for preceptors
Layered Learning Layered learning (PGY2 precepts PGY1/APPE)
Streamlined Orientation Orientation checklist (residents/students) Coordinated student orientation Record orientation information to allow more time for other activities If learner time frames don’t line up, have current learners lead orientation for new ones
Assignments with Meaning Being intentional about assignments - give students something that will assist your workload Have residents share the workload, review protocols, update manuals, or learning experiences Delegate objective work task to learner to take off your plate Align learner projects with service line goals Schedule reflection
Strategic Scheduling Dedicate time away from learners, i.e. blocks off Having multiple students at a time so student load is the same per year, but more free time without students during the year
Topic Discussions Do hybrid discussions - have learner present brief guideline review and preceptor brings cases for discussion Student-led topic discussion Get rid of topic discussions!
Other Manage expectations early in the rotation and customize the rotation based on student interest (increases enthusiasm) Screencast-o-matic to record presentations to grade later Pair preceptors with a mentor who has balance more figured out/not experiencing burnout Acknowledge burnout and talk about it Sharing resources across institutions Incorporate new activity per semester to keep things interesting Have preceptors present topics at RAC burnout/resiliency, precepting pearls, topic discussions for students Setting clear expectations upfront Knowledge exam at the start of the rotation to find gaps/areas to focus on
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
Fall 2018
Important Dates
What we’ve been up to…. Site Visits Palmetto Richland Hospital, Columbia, SC Greenville Health System, Greenville, SC BiLo Pharmacy, Greenville, SC Connected Health Pharmacy, Simpsonville, SC
Conferences & Meetings South Carolina Society of Health-System Pharmacists Fall Meeting, Columbia, SC ASHP National Pharmacy Preceptors Conference, Dallas, TX American College of Clinical Pharmacy Annual Meeting, Seattle, WA All Pharmacy Conference, Columbia, SC SC Board of Pharmacy Meeting, Columbia, SC E*Value Users Conference, St. Paul, MN
December 3 December
January 8–February 14 February
February 18-22 February 21
February 21 February 26-April 11 March 11-15 April 18
2019-2020 APPE schedules are on the way Though it seems like the 2018-19 APPE year just started, it’s already time to start looking ahead to the 2019-20 academic year. Preceptor availability has been entered and P3 students (Class of 2020) have entered their preferences. Following the “spin” (schedule optimization by E*Value), the Office of Experiential Education will meet with each student individually to refine and finalize schedules. This one-on-one meeting time allows for scheduling conflicts to be worked out prior to finalizing the schedules and releasing them to preceptors.
April 19-22 May 1 May 1 May 10, 2019 Graduation
All APPE evaluations due* IPPE workbook logs due (fall semester) IPPE (Spring 1) 2019-2020 IPPE availability requested IPPE make up IPPE workbook logs due (Spring1) Spring Preceptor Workshop IPPE (Spring 2) Spring Break for P1-P3 students IPPE workbook logs due (Spring 2) Easter Holiday for P1-P3 students Final grades due* Class of 2020 begins APPEs Class of 2019
*These two time periods are particularly important to get grades into the Registrar’s Office (December to get all APPE grades in for residency applications and May to certify graduation).
Student Evaluations will be emailed in January 2019 Student evaluations of preceptors for time period May 2018–November 2018 will be emailed to individual preceptors in January. The evaluations will include aggregate student scores, comments, and comparison to other preceptors. If you offer both IPPE and APPE rotations, you will get two reports based on the type of rotation.
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
Fall 2018
E*Value Tip: Student pictures now available on the schedule E*Value has made several updates in recent months and one of these includes the addition of student photos on the schedules. When pulling up your schedule, select “YES” for “Show User Photos”
The student pictures will appear next to their names on the schedule.
IPPE Workbook Tip: P3 presentations
Each P3 student is required to present and discuss at least 1 case presentation in each IPPE segment (both fall and spring). This assignment can be completed in every setting – inpatient and outpatient. The case presentation should include: o Pathophysiology of the disease state o Medications used to treat the disease o Evaluation of the drug therapy of the case If you precept P3 students, please help them identify patients to present during their rotation with you. This will help them tremendously in preparing for APPEs! Case Presentations can be found on page 10 of the P3 IPPE workbook
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
Fall 2018
Preceptor Spotlight: L. Dusty Harmon, PharmD Pharmacist, Union Medical Center Spartanburg Regional Healthcare System Union, South Carolina Dr. Harmon was born and raised in Union, South Carolina. He graduated from South Carolina College of Pharmacy (University of South Carolina Campus ) in 2010. His career at Union Medical Center began in August 2012. He offers an acute care advanced pharmacy practice experience (APPE) every month for fourth year students. During the APPE, students have the opportunity to participate in daily rounding with a multidisciplinary team. The pharmacy department also includes students in their duties in the emergency department and responds to all medical emergencies in the hospital. Dr. Harmon serves as part of the Hospital Emergency Response Team at Union Medical Center, Spartanburg Medical Center, and Pelham Medical Center.
1. What are the most difficult aspects of being a preceptor? And how do you overcome these barriers? The most difficult part of being a preceptor is time management. I try to come up with a schedule, before a student starts rotation, of when we should accomplish each goal of the rotation.
2. What do you value most about being a preceptor? I enjoy being able to show students different areas of pharmacy, whether it is participating in rounding or working in emergency situations. I like to tell students that you do not have to follow a traditional pharmacist role. 3. How do you judge a student's success on your rotation? I judge a students success based on his/her personal growth during the month. The student who have the most success on my rotation is the one who show sup with a positive attitude and an idea of what he/she would like to achieve during the rotation.
“Dusty is one of the best preceptors in my opinion. He is always looking for ways to challenge the student with patient cases and drug questions. He spent adequate time working with me to maximize my experience, but also gave me several opportunities to grow independently. Overall it was a great rotation!� - Taylor Greene, Class of 2017
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
Fall 2018
Student Spotlight: Chris Asbill Chris Asbill, originally from Clinton, SC, is a current P3 student. Following graduation from James F. Byrnes High School, he completed his undergraduate education at the University of South Carolina. His career goals include either owning a methadone clinic or working in a hospital setting. Chris currently works as a pharmacy intern at Walgreens Pharmacy and at Rock Hill Treatment Specialists. He is a student member of APhA Academy of Student Pharmacists (APhA-ASP) and serves as Philanthropy Chair for the student chapter of College of Psychiatric and Neurologic Pharmacists.
1. What has been your most valuable rotation so far and why? Spartanburg Regional has been my most valuable rotation thus far and having a great preceptor played an enormous role in that decision. With every rotation, you will always learn something new but having a preceptor who is willing to go the extra mile will make a rotation memorable for the rest of your career. Dr. Ferguson ensured that each student got the most out of his rotation by allowing us to see specific parts of hospital pharmacy that we agreed would be of interest to us. He also wanted us to see every part of the hospital we could in the time we were given, which was incredibly beneficial for me because it opened up my eyes to other types of hospital pharmacy I had not considered as a career option.
2. How do you balance the demands of your rotations with your school work? Rotations play a big part in our education throughout pharmacy school. Having rotations during the school year has taught me how to manage my time so much more efficiently than I was able to in the past. Understanding deadlines and planning ahead make things so much easier to manage.
3. What is something you have learned about yourself on rotation? Each rotation provides students with first-hand experiences in a variety of settings which can help them decide on a career path. Some students go into pharmacy with no real idea of which type of pharmacy they would like to enter when they finish school. For me personally, I went into pharmacy school thinking I would probably end up working in a methadone clinic or some kind of retail. However, through many of my rotations, I have learned that I do enjoy working in a hospital setting and that working in a style of pharmacy that is ever changing is something that would make me enjoy my career even more.
Since the beginning of Presbyterian College School of Pharmacy, there have been at least 8 pairs of siblings attend the program. Adam and Chris Asbill are currently students of the Class of 2020.