The Pharmacist Preceptor Education Program

x The Pharmacist Preceptor Educatio Program developed by

The Pharmacist Preceptor Educatio Program Advisor Cythia J. Boyle, PharmD, FAPhA Professor ad Chair Departmet of Pharmacy Practice ad Admiistratio School of Pharmacy Uiversity of Marylad, Easter Shore Pricess Ae, Marylad ADVISORY BOARD FROM 2007 Co-chair Marya Z. Skrabal, PharmD, CDE Assistat Director Office of Experietial Educatio Assistat Professor Departmet of Pharmacy Practice School of Pharmacy ad Health Professios Creighto Uiversity Omaha, Nebraska Co-chair Jaee Wiike, BPharm Director of Recruitig ad College Relatios SuperValu Frakli Park, Illiois Arlee A. Fly, RPh, PhD Vice Presidet of Professioal Affairs America Associatio of Colleges of Pharmacy Alexadria, Virgiia Rebecca L. Hefele, RPh Director of Specialty Pharmacy Medicie Shoppe Iteratioal Ic. Earth City, Missouri Eric H. Hobso, PhD Associate Dea for Academic Affairs School of Pharmacy South Uiversity Savaah, Georgia Philip M. Hritcko, PharmD Assistat Cliical Professor Director of Experietial Educatio Departmet of Pharmacy Practice School of Pharmacy Uiversity of Coecticut Storrs, Coecticut Jermaie Smith, RPh Director of College Relatios ad Professioal Recruitmet Rite Aid Pharmacy Baltimore, Marylad Table of Cotets Learig Objectives.... 1 Itroductio.... 1 ACPE Requiremets for Experietial Educatio... 1 Glossary.... 3 Skills Necessary for Effective Preceptig.... 4 Gettig Started.... 9 Buildig a Effective Learig Experiece.... 12 Preparig Your Studet Pharmacist for Success.... 14 Promotig Professioalism.... 20 Feedback ad Assessmet... 21 Cocludig a Rotatio.... 24 Coclusio.... 24 Refereces... 24 Resources.... 25 Appedix.... 26 Worksheets... 28 Cotiuig Educatio Credit.... 37 fiacial disclosures Cythia J. Boyle, PharmD, FAPhA ad APhA s edited staff declares o coflicts of iterest or fiacial iterests i ay product or service metioed i this program, icludig grats, employmet, gifts, stock holdigs, ad hooraria. 2013 by the America Pharmacists Associatio ad the Natioal Associatio of Chai Drug Stores Foudatio. All rights reserved. Prited i U.S.A. Disclaimer The materials ad iformatio provided i this preceptor educatio program are for geeral iformatioal purposes oly ad do ot costitute legal advice o ay matter. These materials ad iformatio are ot a substitute for obtaiig legal advice from the reader s ow lawyer i the appropriate jurisdictio or state, ad the reader is solely resposible for complyig with all applicable laws ad regulatios, icludig but ot limited to laws ad regulatios regardig pharmacy practice/licesig ad patiet privacy. The reader is uder o obligatio to icorporate or use ay materials or ay portio thereof i the reader s ow preceptor activities, ad these materials are ot iteded to set ay stadards or miimum requiremets for preceptor educatio programs. Nothig cotaied herei should be costrued as a edorsemet of ay materials made available or cited i this traiig program. The Natioal Associatio of Chai Drug Stores Foudatio ad the America Pharmacists Associatio assume o liability for the timeliess, completeess, or accuracy of ay iformatio provided herei.

Learig Objectives After completio of this program, pharmacists will be able to: 1. Explai the beefits of preceptig for preceptors, studet pharmacists, pharmacies, ad the professio of pharmacy. 2. Describe the compoets of itroductory ad advaced pharmacy practice experietial educatio. 3. Facilitate effective commuicatio amog all parties ivolved with a pharmacy rotatio. 4. Establish a framework for studet pharmacist learig durig a pharmacy rotatio. 5. Alig the activities of a pharmacy practice rotatio with the stated objectives ad competecies for the rotatio. 6. Provide a effective ad iformative orietatio for studet pharmacists begiig a rotatio. 7. Commuicate feedback to studet pharmacists i a positive ad appropriate maer. 8. Develop strategies for providig accurate, fair assessmets of studet pharmacists. 9. Prepare studet pharmacists to eter practice ad/or the ext level of pharmacy traiig. 10. Cultivate qualities of professioalism i studet pharmacists. Itroductio The educatio of studet pharmacists has shifted to meet the evisioed ad evolvig role of the pharmacy professio. 1 As practicig pharmacists have assumed greater roles i patiet care, the emphasis o experietial educatio ad reliace o preceptors i pharmacy school programs have grow. Itroductory ad advaced pharmacy practice experieces (IPPEs ad APPEs, also kow as rotatios ) are ow critical elemets of future pharmacists educatio ad traiig. These experieces assist studet pharmacists i itegratig ad applyig kowledge from the classroom ad developig critical thikig skills. Ultimately pharmacy practice experieces promote a lifetime of learig. The chages i experietial educatio are drive, i part, by the Accreditatio Coucil for Pharmacy Educatio (ACPE), the atioal agecy that accredits professioal degree programs of schools ad colleges of pharmacy ad providers of cotiuig pharmacy educatio credit. I 2006, ACPE released revised accreditatio stadards ad guidelies for schools ad colleges of pharmacy that educate doctor of pharmacy (PharmD) studets. These stadards ad guidelies (hereiafter referred to as Stadards 2007 ) were effective as of July 1, 2007. 2 Stadards 2007 emphasize the importace of cliical experieces i the educatio of studet pharmacists ad establish IPPEs ad APPEs as critical elemets of future pharmacists educatio ad traiig. Studet pharmacists are ow required to participate i a rage of IPPEs ad APPEs desiged to help them apply classroom kowledge to the practice of pharmacy. Each rotatio will have its ow goals ad objectives, which aim to produce pharmacy graduates capable of ad committed to deliverig excellet patiet care. To meet these requiremets, practicig pharm a cists are beig called o to play a greater role i the developmet of future pharmacists by actig as preceptors. The Pharmacist Preceptor Educatio Program is desiged to help prepare you to coduct rotatios that facilitate your studet pharmacists achievemet of goals ad objectives of their rotatios. I the course of this cotiuig educatio activity, we will highlight ACPE requiremets for experietial learig programs, explore the skills eeded to be a effective preceptor, ad describe how preceptors ca develop activities that will be appropriate for studet pharmacists at differet levels of their educatio. I geeral, we will refer to all schools ad colleges of pharmacy as schools. We will address the role of the preceptor i studet pharmacists educatio ad provide practical strategies that are desiged to ehace the developmet ad implemetatio of pharmacy practice rotatios. Multiple worksheets are provided to assist you i applyig this iformatio to your specific situatio. It may be beeficial to complete these worksheets ad the discuss them with your pharmacy team ad possibly with your cotact at the school s office of experietial educatio. ACPE Requiremets for Experietial Educatio Stadards 2007 require that IPPEs ad APPEs comprise ot less tha 5% ad 25% (or approximately 300 ad 1440 hours), respectively, of the etire PharmD curriculum. Therefore, studet pharmacists will sped early oe third of their educatioal program i pharmacy practice sites. This requiremet represets a major shift from the past, whe may programs did ot provide experietial traiig util the third or fourth professioal year of the pharmacy degree program. Today, some schools itroduce studet pharmacists to real-world practice sites at the begiig of their first professioal year of pharmacy school. For example, some schools require first-professioal-year studet pharmacists to sped oe full day every other week i a practice site. The Pharmacist Preceptor Educatio Program 1

Evolutio of Experietial Educatio i PharmD Degree Programs To better prepare studet pharmacists for expadig patiet care roles, the America Associatio of Colleges of Pharmacy (AACP) voted i 1992 to support the doctor of pharmacy (PharmD) as the sole professioal degree program i pharmacy. 3 Such programs require a miimum of 6 years: studets must participate i at least 2 years of pre-professioal college-level study, followed by at least 4 years of professioal pharmacy traiig. Some schools ad colleges operate o a year-roud basis so that the professioal degree ca be completed i 3 years after pre-professioal prerequisites. The icreased emphasis o experietial educatio is also beig drive by the Accreditatio Coucil for Pharmacy Educatio (ACPE), the atioal agecy that accredits professioal degree programs of schools ad colleges of pharmacy ad providers of cotiuig pharmacy educatio. ACPE adopted the Accreditatio Stadards ad Guidelies for the Professioal Program i Pharmacy Leadig to the Doctor of Pharmacy Degree i 1997. This documet required that pharmacy schools begi offerig oly the PharmD program of professioal classes to studets eterig pharmacy school i the 2000 2001 academic year, ad that 2004 2005 would be the last academic year to graduate studets from a ACPE-accredited baccalaureate i pharmacy program. 2 Therefore, today, all studet pharmacists are erolled i PharmD professioal degree programs. Prior to the establishmet of PharmD programs, there were few educatioal opportuities i direct patiet care. Experietial educatio ofte focused o pharmacy operatios, maagemet, ad dispesig resposibilities. 3 The chages i educatio for PharmD programs defied i ACPE s Stadards 2007 require a greater emphasis o patiet care activities i experietial educatio to achieve patiet-cetered abilitybased outcomes. As outlied by ACPE, experietial educatio should be desiged to support studet pharmacist achievemet of desired professioal competecies ad outcomes. Competece has bee defied as the habitual ad judicious use of commuicatio, kowledge, techical skills, cliical reasoig, emotios, values, ad reflectio i daily practice for the beefit of the idividuals ad commuities beig served. 4 Therefore, studet pharmacists do ot simply observe the pharmacy operatios, they must actively participate i them to have a meaigful learig experiece. ACPE has defied competecies that pharmacy school graduates must be able to demostrate (Figure 1). 2 Idividual schools of pharmacy may icorporate additioal competecies ito their curriculum. The ACPE stadards ad guidelies for pharmacy practice experieces are located i the Appedix of this workbook. Iformatio to access the etire stadards documet is provided i the Resources. Itroductory vs Advaced Pharmacy Practice Experieces IPPEs must be coducted i actual practice settigs where studet pharmacists ca immerse themselves i a real-world pharmacy practice experiece. Studet pharmacists should have the opportuity to iteract directly with patiets, as allowed by laws ad regulatios. These experieces should be itertwied with the didactic course work ad build progressively all the way through the pharmacy school curriculum. I their etirety, the pharmacy practice experieces that studet pharmacists egage i durig pharmacy school should support the achievemet of all required competecies. The complexity ad decisio-makig requiremets of the activities should be tailored to the level of the studet i pharmacy practice. Examples of activities that studet pharmacists might udertake durig IPPEs ad APPEs are listed i Table 1. 2 Some studet pharmacists may begi IPPEs the very first week of pharmacy school, ad atted their rotatio o a part-time basis throughout their first professioal year. Activities for these studets should be more basic tha those developed for studets i their secod professioal year of pharmacy school. Cosecutive rotatios should build i complexity. Preceptors should collaborate with their school s departmet of experietial educatio to desig activities that will complemet classroom course work ad that are appropriate to the studet pharmacists level of experiece. Studet pharmacists must be give multiple opportuities to participate i patiet care. ACPE requires that studet pharmacists participate i IPPEs i both commuity ad istitutioal settigs. APPEs should be desiged to provide adequate itesity, duratio, ad breadth to achieve stated competecy ad outcome requiremets of pharmacy school. These experieces are usually full time (i.e., 40 hours per week), allowig studet pharmacists to fully immerse themselves i real-life practice experieces. Model APPEs iclude activities that require more advaced itegratio of pharmacy kowledge ad patiet care skills. ACPE also ecourages studet pharmacists to egage i iovative practice experieces that allow them to pursue idividual iterests where possible. ACPE requires that studet pharmacists participate i APPEs i a variety of settigs, icludig commuity pharmacy, hospital or health-system pharmacy, ambulatory care, ad ipatiet/acute care/geeral medicie. APPEs may iclude electives i additioal settigs, such as research, maagemet, drug iformatio, educatio, maaged care, log-term care, hospice, ad home health care. The Preceptor s Role i Experietial Educatio Preceptors are practicig pharmacists who supervise ad iteract with studet pharmacists durig rotatios. 2 APhA ad NACDS Foudatio

Glossary Accreditatio Coucil for Pharmacy Educatio (ACPE) The atioal agecy that accredits schools ad colleges of pharmacy ad providers of cotiuig pharmacy educatio. Advaced Pharmacy Practice Experiece (APPE) These rotatios require advaced itegratio of pharmacy kowledge ad patiet care skills. They are geerally full time ad ca occur i a variety of practice settigs. Competecy The ability to apply kowledge i a cliical situatio. Withi pharmacy, this ability icludes the use of commuicatio skills, techical skills, cliical reasoig, emotios, ad values for the beefit of the patiet ad the commuity. Cotiuous Quality Improvemet A ogoig process i which the parties ivolved regularly ad frequetly evaluate ad take steps to improve their practices. Cultural Competece The itegratio ad trasformatio of kowledge about idividuals ad groups of people ito specific stadards, policies, practices, ad attitudes used i appropriate cultural settigs to icrease the quality of services ad thereby produce better outcomes. Departmet of Experietial Educatio The departmet or office at a school or college of pharmacy that is resposible for the developmet, coordiatio, ad oversight of experietial educatio programs for that school. Disease State Maagemet A process of orgaizig care for a specific high-cost ad/or high-volume diagosis, with the itetio of improvig patiet outcomes ad, whe possible, lowerig overall costs. Experietial Educatio The compoet of studet pharmacists traiig durig which they are directly ivolved i the practice of pharmacy with oversight by a preceptor. Goals Broad, geeralized statemets about what is to be leared. Iterdiscipliary Ivolvig collaboratio amog health care providers from differet fields, such as pharmacists, urses ad urse practitioers, physicias ad physicia assistats, dietitias, ad others. Itroductory Pharmacy Practice Experiece (IPPE) These itroductory rotatios are geerally part time ad may begi as early as the first week of pharmacy school. They should allow for direct patiet iteractio i both ambulatory ad istitutioal settigs. Medicatio Therapy Maagemet (MTM) As defied by 11 atioal pharmacy orgaizatios, MTM is a distict service or group of services that optimize therapeutic outcomes for idividual patiets. MTM services are idepedet of, but ca occur i cojuctio with, the provisio of a medicatio product. (All Medicare Part D plas are required to establish a MTM program.) Objectives Objectives are measurable, achievable statemets about specific kowledge, attitudes, or skills that are to be leared. Office of Experietial Educatio See Departmet of Experietial Educatio. Patiet Care Services Pharmacy services that ivolve direct patiet iteractio. Such iteractios may take a variety of forms, such as routie patiet couselig or comprehesive disease state maagemet services. Professioal Experiece Program (PEP) Director The perso at the school of pharmacy who heads the departmet of experietial educatio ad leads the experietial program admiistrative team. This title may vary amog istitutios. Stadards 2007 The Accreditatio Stadards ad Guidelies for the Professioal Program i Pharmacy Leadig to the Doctor of Pharmacy Degree, released by the Accreditatio Coucil for Pharmacy Educatio for implemetatio i 2007. Studet Pharmacist A studet ivolved i the 4-year professioal compoet of the educatio ad traiig to become a pharmacist. The preceptor is resposible, uder the guidace of the parter school (ad supervisor, whe applicable), to desig ad implemet the activities of the rotatio. Preceptors are also resposible for moitorig ad assessig studet pharmacists to determie whether they have egaged i the activities appropriately ad achieved the desired outcomes. (We ll explore specific skills ad resposibilities for preceptors later i this program.) Because IPPEs are a ewer compoet of the curriculum, ot all preceptors have participated i such experieces themselves. Preceptors, especially those who are preceptig for the first time, should work very closely with their school (ad their supervisor, whe applicable) to clarify their resposibilities ad to appropriately desig activities for the rotatio. Each school of pharmacy has a departmet or office of experietial educatio that oversees the pharmacy practice learig programs ad provides substatial support to preceptors. The perso i the leadership positio i these programs is usually referred to as the experietial educatio (EE) director; however titles vary amog istitutios. A sample of a experietial director s resposibilities is show i Table 2. 5 The role of the departmet or office is to develop, coordiate, ad oversee the school s IPPEs ad APPEs. I some istaces, there may be a regioal experietial educatio office that iterfaces with preceptors. Together, the members of the departmet of experietial educatio are resposible for quality assurace ad oversight of all rotatios to esure that desired outcomes for practice experieces are achieved. The Pharmacist Preceptor Educatio Program 3

Figure 1. Accreditatio Coucil for Pharmacy Educatio Professioal Competecies ad Outcome Expectatios Professioal pharmacist competecies that must be achieved by graduates through the professioal degree program curriculum are the ability to: 1. Provide patiet care i cooperatio with patiets, prescribers, ad other members of a iterprofessioal health care team based upo soud therapeutic priciples ad evidece-based data, takig ito accout relevat legal, ethical, social, cultural, ecoomic, ad professioal issues, emergig techologies, ad evolvig biomedical, pharmaceutical, social/behavioral/admiistrative, ad cliical scieces that may impact therapeutic outcomes. 2. Maage ad use resources of the health care system, i cooperatio with patiets, prescribers, other health care providers, ad admiistrative ad supportive persoel, to promote health; to provide, assess, ad coordiate safe, accurate, ad time-sesitive medicatio distributio; ad to improve therapeutic outcomes of medicatio use. 3. Promote health improvemet, welless, ad disease prevetio i cooperatio with patiets, commuities, at-risk populatios, ad other members of a iterprofessioal team of health care providers. Source: Referece 2. The CE director should act as the preceptor s parter i the developmet of rotatios ad should also serve as a resource ad support for all preceptors participatig i their program. Preceptors should feel comfortable cosultig with the school s experietial program admiistrative team wheever guidace is eeded for the rotatio. Depedig o the practice settig, a corporate headquarters or supervisor may facilitate the rotatio. May pharmacy chais have siged agreemets with schools that gover preceptors ad rotatios. These etities may have requiremets for the developmet of rotatios, ad may provide guidace for various situatios throughout the rotatio. Why Should You Participate i the Educatioal Program as a Preceptor? The icreased reliace o IPPEs ad APPEs i pharmacy educatio has made the role of preceptig eve more importat to the pharmacy professio. Studet pharmacists experiece a myriad of educatioal beefits icludig expasio of their kowledge base ad developmet of their cliical competecies ad cofidece from participatig i rotatios. Most preceptors fid preceptig to be both persoally ad professioally rewardig. High-quality rotatio experieces play a large role i addig to the umbers of graduatig pharmacists who have the ability ad the desire to provide patiet care services i a commuity pharmacy settig. 6 Icreasig the umber of pharmacists with these skills ad attitudes ca help to secure the pharmacist s role as the key provider of medicatio therapy maagemet (MTM) services. Therefore, preceptors play a crucial role i the developmet of the pharmacy professio. Pharmacists recogize that preceptig has may practical beefits for both the preceptor ad the practice site. Although studet pharmacists should ot be treated as pharmacy techicias, they ca cotribute to all aspects of the prescriptio fulfillmet process, from basic dispesig fuctios to patiet iteractio. Studet pharmacists also ca cotribute value-added beefits to the practice site by providig additioal services, such as patiet couselig, commuity welless classes, health screeigs, ad other activities, as allowed by applicable laws. Health screeigs ad educatioal programs that studet pharmacists develop may cotiue well beyod their rotatio, thereby cotributig to ogoig practice site developmet. May preceptors fid that while their primary role is that of a educator they lear from their studet pharmacists as well. Your studet pharmacist may have bee exposed to ovel kowledge or skills i the classroom or o prior rotatios that they ca share. Although you are the teacher, remai ope to this ew chael of potetial learig. Preceptors may obtai additioal beefits from the school, such as eligibility to opportuities for cotiuig professioal developmet, access to the school s library resources, ad research opportuities. 6 I some situatios, preceptors may be awarded adjuct faculty status, which may brig certai privileges ad etrace to participate i other aspects of the educatioal program, such as servig o committees, or attedig lectures ad workshops. Cotact the office of experietial educatio at the school you work with to fid out what types of beefits they may provide for preceptors. Worksheet 1 i the back of this workbook will help you idetify the beefits you may aticipate from your service as a preceptor. Skills Necessary for Effective Preceptig Now let s take a closer look at the resposibilities of a preceptor ad the skills you will eed i this role. Beyod plaig activities ad addressig admiistrative tasks, preceptors maage, metor, ad promote the professioal developmet of studet pharmacists. There are several specific skills that effective preceptors possess. 7 Preceptor criteria of excellece that were idetified by the Academic- Practice Partership Iitiative of the America Associatio of Colleges of Pharmacy are show i Table 3. 7 This is a comprehesive list of qualities ad attributes that 4 APhA ad NACDS Foudatio

Table 1. Examples of Appropriate Activities for Itroductory ad Advaced Pharmacy Practice Experieces Activities that studet pharmacists may observe ad egage i durig their rotatios iclude, but are ot limited to, the followig examples, as allowed by state laws ad regulatios. Itroductory Pharmacy Practice Experieces Advaced Pharmacy Practice Experieces Shadow preceptors, pharmacy staff, or more advaced studet pharmacists Participate i service learig projects Process ew ad refill prescriptio orders Iterview actual patiets to obtai iformatio ad create a patiet profile Iterpret ad evaluate patiet iformatio Triage patiets for self-care ad/or referral Assess patiet health literacy ad adherece to treatmet recommedatios Perform calculatios Admiister medicatios Provide poit-of-care ad patiet-cetered services Coduct physical assessmets Prepare ad compoud products Commuicate with patiets ad other health care providers Iteract with pharmacy techicias Documet patiet itervetios Preset patiet cases Bill third-party payers Practice as a member of iterdiscipliary care teams Idetify, evaluate, ad commuicate the appropriateess of a patiet s pharmacotherapy to the patiet ad other health care providers Provide patiet self-care cosultatios Recommed prescriptio ad oprescriptio products, ad complemetary ad alterative therapies Admiister medicatios Idetify ad report medicatio errors ad adverse drug reactios Assess ad moitor patiets to maage medicatio regimes Provide patiet care ad educatio to a diverse patiet populatio Educate other health care providers about medicatios ad other pharmacy items Access ad use cliical ad scietific literature to support decisio makig Esure cotiuity of patiet care across various settigs Participate i activities ivolvig compliace with accreditatio, legal, regulatory/legislative, ad safety requiremets Participate i activities that focus o the drug approval process Participate i activities focusig o key health care policy matters that may affect pharmacy Utilize techologies that support pharmacy practice Source: Referece 2. preceptors ca strive to embody as they start to precept ad as the rotatio evolves. We will focus o a few of these skills here. Metorig I additio to teachig cliical iformatio ad skills, preceptors serve as role models ad metors. Will you be a good metor? Are you a effective, orgaized, ad ethusiastic teacher? Are you willig to devote your eergies to promote the educatioal advacemet of oe or more studet pharmacists? These are importat questios for ay begiig preceptor to cosider. Effective metors are able to combie a empathetic ad supportive attitude toward their studet pharmacist while maitaiig a uwaverig commitmet to excellece i patiet care. Preceptors should esure that the etire pharmacy staff embodies the same priciples of practice that they hope their studet pharmacists will embrace. Providig studet pharmacists with a role model i a real-world practice settig is very importat to professioal developmet. Combiig a commitmet to cotiuous quality improvemet with reflectio o actio ca be used to support meaigful learig experieces. Preceptors should be able to idetify their ow areas for improvemet ad be willig to opely discuss ay issues or evets that eed improvemet as a learig experiece for both themselves ad their studet pharmacists. Commuicatio Skills Effective preceptors must have solid commuicatio skills to work with patiets, other health care providers, ad studet pharmacists. Preceptors should model good commuicatio skills whe iteractig with patiets, caregivers, pharmacy staff, ad other health care professioals to support developmet of these skills by studet pharmacists. A discussio of how to support The Pharmacist Preceptor Educatio Program 5

Table 2. Sample Resposibilities of a Experietial Program Director The director provides oversight for plaig ad implemetatio of experietial educatio programs. Activities required iclude: Developig ad overseeig operatioal ad educatioal aspects of the experietial educatio program. Establishig ad overseeig experietial educatio schedules for studets. Developig ad implemetig cotiuous quality improvemet programs for itroductory ad advaced pharmacy practice experieces. Maitaiig a maual of policies ad procedures for experietial educatio programs. Idetifyig ew preceptor sites ad helpig their developmet ad maagemet. Maagig the staff, budget, ad techology of the experietial educatio office. Servig as a liaiso betwee faculty, staff, ad studets i matters ivolvig experietial educatio. Maagig commuicatios related to experietial educatio. Overseeig ad assistig with creatio of rotatio objectives for each rotatio. Orgaizig ad overseeig a comprehesive preceptor developmet program. Source: Referece 5. studets developmet of commuicatio skills is provided later i this program. Regular commuicatio with the studet pharmacist is essetial to the rotatio experiece. For example, adequately commuicatig your expectatios of studet pharmacists durig their orietatios is fudametal to start the rotatio o the right track. Positive reiforcemet ad costructive criticism are corerstoes of learig i a practice eviromet, ad it is importat to maitai ope chaels of commuicatio with your studet pharmacist to provide ogoig guidace ad prevet or resolve misuderstadigs. Ideally, iformal feedback should be provided cotiually, ad there should be structured time throughout the rotatio for more formal debriefigs. Specific strategies are provided i the Feedback ad Assessmet sectio of this program. Selected materials that support the developmet of commuicatio skills for pharmacists are listed i the Resources. Coflict Maagemet Preceptors eed to possess coflict maagemet skills, ad be prepared to teach studet pharmacists to use them. 8 Preceptors have a uiquely powerful positio to model such skills for studet pharmacists. Coflict is a ievitable compoet of virtually all work experieces. Stress ad egative emotios are a part of beig huma, ad may arise frequetly i highpressure eviromets, such as pharmacy practices. Disagreemets may occur with patiets, pharmacy staff, studet pharmacists, ad other members of the health care team. Coflict ca arise for may reasos, icludig poor commuicatio, seekig cotrol, or redirectio of egative feeligs from aother situatio. To adequately resolve a coflict, parties eed to commuicate their grievaces ad reach a mutually agreeable solutio. Good listeig skills should be used to try to uderstad the ature of the coflict. Askig those o the other side to explai their perspective first ad givig them the opportuity to feel truly listeed to ca help defuse tesios ad may make them more ope to calmly listeig to your poit of view. May differet skills ca be used to address coflict situatios (Table 4). 8 Applicatio of these skills ca be used ot oly to resolve issues with prescribers ad patiets, but also to resolve issues with studet pharmacists ad amog other pharmacy staff. To help studets develop such skills durig rotatios, you ca poit out coflict situatios, discuss the feeligs that arose, review how the situatio was resolved, ad braistorm additioal strategies that could have improved the outcome or avoided the clash i the first place. Because coflict ca arise for a myriad of reasos, there is o sigle way to resolve all discord. I fact, some coflicts may ever be resolved. Rather, the parties ivolved may eed to agree to disagree to maitai a positive workig relatioship. (Such a situatio may arise if the pharmacist disagrees with a prescriber s iterpretatio of a cliical situatio, eve after both parties have explaied their positios.) Worksheet 2 provides several coflict situatios that may arise durig a rotatio ad allows you to braistorm possible solutios. If you fid yourself faced with a situatio with your studet pharmacist that you re ot sure how to hadle, you ca cosult with someoe i the school s office of experietial educatio. They may have experiece with similar situatios ad have suggestios for how to maage it, or be able to direct you to other preceptors who have worked through the same issue. Cultural Competece Studet pharmacists must be prepared to address issues that arise whe workig with a icreasigly diverse patiet populatio ad workforce. Thus, it is importat for preceptors to possess ad promote cultural competece skills. Cultural differeces may arise from factors such as age, race, ethicity, ad emergig health care treds. 6 APhA ad NACDS Foudatio

Table 3. America Associatio of Colleges of Pharmacy Criteria for Preceptor Excellece Criteria Examples Be a role-model practitioer by: Providig patiet-cetered care Makig ethical decisios Solvig patiet care problems Providig medicatio, disease, ad health educatio to patiets Exhibitig professioal ad patiet care behavior Be a effective, orgaized, ad ethusiastic teacher by: Teachig by example Demostratig patiet assessmet skills Demostratig ad discussig oe s ow cliical reasoig process Displayig ethical behavior ad high persoal character Havig a strog commad of drug therapy kowledge Demostratig a carig attitude toward studet pharmacists ad patiets Teachig patiet-provider commuicatio skills icludig empathetic listeig skills Ecourage self-directed learig of the studet pharmacist with costructive feedback by: Idetifyig ad respodig to each studet pharmacist s specific learig eeds Challegig the learig process i each studet pharmacist Coachig studet pharmacist behavior through effective, costructive, ad timely feedback Makig studet pharmacist teachig a importat focus of the practice site Treatig studet pharmacists as colleagues i traiig Demostrate well-developed iterpersoal/commuicatio skills by: Commuicatig effectively with patiets, studet pharmacists, other health care providers, ad stakeholders i the rotatio Possess leadership/maagemet skills by: Demostratig effective maagerial ad leadership relatioships with pharmacist colleagues ad staff Demostratig aspects of humility related to oe s ow limitatios Moitorig quality of professioal practice ad teachig activities Practicig odiscrimiatory behaviors Beig active i professioal orgaizatios Embody a persoal practice philosophy by: Demostratig persoal motivatio ad ispirig pharmacists to develop patiet care practices Havig a missio or visio statemet of pharmacy Patterig oe s practice after stadard guidelies or other model practices Ecouragig owership or admiistratio to support patiet care services Source: Referece 7. The Pharmacist Preceptor Educatio Program 7

Table 4. Coflict Resolutio Skills Skill Whe to Use Example Paraphrasig ad restatig Escalatio of coflict eeds to be avoided Dr. Smith, you soud upset because I made this recommedatio to discotiue your patiet s aspiri. Partial agreemet without selfidictmet The other party has a piece of the truth that eeds to be ackowledged You are right, there are some patiets with a history of gastric ulcers who ca beefit from aspiri. Askig for specifics Ager that comes your way is overly vague What is it about the recommedatio that upsets you? Owership of laguage ad appropriately assertive toe of message The coflict is ufairly abusive ad eve after iquiry, you still do ot kow the corrective actio to take I am ucomfortable with your toe regardig this situatio without uderstadig my reaso for the recommedatio. Cotractig to talk at a later time The coflict has escalated ad/or emotios are becomig heated I eed some time to thik about what you said. Source: Referece 8. Cultural competece has become a widely used cocept to describe the relatioship of health care providers to diverse members of their commuity. Cultural competece i health care settigs has bee defied as the ability to provide care to patiets with diverse values, beliefs, ad behaviors, icludig tailorig delivery to meet patiets social, cultural, ad liguistic eeds. 9 These factors are importat to cosider because they ifluece how patiets respod to or uderstad health-related iformatio. To address these differeces, pharmacists should aim to be culturally competet ot to merely tolerate people of differig backgrouds, but to seek additioal isights ito the patiet s backgroud ad to value diversity. Health care professioals who appreciate ad value cultural differeces are better able to provide high-quality care to patiets from diverse backgrouds. 10 Just as you may treat a diverse set of patiets, you may have studet pharmacists whose cultural backgrouds differ substatially from your ow. Be prepared to respect ad value these differeces ad collaborate i a maer that promotes studet pharmacists educatio. I additio, preceptors should strive to foster a attitude of cultural competece i their studet pharmacists. Ecourage studet pharmacists to accept ad respect differeces, create a ope ad trustig eviromet for commuicatio with people from diverse cultures, ad be willig to self-assess their performace i workig with patiets from differig backgrouds. You ca provide studet pharmacists with resources, such as liks to Web sites that support cultural competecy ad diversity, to help expad their cultural kowledge. A samplig of materials is listed i the Resources. Studet pharmacists may particularly beefit from materials that focus o cultural groups that are well represeted i your commuity. Time Maagemet Strog time maagemet skills are ecessary to facilitate high-quality rotatios. Startig to precept is a excitig experiece, but it also requires time to prepare for the added resposibilities associated with maagig a studet pharmacist. To provide studet pharmacists with a effective learig experiece, preceptors must maage their ow time well, maage their studet pharmacist s time, ad teach studet pharmacists to maage their time efficietly. Good time maagemet will allow you to maximize 8 APhA ad NACDS Foudatio

the use of your time so that you are as productive as possible while maitaiig balace i your life. May tools ca help you to maage your time. These iclude simple strategies such as writig dow ad prioritizig to-do lists as well as comprehesive time maagemet systems that allow you to track ad evaluate how you sped your time throughout the day. A good time maagemet system will help you clarify, prioritize, ad achieve both your professioal ad persoal goals, ad determie which tasks (if ay) are ot ecessary or ca be delegated. See the Resources for a samplig of tools that ca support your time maagemet eeds. Maagig your ow time effectively will help you secure adequate time to sped with your studet pharmacists to support their learig experiece. You will eed to devote time to workig with studet pharmacists to provide istructio, feedback, ad guidace. Ideally, you should set aside specific times i your schedule whe you have coverage i the pharmacy to dedicate to your studet pharmacists. Time maagemet is a importat priciple for allocatig activities through the rotatio effectively. Just as classroom teachers must develop lesso plas to structure classroom activities, you should carefully map out how you pla to have the studet pharmacist sped each segmet of time durig the rotatio. Reiforcig the importace of time maagemet skills i pharmacy practice is a importat lesso for studet pharmacists. Provide guidace o how to work efficietly ad share time-savig tips durig the rotatio. Focus o how to maage time for the various tasks that studet pharmacists perform throughout the day to support their developmet as effective ad efficiet pharmacists. Studet pharmacists also must be educated about the role that time maagemet plays i the fiacial health of ay practice settig. Worksheet 3 will help you evaluate the amout of time that you will sped o rotatio-related activities ad determie how they fit ito your schedule. I additio, you should create a caledar for the studet pharmacist s rotatio (Figure 2) to supplemet the syllabus provided by the school. 11 Commitmet to Cotiuous Quality Improvemet Effective preceptors are committed to a process of cotiuous quality improvemet for their maagerial techiques, their cliical skills, ad their practice site. Such a commitmet helps to support the professioalism of pharmacy practice. I such a model, pharmacists ad the etire pharmacy team evaluate ad refie their practices ad activities o a ogoig basis to cotiually improve their activities i the pursuit of excellece. If you do ot already have a process i place to drive cotiuous quality improvemet, you may fid materials i the Resources to be beeficial for your pharmacy practice. Gettig Started This sectio will get you started thikig about bigpicture issues associated with becomig a preceptor. It will help you defie what you are able to offer as a preceptor, idetify the issues that eed to be o your radar scree, ad take the first steps toward establishig your practice as a rotatio site. What Do You Have to Offer? Oe of the most importat tasks for developig a rotatio is to determie what you ad your site have to offer. What objectives could a studet pharmacist achieve at your practice site uder your guidace? Do your patiet care activities meet IPPE ad/or APPE goals? These are importat questios to bear i mid as you cotemplate becomig a preceptor or expadig your preceptig activities. A thorough assessmet of your kowledge ad skills ad your practice site s patiet care activities ad resources ca help you determie how you are able to provide a rotatio that fits the desired goals ad objectives for the studet pharmacist s experiece. Cosider also what makes your pharmacy uique what iterdiscipliary iteractios or patiet populatios could provide a meaigful experiece for a studet pharmacist? You may wat to begi by reviewig the activities that take place at your site, ad take ito accout what studet pharmacist experieces these activities could support. (Keep i mid that programs i a variety of settigs have much to offer studet pharmacists at differet stages of their learig.) Cosult with the office of experietial educatio ad/or other preceptors for guidace, as eeded, o developig activities that complemet your practice site. Whe evaluatig your site, iclude the followig activities: Prescriptio dispesig ad associated couselig MTM services Over-the-couter (OTC) product couselig opportuities Pharmacy maagemet traiig Iterdiscipliary health care services Commuity-based health ad welless services Ogoig disease state maagemet programs (e.g., diabetes, hypertesio, lipid maagemet, asthma/ chroic obstructive pulmoary disease) Evaluate activities that studet pharmacists could egage i at your practice site. Review the list of IPPE ad APPE activities suggested by ACPE (Table 1), ad idetify which oes you could support at your site. List activities that you could expose studets to outside the pharmacy. For example, if you are ivolved with research or pharmacy associatio work, you could share these activities with studet pharmacists. Other possible activities that you might be able to implemet iclude 11 : Dispesig Drug iformatio Patiet couselig Patiet/case discussios Joural club (studet pharmacists write a summary of a joural article) The Pharmacist Preceptor Educatio Program 9

Figure 2. Rotatio Caledar Example Moth Moday Tuesday Wedesday Thursday Friday Studet pharmacist s ame: Daily schedule: Moday Friday 9:00 5:00 30-miute luch break 1 9:00 12:00 Orietatio 12:30 5:00 Shadow pharmacy staff 8 2 9:00 5:00 Patiet Care/ Pharmacy Operatios 9 3 9:00 10:00 Discussio 10:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 Idepedet project 1 10 4 9:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 OTC aisle 11 5 9:00 10:00 Discussio 10:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 Idepedet project 1 12 Pharmacy phoe umber: Preceptor phoe umber: Other importat cotact iformatio: 9:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 Idepedet project 1 15 9:00 5:00 Iterdiscipliary shadowig 16 9:00 10:00 Discussio 10:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 Idepedet project 1 17 9:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 OTC aisle 18 9:00 10:00 Discussio 10:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 Idepedet project 1 due; midpoit evaluatio 19 9:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 Idepedet project 2 9:00 5:00 Patiet couselig activities 9:00 10:00 Discussio 10:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 Idepedet project 2 9:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 OTC aisle 9:00 10:00 Discussio 10:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 Idepedet project 2 22 23 24 25 26 9:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 Idepedet project 2 9:00 5:00 Patiet couselig activities 9:00 10:00 Discussio 10:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 Idepedet project 2 9:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 OTC aisle 9:00 10:00 Discussio 10:00 12:00 Patiet Care/ Pharmacy Operatios 12:30 5:00 Idepedet project 2 due; fial evaluatio ad discussio OTC = over-the-couter. Source: Adapted from referece 11. 10 APhA ad NACDS Foudatio

Noprescriptio formulary (studet pharmacists develop a formulary of their preferred o prescriptio products) Drug moograph (studet pharmacists write a detailed report o a selected medicatio) Off-site elective activities (e.g., shadowig a district or regioal pharmacy maager or aother health care provider) Patiet care activities (e.g., diagostic screeigs, providig immuizatios, etc. as permissible by law) Adverse evet reportig Commuity educatio semiars Empathy assigmet (studet pharmacists follow treatmet protocols for a chroic disease by adherig to a particular diet, performig self-assessmet tests, pretedig to take medicatios o a set schedule, etc.) Pharmacy maagemet activities Third-party billig ad processig Medical device ad diagostics maagemet (e.g., educatig a patiet o the use of a device) Beyod reviewig the services available at your site, it will be worthwhile to assess both your ow patiet care stregths ad challeges, ad those of your site so that you attract studet pharmacists who will gai the desired beefit from your site. Reflect o your cliical kowledge ad patiet care skills as well as your attitudes toward patiet care activities. What is your philosophy about patiet care? What is your practice site s missio statemet? What credetials do you have? Do you wat to take a cotiuig educatio course o a special topic? Also review the logistics of your site, icludig the pharmacy s physical layout ad how it will accommodate the eeds of the studet pharmacist. Some issues to regard iclude: Will the studet pharmacist have a dedicated space to do writte work? Will there be a computer with Iteret access? Are there private couselig rooms for patiet assessmet ad educatio? Is there a classroom-sized area that the studet pharmacist could use for a commuity activity? Fially, cosider the amout of time you are able to devote to your studet pharmacist. Both you ad your site should be willig to support the educatio of the studet pharmacist, ad provide the ecessary opportuities for him or her to lear the material eeded to improve kowledge ad skills. Use Worksheet 4 to assess your practice site ad help defie the learig experieces you are able to offer. You may wat to use this ad other worksheets provided i this learig activity as a sprigboard for discussios with the PEP director (or your supervisor, where applicable) to assist i the developmet of your rotatio. Commuicatig About the Rotatio A successful rotatio depeds o ope chaels of commuicatio amog all parties ivolved. It is importat to esure that all stakeholders are aware ad supportive of the rotatio, icludig idividuals at your practice site, the school, ad ay corporate office ivolved. You should be i close commuicatio with the experietial program admiistrative team at your parter school to support the developmet ad ogoig operatio of the rotatio. They should be able to provide support to help you maage your commuicatios with the various people affected by the rotatio. Your Radar Scree School, Employer, Site, ad State Requiremets So far, we have primarily discussed the ACPE requiremets for preceptors ad rotatios. However, the rotatio will likely be govered by may requiremets beyod those of ACPE. Rotatios are experietial courses that have bee approved for the school s curriculum. For that reaso, the school of pharmacy that you are affiliated with may have specific requiremets for preceptors ad rotatios, icludig detailed record-keepig requiremets for you ad/or your studet pharmacist. Documetatio is also importat for boards of pharmacy because rotatio hours may satisfy some or all of the experiece requiremets for pharmacist licesure. Review ay such requiremets with the school s office of experietial programs. Also be sure to review your employer s policies ad procedures (if ay) for rotatios with your supervisor. May legal ad regulatory issues, icludig liability, cofidetiality, ad academic codes of coduct may be addressed by a affiliatio agreemet betwee your practice site or employer ad the school of pharmacy. Stadards 2007 dictate that there be at a miimum writte affiliatio agreemets betwee the school ad the required ad elective pharmacy practice experiece sites. I additio, your employer ad/or the school may require studet pharmacists to have crimial backgroud checks ad drug testig performed prior to the start of the rotatio. If applicable, you should familiarize yourself with school ad employer policies for drug testig, backgroud checks, figerpritig, or other specific requiremets to be performed prior to the start of the rotatio. Work with the school ad your employer to esure that studets set to your site have accurate iformatio about these requiremets. Some states have specific requiremets goverig activities that studet pharmacists are allowed to participate i ad the amout of madatory studet pharmacist supervisio. I some states, studet pharmacists must register as pharmacy techicias or pharmacy iters, while i others studet pharmacists are required to complete a certificate course i immuizatios if they will be ivolved i providig vaccies. The office of experietial educatio, as well as the state pharmacy associatio ad The Pharmacist Preceptor Educatio Program 11

state board of pharmacy, ca provide guidace o statespecific requiremets ad ay other issues that should be o your radar scree. Buildig a Effective Learig Experiece Now, let s look at how you might map out the details of the rotatio. You will address may importat issues whe shapig the rotatio to provide a optimal experiece for your studet pharmacist. These activities rage from establishig the schedule for the rotatio to plaig activities that will egage the studet ad promote achievemet of the rotatio s goals ad objectives to support the itegratio of the studet pharmacist ito your practice site ad commuity. I additio to carefully plaig specific learig activities, attetio to the ifrastructure of the program is essetial to a successful rotatio experiece. Program Logistics There are may factors to cosider as you begi to establish the details of the rotatio at your site withi the school s framework. Geeral logistical issues affectig the rotatio iclude how log each rotatio will last, how may hours per week studet pharmacists will be at the practice site, ad how may studet pharmacists you will have at oe time. If you host multiple studet pharmacists, you will wat to either sychroize their schedules or devise complemetary activities. The school that you parter with should supply a syllabus with objectives that are to be met durig the rotatio. This syllabus should have bee approved by the school s faculty ad curriculum committees ad should be the foudatio for the developmet of the rotatio. Syllabi should iclude details about assigmets, due dates, ad other requiremets for the rotatio. The syllabus ca iclude rotatio times ad dates, gradig periods, ad details of the gradig process. Strive to desig activities that led themselves well to assessmets ad to the admiistrative requiremets of the school, icludig those outlied i the syllabus. For example, if your parter school wats you to report o the studet pharmacist s progress every 2 weeks, desig activities that allow you to evaluate the studet pharmacist shortly before evaluatios are due. Follow the existig syllabus to the extet possible, ad use it as a driver for the developmet of your educatioal plas. Make sure you are aware of ay requiremets or guidelies that the school has for assessig studet pharmacists, so that you ca itegrate them ito your plas for the rotatio. Keep i mid the gradig system that the school uses for rotatios (e.g., pass/fail, competecy based, or letter grades). Will you be expected to idividually assess specific sets of kowledge ad skills, provide a overall assessmet, or submit both types of reviews? Factor these elemets ito both the developmet of the activities ad your plas for providig feedback ad assessmet. Schools should have a process or form for studet pharmacists to evaluate preceptors. You may wat to determie i advace how the studet pharmacist will assess you, ad how you will receive this feedback. Aligig Activities With Goals ad Objectives It is essetial that you develop rotatio activities that allow the studet pharmacist to achieve the objectives ad goals for the rotatio. These objectives may be kowledge based or skill ad competecy based, ad should be desiged to help the studet achieve the required competecies of the pharmacy school ad prepare the studet to be a better pharmacist. Objectives may relate to providig patiet care services (e.g., orgaize patiet iformatio i a maer that allows idetificatio ad resolutio of drug-related problems), medicatio use systems (e.g., develop, implemet, evaluate, ad modify a formulary), commuicatio (e.g., provide medicatio iformatio to patiets), or other pharmacy-related issues. Preceptors should develop a pla for meetig all of the objectives withi the rotatio. IPPE studet pharmacists may be expected to gai a umber of competecies durig the rotatio, icludig the developmet of basic techical skills, kowledge of pharmacotherapeutics, ad improved commuicatio skills. 3 APPEs geerally ivolve more advaced objectives that support the studet pharmacist s ability to provide all aspects of patiet care. Challege studet pharmacists durig APPEs to produce evidece to support therapeutic decisios ad recommedatios. Develop activities that support achievemet of each objective ad develop a strategy to assess that objective. Esure that you, as a preceptor, uderstad how the objectives provided by the school are meaigful ad measurable withi the cotext of your rotatio. Ideally, the objectives for the rotatio will be specific. For example, the objective, improve commuicatio skills, is rather vague. A objective such as develop the ability to educate patiets o the appropriate use of oprescriptio medicatios, provides greater detail o the outcome that is desired ad is more easily measurable. If there is ambiguity i the objectives that are provided to you, clarify the desired outcome with the school s departmet of experietial educatio ad request assistace as eeded. For example, if you are ucertai of how to best meet a objective, ask for guidace. The school s experietial program admiistrative team ca either provide guidace directly or arrage for you to etwork with other preceptors who are willig to share their experieces with you. You will eed to provide sufficiet opportuities withi the rotatio for the studet pharmacist to work toward each objective. For example, if studet pharmacists are to develop skills for commuicatig with other health care providers, you should make certai that the studet pharmacists have adequate iteractio with other providers 12 APhA ad NACDS Foudatio