Preceptors' perspectives on benefits of precepting student pharmacists to students, preceptors, and the profession.

OBJECTIVES: To educate pharmacists on the shortage of quality preceptors and the benefits received from precepting; present insights from successful preceptors and offer guidance to current and prospective preceptors; and encourage pharmacists to become preceptors and mentor aspiring pharmacy professionals. SETTING: Advanced experiential settings for Nova Southeastern, Ohio Northern, and Creighton Universities. PRACTICE DESCRIPTIONS: Hospital, community, and outpatient clinic settings. PRACTICE INNOVATION: Successful incorporation of student pharmacists and the experiential process into pharmacy practice. MAIN OUTCOME MEASURE: Not applicable. RESULTS: A variety of factors has produced an increased demand for qualified pharmacist preceptors, including workload issues, an increasing number of pharmacy schools, and an increased experiential load in the pharmacy school curricula. Characteristics of quality preceptors include demonstrating enthusiasm in their teaching, being open to questions, and providing constructive feedback. Sites and preceptors can benefit from teaching student pharmacists by receiving assistance in developing and maintaining clinical services, sensing the satisfaction of giving back to the profession, and material rewards provided by schools of pharmacy. In this article, three successful preceptors share their perspectives and insights about precepting, and a professional organization perspective is included to highlight the support for precepting student pharmacists. CONCLUSION: Additional introductory and advanced quality pharmacy experiential practice sites are needed, and pharmacists are encouraged to contact nearby pharmacy schools to become preceptors.     

Designing an Escape Room to Increase Pharmacy Preceptor Knowledge of the Pharmacists’ Patient Care Process

Objective. To design and assess the use of an escape room for pharmacy preceptor development.Methods. An escape room for preceptor development that focused on the Pharmacists’ Patient Care Process (PPCP), preceptor resources, and the school of pharmacy’s mission and vision was created. Teams had to solve digital and practical puzzles to escape a pharmacy. The team to correctly solve all the puzzles the fastest was considered to have escaped the pharmacy. Escape room puzzles included digital locks, cipher wheels, a rebus puzzle, riddle, hidden object, and other puzzles. Preceptor’s knowledge of the PPCP and perceptions of the game were evaluated using a pre- and post-activity test and survey.Results. Fifteen preceptors with a variety of practice sites and precepting experience participated in a matched pre-and post-activity survey. Preceptor knowledge of the order of the PPCP improved, with nine (60%) preceptors answering correctly before participating in the activity vs 13 (87%) after. However, the preceptors were less likely to correctly answer the type of approach the PPCP uses after completing the escape room activity, with 14 (93%) answering correctly before vs 10 (67%) after. Participants’ perceptions of the game were positive and all preceptors agreed or strongly agreed that they would recommend participating in this activity to another preceptor.Conclusion. A preceptor development escape room was viewed positively by preceptors. Future research should focus on digital-only escape rooms for preceptors to increase availability and participation.     

A nationwide survey of the perception of the APPE by community pharmacy preceptors in South Korea

BackgroundConsidering that approximately 75% of active pharmacists work in a community pharmacy globally, experiential practice in community pharmacies is a crucial part of pharmacy education. Skilled preceptors and their perceptions are integral to experiential practice. However, the perception of community pharmacy preceptors on a nationwide level is rarely studied.ObjectivesTo examine the perception of community pharmacy preceptors who had undertaken the newly implemented community pharmacy experiential practice in South Korea.MethodsThis study was based on a self-administered, nationwide, online cross-sectional survey performed by the Korean Pharmaceutical Association in 2017. Active community pharmacy preceptors undertaking experiential practice in South Korea were enrolled. The preceptor’s competence, satisfaction, stress, achievement, and the likelihood of continuing preceptorship were evaluated using a 4-point Likert scale. In addition, the determinants of perception were evaluated using multivariate logistic regression analysis.ResultsOf the 681 active preceptors, 390 (response rate: 57.3%) participated in this study, and the data of 385 participants were used for the final analysis. The majority of the preceptors were satisfied (83.1%), felt high achievement (85.8%), and were likely to continue with the preceptorship (85.7%). However, 52.8% reported increased stress due to the increased workload and lack of personal time. Preceptors who participated voluntarily had higher competence (odds ratio [OR] 2.050, 1.265–3.322) and exhibited lower stress (OR 0.560, 0.368–0.852). The academic degrees of preceptors and the number of preceptees trained by them were significantly related to competence. Preceptor age (>50 years) was negatively associated with stress (OR 0.635, 0.419–0.962).ConclusionBecause competence is a key element associated with community pharmacy preceptors, it is necessary to create an environment in which preceptors can consider themselves competent. This nationwide study with community pharmacy preceptors will provide a basis for improving the quality of training at community pharmacies and may aid experiential practice administrators in revising the current program.     

Exploring factors associated with scholarly writing among US pharmacy practice faculty

ObjectivesThis study explored intrinsic facilitators (i.e., grit, self-efficacy, and writing motivation) and barriers associated with scholarly output as measured by self-reported publications among US pharmacy practice faculty.MethodsA cross-sectional study design was used to gather information regarding scholarly writing output and intrinsic facilitators and barriers among US pharmacy practice faculty using an online self-reported survey. The survey link was distributed via email between October and November 2017. The Grit-S, New Generalized Self-Efficacy Scale (NGSE), and Scholarly Writing Motivation Scale (SWMS) were used to measure grit, self-efficacy, and writing motivation, respectively. Perceived barriers, self-reported quantity of publications, and demographics were also collected. A structural equation modeling (SEM) approach was used to determine effects of perceived barriers and each intrinsic factor on self-reported total publications.ResultsN = 208 participants were included in the analyses. The average number of self-reported annual publications was 1.88. Participants who reported having higher than average numbers of annual publications (n = 85, 40.9%) more frequently held a PhD degree and were more frequently in the tenure track, compared to those with annual publications less than the average (n = 123, 59.1%). The majority of both groups reported being employed in public institutions. Lack of time for scholarly writing was the highest perceived barrier and lack of knowledge about technical writing/English mastery was the lowest. All three SEM models consistently showed that perceived barriers were negatively associated with numbers of self-reported publications. However, only scholarly writing motivation according to SWMS was positively associated with the numbers of self-reported publications.ConclusionsWriting motivation and barriers to scholarly writing are shown to have a significant impact on scholarly output. These factors can be identified and should be appropriately addressed by colleges/schools of pharmacy to enhance scholarly activities among pharmacy practice faculty.     

Exploration of Methods Used by Pharmacy Professional Programs to Contract with Experiential Practice Sites

Objective. To explore methods used by pharmacy programs to attract and sustain relationships with preceptors and experiential practice sites.Methods. Interviews with eight focus groups of pharmacy experiential education experts (n=35) were conducted at two national pharmacy meetings. A semi-structured interview guide was used. Focus group interviews were recorded, transcribed verbatim, and categorically coded independently by two researchers. Codes were compared, consensus was reached through discussion, and two experiential education experts assisted with interpretation of the coded data.Results. Six themes emerged consistently across focus groups: a perceived increase in preceptor compensation, intended vs actual use of payments by sites, concern over renegotiation of established compensation, costs and benefits of experiential students, territorialism, and motives.Conclusion. Fostering a culture of collaboration may counteract potentially competitive strategies to gain sites. Participants shared a common interest in providing high-quality experiential learning where sites and preceptors participated for altruistic reasons, rather than compensation.     

Assessment of Volunteer Preceptors at Colleges and Schools of Pharmacy in the United States

Objective. To identify the way colleges and schools of pharmacy in the United States assess the performance of volunteer preceptors who precept students in advanced pharmacy practice experiences (APPEs).Methods. In the summer and fall semesters of 2018, directors of experiential education were invited to complete an online, self-administered questionnaire that included questions dealing with assessment of APPE volunteer preceptors related to promotion and reappointment procedures, abilities and attributes assessed, methods of assessment, and frequency of conducting such assessments. Several attempts were made via email and phone to encourage participation.Results. Eighty-one of 132 (61.4%) fully accredited programs responded with all but one reporting that they evaluated the performance of APPE volunteer preceptors. Forty-one of these 80 (51.3%) indicated that preceptors cannot be promoted in rank, while 47 (58.8%) had a process for preceptor reappointment. The most commonly assessed preceptor abilities and attributes were accessibility, ability to provide feedback to students, communication skills, and professional demeanor. The most reported assessment strategies were summative student evaluations and on-site evaluation of the preceptor by college or school personnel. The frequency of assessments varied based on the assessment method the institution used.Conclusion. Assessment of APPE volunteer preceptors was an integral component of the quality assurance process at almost all responding US pharmacy colleges and schools. The institutions evaluated various preceptor abilities and attributes and used multiple assessment strategies. Findings from this study may help programs review their existing assessment practices, implement new ones, and help to standardize preceptor assessment.     

Use of an objective structured clinical examination (OSCE) to assess intern performance in an advanced pharmacy practice experiences (APPE) Ambulatory Care rotation

PurposeIntern assessment during advanced pharmacy practice experiences (APPEs) are generally based upon each individual preceptor’s perceptions without an objective measurement of intern understanding and performance. Therefore, we sought to determine whether a pre- and post-OSCE could be used to confirm that interns achieved the goals and objectives of the Ambulatory Care rotation. The aims of this study were to determine whether a pre-rotation OSCE can help pharmacy interns self-assess their clinical strengths and weaknesses and assess whether their knowledge and skills improved after completing a post-rotation OSCE.MethodsPharmacy interns undergoing APPE Ambulatory Care rotations from September 2018 to March 2020 participated in a pre- and post-rotation OSCE to assess their knowledge of various chronic disease states. Interns completed pre- and post-OSCE surveys to assess their perceptions about their knowledge and the OSCE experience.ResultsPharmacy intern knowledge about diabetes, hypertension, dyslipidemia, and atrial fibrillation significantly improved post-OSCE compared to their pre-OSCE scores (p < 0.001). The mean post-OSCE scores for diabetes (p < 0.001), dyslipidemia (P = 0.046), anticoagulation (P = 0.006), and the overall mean post-OSCE scores (P = 0.005) were significantly higher compared to interns’ pre-OSCE scores. Students believed that the post-OSCE significantly highlighted their strengths and weaknesses in skills and knowledge compared to the pre-OSCE (P = 0.008).ConclusionPre- and post-APPE OSCE assessments are important tools that can provide interns and preceptors with objective evaluations of student performance. OSCEs can either be used as an alternative to perception-based assessments or integrated into existing preceptor evaluations. Furthermore, OSCEs can help preceptors identify areas that require more emphasis in their rotations.     

Precepting skills for precepting challenges

ObjectivesTo guide pharmacy preceptors in developing a systematic approach to students who have performance or behavioral issues and to provide advice on how to proceed if a failing grade or student dismissal is being considered.Data sourcesRelevant medical and pharmacy education literature as selected by the authors.SummaryWhen a student performs poorly on a rotation, a preceptor must reflect upon the circumstances surrounding the situation. Examining the approach to precepting is key in identifying and preventing performance issues. Many problems can be easily addressed by delineating rotation expectations, refining feedback delivery methods, capturing proper documentation, and seeking additional assistance as needed. A successful rotation can be assured if both the student and preceptor are adequately prepared for the experience.ConclusionDeveloping a consistent and systematic approach to precepting challenges can minimize the potential for a negative experience for both the preceptor and student.     

Characteristics of Experiential Education Web Sites of US Colleges and Schools of Pharmacy

Objective. To evaluate the characteristics of experiential education Web sites of colleges and schools of pharmacy in the United States.Methods. The experiential education Web pages of 124 US colleges and schools of pharmacy were reviewed for office or program name, practice experience management software, experiential education newsletter, practice experience manual, preceptor development programs, new preceptor application processes, and interactive Web site interfaces.Results. The term “office of experiential education” was used by 27.4% of colleges and schools. Fifty percent of the colleges and schools used E-value as their practice experience management software. Only a minority of colleges and schools made experiential manual(s) available online, offered newsletters targeted to preceptors, and/or provided Web site interactive interfaces for preceptor communication. The Preceptors Training and Resource Network was the preceptor development program most frequently promoted.Conclusions. The majority of US colleges and schools of pharmacy have official Web sites for their experiential education program; however, few offer resources online or use interactive or social media to their advantage.     

An Analysis of Community Pharmacy Shared Faculty Members’ Contributions to Teaching,Service, and Scholarship

Objective. To identify community pharmacy shared faculty members across the United States and to describe their roles and responsibilities in terms of teaching, service, and scholarship.Methods. This study was a mixed-methods analysis using surveys and key informant interviews.Results. Twenty-two faculty members completed the survey; nine were interviewed. Their major roles and responsibilities included teaching in community-based and experiential learning courses, precepting students and/or residents, being actively involved in professional organizations, providing patient care while leading innovation, and disseminating findings through scholarship.Conclusion. Community pharmacy shared faculty members contribute to their academic institutions and community pharmacy organizations by educating learners, providing direct patient care, and advancing community practice through innovation and service to the profession. Findings of this study can be used as a guide for academic institutions and community pharmacy organizations interested in partnering to develop a community pharmacy shared faculty position.     

The Impact of Preceptor and Student Learning Styles on Experiential Performance Measures

Objectives. To identify preceptors’ and students’ learning styles to determine how these impact students’ performance on pharmacy practice experience assessments.Methods. Students and preceptors were asked to complete a validated Pharmacist’s Inventory of Learning Styles (PILS) questionnaire to identify dominant and secondary learning styles. The significance of “matched” and “unmatched” learning styles between students and preceptors was evaluated based on performance on both subjective and objective practice experience assessments.Results. Sixty-one percent of 67 preceptors and 57% of 72 students who participated reported “assimilator” as their dominant learning style. No differences were found between student and preceptor performance on evaluations, regardless of learning style match.Conclusion. Determination of learning styles may encourage preceptors to use teaching methods to challenge students during pharmacy practice experiences; however, this does not appear to impact student or preceptor performance.     

Primary care provider perceptions of an integrated community pharmacy hypertension management program

BackgroundTrained community pharmacists provided hypertension (HTN) management services in collaboration with a patient-centered medical home (PCMH).ObjectiveTo explore primary care provider (PCP) perceptions of a HTN management program in which patients at the PCMH with elevated blood pressure could choose to receive follow-up care with a trained community pharmacist at a chain community pharmacy.MethodsWe conducted informal interviews with 8 PCPs with a range of level of involvement with the collaborative HTN management program to inform the development of a 13-question online survey that was distributed to PCPs at 10 participating Michigan Medicine PCMH clinics. The primary outcome was the percent of PCPs who reported that the program improved their patient’s blood pressure. Secondary outcomes included awareness of the program, alternative follow-up strategies, PCP satisfaction, and barriers to using the program.ResultsA total of 39 PCPs (30.0%) responded to the survey. More than one-half (n = 21 of 39, 53.9%) of respondents reported that at least 1 of their patients had seen a trained community pharmacist for HTN management services. Almost all of these PCPs (n = 19 of 21, 90.5%) reported being satisfied with the program, and 80.9% (n = 17 of 21) agreed that it helped patients improve their blood pressure control. The most common barriers identified were patients preferring to follow up directly with their PCP (n = 18 of 39, 46.2%), PCPs being more comfortable with patients having a visit with an embedded ambulatory care pharmacist (n = 16 of 39, 41.0%), and a lack of written materials to share with patients about the program (n = 15 of 39, 38.5%).ConclusionPCPs who used the integrated community pharmacy HTN management program were satisfied with the program and thought that it resulted in improved blood pressure control. PCPs may benefit from written information to share with their patients as well as education to increase their awareness of the program and its beneficial effect on patient blood pressure.     

Preceptors�� Self-Assessment of Their Ability to Perform the Learning Objectives of an Experiential Program

Objective. To evaluate preceptors’ perception of their ability to perform the Structured Practical Experiences in Pharmacy (SPEP) learning objectives through a self-assessment activity.Methods. A self-assessment instrument consisting of 28 learning objectives associated with clinic, community, and hospital pharmacy practice experiences were developed. Preceptors rated their performance ability for each of the learning objectives using a 3-point Likert scale.Results. Of the 116 preceptors, 89 (77%) completed the self-assessment survey instrument. The overall preceptor responses to the items on performance of the 28 SPEP learning objectives ranged from good to excellent. Years of experience, practice experience setting, and involvement as a SPEP or SPEP and PharmD preceptor had no influence on their self-reported capabilities.Conclusion. Most preceptors rated their ability to perform the learning objectives for the structured practical experiences in pharmacy as high. Competency areas requiring further preceptor development were identified.     

Community pharmacists and Colleges of Pharmacy: the Ohio partnership.

OBJECTIVE: To develop pharmacist practice standards, pharmacy preceptor standards, and objectives for students completing advanced practice community pharmacy rotations. SETTING: Ohio. PRACTICE DESCRIPTION: Pharmacy schools and community pharmacies that serve as advanced practice rotation sites. PRACTICE INNOVATION: Developed standards for preceptors and objectives for student experiences. INTERVENTIONS: Focus groups that included both community pharmacists and pharmacy faculty collaborated on defining key standards for advanced community pharmacy rotations. MAIN OUTCOME MEASURE: Not applicable. RESULTS: Three main documents were produced in this initiative, and these are provided as appendices to this article. Professional and patient care guidelines for preceptors define minimum standards for these role models. Expectations of pharmacists as preceptors provide insights for managing this student-teacher relationship, which is fundamentally different from the more common employer-employee and coworker relationships found in pharmacies of all types. Objectives for student experiences during advanced practice community pharmacy rotations present core expectations in clinical, dispensing, patient education, wellness, and drug information areas. CONCLUSION: Through this collaboration, Ohio colleges of pharmacy developed a partnership with practitioners in community settings that should enhance the Ohio experiential educational program for student pharmacists. Use of the established guidelines will help educators and practitioners achieve their shared vision for advanced practice community pharmacy rotations and promote high-quality patient care.     

The role of pharmacy technicians in vaccination services: a scoping review

BackgroundA busy pharmacy workload may limit a pharmacist’s ability to meet the needs of vaccine-willing patients and also contribute to missed opportunities to engage with vaccine hesitant individuals. Opportunities for pharmacy technicians to support vaccination services may play a role in addressing increasing patient vaccination needs.PurposeThis research aims to review the role of pharmacy technicians in vaccination services that is supported by pharmacy practice research to date.MethodsIn compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols, systematic searches were performed in PubMed, Embase, International Pharmaceutical Abstracts, Scopus, and CINAHL. Articles published through June 2020, in French, English, and Spanish, were screened for eligibility. Two independent reviewers screened titles and abstracts for inclusion. Data extraction of included study methodologies and results was performed by one reviewer and verified by a second reviewer.ResultsA total of 656 records were identified through the search of published literature. Full-text screening of 145 records identified 14 articles for inclusion. Most articles evaluated emerging pharmacy technician roles in patient screening (n = 8, 53%) and vaccine administration (n = 5, 36%). Implementation of both emerging roles demonstrated positive patient outcomes (n = 10, 72%). Screening activities were complicated by the complexity of the role, as well as its potential to increase overall time spent on vaccination services. Pharmacists and technicians advocated for accredited vaccine administration training owing to consistent benefits in pharmacy workflow efficiency, pharmacist clinical time, and pharmacy technician job satisfaction.ConclusionThis review supports the effective deployment of pharmacy technicians in delivering vaccination services. Despite pharmacy technician vaccine administration roles being highly regulated, professional advocacy by pharmacists and technicians can use the advantageous training, workflow, and patient outcomes benefits presented in this review. Early adopters of professional practice advancements for pharmacy technician vaccine administration may expand vaccination service capacity efficiently and safely, thereby reaching more patients.     

Strategies for implementing the Appointment-Based Model at a rural independent chain of community pharmacies

BackgroundThe Appointment-Based Model (ABM) is a care model that helps community pharmacists streamline their medication dispensing workflow while simultaneously integrating patient care into the medication preparation process through medication synchronization. Implementation of the ABM has varied across community pharmacies. Further studies that identify tailored implementation approaches are needed to support broad adoption of the ABM in practice.Objectives(1) To determine facilitators and barriers to ongoing adoption and implementation of the ABM at a small chain of rural independent pharmacies where adoption has stalled and (2) to identify implementation strategies to support further adoption of the ABM at these pharmaciesMethodsThis project was an exploratory, mid-implementation study. Semistructured interviews were conducted with pharmacy staff who participated in the ongoing implementation and use of the ABM at the pharmacies. Interviews elicited stakeholder-centered perspectives on (1) experiences with the ABM to date, (2) processes and roles for the ABM, and (3) opinions on how implementation of the ABM could be improved at the pharmacies. Rapid qualitative assessment methodology was used for analysis to identify facilitators and barriers and to select implementation strategies.ResultsThirty-one pharmacy personnel were interviewed: pharmacists (n = 10), pharmacy technicians (n = 7), and fill clerks (n = 14). The research team identified 6 facilitators and 4 barriers to the implementation of the ABM at the pharmacies. Five implementation strategies were selected based on the facilitators and barriers: (1) capture and share local knowledge across pharmacy sites, (2) conduct educational outreach visits, (3) conduct ongoing training, (4) prepare patients to be active participants in the ABM, and (5) organize clinician implementation team meetings.ConclusionsDevelopment of a stakeholder-driven implementation approach may support further implementation and adoption of the ABM in practice.     

Developing Preceptors through Virtual Communities and Networks: Experiences from a Pilot Project

Background:

Supporting preceptors is critical to the expansion of experiential learning opportunities for the pharmacy profession. Informal learning opportunities within communities of practitioners are important for hospital preceptors. However, such communities may be limited by geographic separation of preceptors from peers, faculty members, and supports within the pharmacy services department.

Objective:

To use computer-mediated conferencing to create a sense of community among preceptors, specifically by using this medium to provide initial development of and continuing support for preceptors, and to examine preceptors’ satisfaction with this approach.

Methods:

Thirty-nine preceptors who had completed a day-long face-to-face preceptor development workshop and who were supervising students in 1 of 2 specific rotation blocks were invited to participate in the study. The pharmacists used computer-mediated conferencing to meet for virtual networking about specific topics. They met once before the student rotation to receive instructions about the technology and to discuss student orientation and scheduling, and 3 times during the student rotation for open discussion of specific topics. Evaluation and feedback were solicited by means of an electronic survey and virtual (i.e., computer-based) feedback sessions with an independent facilitator.

Results:

The response rate was 66% (26/39) for the electronic survey, but only 15% (6/39) for the virtual feedback sessions. All of the respondents were experienced preceptors, but for 92% (22/24), this was their first experience with computer-mediated conferencing. Overall, the sessions had a positive reception, and participants found it useful to share information and experiences with other preceptors. The main challenges were related to the technology, perceived lack of support for their participation in the sessions, and inconvenience related to the timing of sessions.

Conclusion:

Computer-mediated conferencing allowed preceptors to learn from and to support each other despite geographic distance. The participants felt that these sessions encouraged them to serve as preceptors regularly. Such encouragement could contribute to the retention of preceptors, which is important to the expansion of experiential learning.     

Patient assessment and documentation integrated in community practice: Chat,check, and chart

ObjectiveTo explore how pharmacists integrated the Chat,Check andChart (CCC) tools in community practice and to identify barriers and facilitators to use.DesignConcurrent nested mixed-method study. Open-ended, semi-structured qualitative interviews on tools use and a quantitative survey were completed via telephone.SettingCommunity-based pharmacy practice.Participants39 community pharmacists consented to interviews2 months after the CCC training workshop; 22 completed an interview.InterventionWorkshop training on CCC tools and workplace implementation strategies.Main outcome measuresBarriers, facilitators and implementation strategies for CCC tools.ResultsMore pharmacists were implementing or had made patient assessment part of their practice (54%) than documentation of patient care (36%). Integration was facilitated by patient success, collaborative worksite, personal beliefs, and provincial regulations. Lack of routines, patient expectations, reimbursement, and time were familiar barriers. Strategies to overcome these barriers included practicing new habits, using technology, starting small, using physical reminders, and recognizing benefits.ConclusionPatient care tools for assessment and documentation had both positive and negativeeffects on patients, pharmacists, and community pharmacies because of demands on time, lack of resources, and limited personal, external, and patient expectations of pharmacists’ care. Findings resulted in Alberta College of Pharmacists academic detailing of the CCC tools duringonsite pharmacy assessments to help pharmacists meet or exceed provincial practice standards.