Pharmacy Student and Preceptor Perceptions of Preceptor Teaching Behaviors

Objectives

To compare PharmD students'' and preceptors'' perceptions of preceptors'' teaching behaviors.

Methods

A 47-item survey instrument was developed and distributed to students and preceptors for rating the frequency and adequacy of each teaching behavior as not done, done but inadequate, and well done and adequate.

Results

Seventy-seven (99%) students and 53 (55%) preceptors responded to the survey. Students were somewhat satisfied with their preceptors'' teaching behaviors. In comparison, preceptors overrated their own teaching behaviors as well done and adequate on 9 of 47 (19%; p ≤ 0.05) items, with the majority being in the areas of providing feedback to students and evaluation.

Conclusion

Preceptors tended to overestimate the quality of their performance compared with students'' evaluations. These findings suggest the need for a preceptor development program.     

National Survey of Volunteer Pharmacy Preceptors

Objectives

To survey pharmacy preceptors regarding experiential education and determine the implications of the findings on colleges and schools of pharmacy.

Methods

An online survey was sent to 4,396 experiential sites. The survey instrument consisted of 41 questions regarding the experiential education environment from the preceptor''s perspective (eg, experiential load, time-quality issues, compensation, etc).

Results

One thousand one hundred sixty-three preceptors responded (26.5%) to the survey. Concerning experiential load, 73% took 2 or more students in the past year and almost half of the sites had to turn placements away. Nearly all preceptors felt that the more time they spent with students, the higher quality the experience, and 20% felt they didn''t have enough time to provide a quality experience. Thirty-six percent of respondents chose monetary stipend as the form of compensation they valued most.

Conclusions

This study provides insights into the issues that concern volunteer preceptors and the findings could be used to enhance the quality of experiential education in pharmacy.     

Identifying Perceptions of Professionalism in Pharmacy Using a Four-Frame Leadership Model

Objectives

To determine whether professionalism in pharmacy education is addressed from Bolman and Deal''s four-frame leadership model.

Methods

Students (N = 624), faculty (N = 57), preceptors (N = 56), and academic administrators (N = 8) at 6 colleges and schools of pharmacy were surveyed to assess professionalism. Using grounded theory methodology and a constant comparative process, common themes were identified for each question in each group. Themes were assigned to the four-frame model and the data were compared.

Results

Mechanisms of addressing professionalism consistent with all 4 frames of the Bolman and Deal''s model were identified. Faculty assessment of student professionalism was significantly lower (P < 0.05) than the student group, preceptors, and administrators.

Conclusions

Mechanisms of addressing professionalism in pharmacy education span all four frames of Bolman and Deal''s leadership model. The values students bring into a pharmacy program may play an important role in the process of professional socialization. Faculty members have a tremendous opportunity to enhance student professionalism with their daily verbal and nonverbal interactions with students.     

Learning bridge tool to improve student learning, preceptor training, and faculty teamwork

Objectives

To implement a Learning Bridge tool to improve educational outcomes for pharmacy students as well as for preceptors and faculty members.

Design

Pharmacy faculty members collaborated to write 9 case-based assignments that first-year pharmacy (P1) students worked with preceptors to complete while at experiential sites.

Assessment

Students, faculty members, and preceptors were surveyed about their perceptions of the Learning Bridge process. As in our pilot study,¹ the Learning Bridge process promoted student learning. Additionally, the Learning Bridge assignments familiarized preceptors with the school''s P1 curriculum and its content. Faculty teamwork also was increased through collaborating on the assignments.

Conclusions

The Learning Bridge assignments provided a compelling learning environment and benefited students, preceptors, and faculty members.     

Preceptor Perceptions of Pharmacy Student Team Quality Assurance Projects

Objectives

To assess preceptors'' opinions of the impact of quality assurance projects.

Methods

Students were given the opportunity to directly apply material learned in class in a “real world” environment by completing a quality assurance project in a community or health-system pharmacy. All preceptors (n = 38) were contacted via telephone and given the opportunity to respond to open-ended questions concerning their experience with student-team quality assurance projects.

Results

Preceptors indicated the quality assurance projects benefited their practice sites by providing additional resources (53%, n = 19), decreased medication errors (22%, n = 8), and increased awareness of the importance of quality assurance (22%, n = 8). Ninety-four percent of respondents (n = 34) perceived the projects had a positive impact on patient care and 92% (n = 33) perceived a positive impact on themselves.

Conclusions

Preceptors felt that quality assurance projects performed by pharmacy-student teams were beneficial to patient care, the practice site, and themselves. The quality assurance projects have broad applications and can be added to a medication safety class or to the introductory pharmacy practice experience (IPPE) sequence.     

Development needs of volunteer pharmacy practice preceptors

Objective

To determine the training needs and interests of volunteer pharmacy preceptors.

Methods

Volunteer preceptors (n=576) were surveyed on various aspects of precepting and their needs related to additional training.

Results

Two hundred thirty-six preceptors (40.9%) responded. Preceptors were less confident about enforcing attendance policies, identifying and managing unmotivated or failing students, identifying dishonesty or plagiarism, and handling conflict. While only 29.5% of respondents agreed that having an APPE student decreased their overall workload, approximately half (48.1%) indicated that student pharmacists helped them complete their daily tasks and 67.8% agreed that APPE students extended patient care. Respondents who had received training were significantly more confident than preceptors who had not received training in their abilities to clarify expectations, evaluate a student''s knowledge, and foster skills related to critical thinking and problem solving.

Conclusions

Training programs for pharmacy preceptors are effective; however, important areas in which additional training is needed or desired were identified among both new and experienced preceptors.     

Integration of First- and Second-Year Introductory Pharmacy Practice Experiences

Objectives

To describe the integration of a first- and second-year introductory pharmacy practice experience (IPPE) involving direct patient contact in hospitals and clinics as a means of more efficiently using academic and preceptor resources.

Design

Two IPPE courses were integrated in fall 2004 to accomodate increasing enrollment in classes and limited clinical practice sites and preceptors, as well as to meet the increased need for students and clinicians to practice principles of self-education. P1 and P2 students interviewed patients and presented patient cases; preceptor expectations were structured by instructional objectives. Student and preceptor course evaluations were assessed from survey data.

Assessment

During the assessment period, all students passed the courses. Following integration of the IPPEs, both courses received positive evaluations from students and preceptors. Initial advanced pharmacy practice experience (APPE) grades for students completing the courses further suggests that the integrated IPPEs were beneficial to students.

Conclusion

The successful integration of first- and second- year IPPE courses resulted in more efficient use of academic and preceptor resources and created a model for other colleges of pharmacy to consider.     

Educational card games to teach pharmacotherapeutics in an advanced pharmacy practice experience

Objective

To implement and assess the effectiveness of card games to teach pharmacotherapeutic topics to pharmacy students and to determine the relationship between students'' assessment scores and their learning styles.

Design

Two card games, Cardiology Go Fish and Infectious Diseases Gin Rummy, were created and taught to pharmacy students enrolled in an advanced pharmacy practice experience (APPE). Students were required to play each game for 1 hour, 3 times over a 6-week period.

Assessment

Forty-five students completed a 90-question assessment administered prior to and after the 6-week period in which the games were played. Students'' cardiology and infectious diseases assessment scores improved significantly as compared with scores on pharmacy practice questions, 19.2% vs. 5.1%, (p < 0.001) and 10.3% vs. 5.1% (p = 0.006), respectively. Students learned from participating in the games regardless of their learning preference as determined by the VARK (visual, aural, read/write, kinesthetic) questionnaire; however, the cardiology assessment scores of students with a preference for kinetic learning improved the most.

Conclusions

Incorporating innovative learning tools such as card games into the curriculum of APPEs can enhance the educational experience of pharmacy students.     

Refinement of strengths instruction in a pharmacy curriculum over eight years

Objective

To develop, refine, and integrate introductory-level strengths instruction within a doctor of pharmacy (PharmD) curriculum.

Design

Over 8 years, student pharmacists completed the StrengthsFinder assessment tool and identified their top 5 Signature Themes (talents). They then participated in either Web-based learning modules or live workshops designed to facilitate professional development.

Assessment

Students preferred the live instruction over Web-based learning modules. Post-instruction evaluations demonstrated that students discussed their Signature Themes with peers, preceptors, and family members. Pharmacists working with students in strengths-related activities reported that the students applied the information in the practice setting. Both pharmacists and students recommended that this material be required for all students.

Conclusions

Identifying a role in pharmacy that aligns with one''s personal talents is critical for the success of pharmacy graduates. Strengths instruction is an important component of professional and career development, and can aid in identifying roles.     

A needs assessment study of hospital pharmacy residency preceptors

Background:

Canadian pharmacy residency programs rely on preceptors to support the growing demand of graduates wishing to pursue hospital residencies. Understanding the educational needs of these preceptors is important to ensure that they are well prepared to deliver successful programs.

Objective:

To determine what new and experienced residency preceptors self-identify as learning needs in order to become more effective preceptors for pharmacy residents.

Methods:

A needs assessment of preceptors from the 31 accredited Canadian general hospital pharmacy residency programs was conducted. The study had 4 key components: interviews and focus group discussions with key informants, a pilot study, an online survey, and member checking (seeking clarification and further explanation from study participants). The residency coordinators and a convenience sample of 5 preceptors from each program were invited to participate in the survey component.

Results:

Of a possible 186 participants, 132 (71%) responded to the survey. Of these, 128 (97%) were confident that they met the 2010 standards of the Canadian Hospital Pharmacy Residency Board (CHPRB). Preceptors ranked communication skills, giving effective feedback, and clinical knowledge as the most important elements of being an effective preceptor. Managing workload, performing evaluations, and dealing with difficult residents were commonly reported challenges. Preceptors expressed a preference for interactive workshops and mentorship programs with experienced colleagues when first becoming preceptors, followed by 1-day training sessions or online learning modules every other year for ongoing educational support. The most beneficial support topics selected were providing constructive feedback, practical assessment strategies, small-group teaching strategies, effective communication skills, and setting goals and objectives.

Conclusions:

This study identified several learning needs of hospital residency preceptors and showed that preceptors would appreciate educational support. Utilization of these results by residency program administrators, the CHPRB, and faculties of pharmacy could be beneficial for residency programs across Canada.     

An electronic NAPLEX review program for longitudinal assessment of pharmacy students' knowledge

Objectives

To track pharmacy student knowledge over time using a proprietary software program in an accelerated program for curricular assessment.

Methods

All students were required to complete a computerized comprehensive diagnostic examination 3 times during the doctor of pharmacy (PharmD) program: at the beginning of the second year, and near the end of the second and third years. The examination was comprised of 100 questions in 3 content areas: pharmacotherapy, preparation and dispensing of medications, and providing health care information. Within-subject differences in mean area and total percent scores were compared.

Results

Based on 123 students'' data, mean scores for pharmacotherapy and total percent scores for examination 1 were significantly different from examinations 2 and 3.

Conclusion

The computer-based comprehensive diagnostic examination shows promise for use as a component of a comprehensive assessment plan.     

Factors Associated With Reflection Among Students After an Advanced Pharmacy Practice Experience (APPE) in Sweden

Objective

To identify individual and social factors associated with pharmacy students'' level of reflection in an advanced pharmacy practice experience (APPE).

Methods

A postal questionnaire, including a reflective assignment, was sent to all pharmacy interns (n=262) at Uppsala University, Sweden, for 4 semesters in 2005-2007.

Results

In a univariate analysis, 7 factors were found to be associated with students'' level of reflection. After controlling for covariates, 3 social factors were found to be independently associated with reflection: having a formal preceptor (OR=5.3), being at a small pharmacy (OR=19.8), and students'' perception of the importance of discussing critical thinking with the preceptor (OR=1.2). No correlation could be observed between level of reflection and critical thinking, nor learning style.

Conclusion

Social components seem to be of higher importance than individual components in students'' reflective levels after pharmacy internship experience. Trained preceptors are important to foster reflection skills.     

Multiple rubric-based assessments of student case presentations

Objectives

To evaluate a rubric-based method of assessing pharmacy students'' case presentations in the recitation component of a therapeutics course.

Methods

A rubric was developed to assess knowledge, skills, and professional behavior. The rubric was used for instructor, student peer, and student self-assessment of case presentations. Rubric-based composite scores were compared to the previous dichotomous checklist-based scores.

Results

Rubric-based instructor scores were significantly lower and had a broader score distribution than those resulting from the checklist method. Spring 2007 rubric-based composite scores from instructors and peers were significantly lower than those from the pilot study results, but self-assessment composite scores were not significantly different.

Conclusions

Successful development and implementation of a grading rubric facilitated evaluation of knowledge, skills, and professional behavior from the viewpoints of instructor, peer, and self in a didactic course.Key words: rubric, pharmacy, peer assessment, self-assessment, assessment     

Health Promotion Integrated Into a Thai PharmD Curriculum to Improve Pharmacy Practice Skills

Objective

To implement and evaluate 5 integrated teaching modules in the fifth-year doctor of pharmacy (PharmD) curriculum to increase students'' ability to promote patients'' health as part of their pharmacy practice.

Design

Activity-based learning was added to each module: (1) a practice experience in which students provided health information and counseling to the public; (2) academic debates on current issues in pharmacy (3) journal clubs on articles from the pharmacy literature; and (4) research projects relating to ongoing faculty research on diabetes. Students on 12-week practice experiences had visits to patients in inpatient wards, outpatient clinics, and either primary care units or community pharmacies.

Assessment

Practice examinations at the end of the first semester, the average student score was above 80% as determined by preceptors in experience sites and from faculty members. Group interviews found that students were positive about the benefits of integrated teaching.

Conclusion

The integration of the teaching between modules in the same semester is possible and greatly benefits student learning.     

Expanding voluntary active-learning opportunities for pharmacy students in a Respiratory Physiology Module

Objectives

To expand voluntary active-learning opportunities for bachelor of pharmacy students enrolled in a third-year human physiology and pharmacology course and determine whether the additional course components improved learning outcomes.

Design

Additional voluntary active-learning opportunities including a large-class tutorial, additional formative assessment, and an online discussion were added to the Respiratory Physiology Module of the course. Examination scores were compared with those from previous years. A questionnaire was administered to assess students'' perception of the active-learning components.

Assessment

Mean examination scores increased from 69.3% ± 24.4% in 2003 to 88.9% ± 13.4% in 2004 and 86.9% ± 17.6% in 2005, after the addition of the active-learning components. Students'' overall perception of the value of the active-learning activities was positive.

Summary

The addition of voluntary active-learning course components to a required pharmacy course resulted in improved student examination scores, and decreased failure rate, and were accomplished at low cost and with little additional staff time.     

Using game format in small group classes for pharmacotherapeutics case studies

Objective

To incorporate games in classroom teaching to encourage student interest and participation in a small group pharmacy therapeutics case studies class.

Design

Using a television quiz show and classic board game format, students and the instructor developed games to discuss patient care plans. At the end of the course, a questionnaire was administered to assess students'' attitudes and perception of using game format in the class and whether this teaching method was useful in reinforcing therapeutic knowledge.

Assessment

The majority of the students felt that games were beneficial in their learning process. The game format also resulted in higher student participation scores.

Conclusions

The game-format approach to learning aroused student interest, enhanced participation, and improved their participation grades. Although the game format of leaning is an effective way of actively engaging students in higher leaning, determining how these games improve test scores will require further assessment.     

Preceptors, interns, and newly registered pharmacists' perceptions of New Zealand pharmacy graduates' preparedness to practice

Objective

To determine the perceptions of pharmacy interns and newly registered pharmacists and preceptors regarding the preparedness of graduates to enter professional practice.

Methods

A questionnaire was developed from the New Zealand Competence Standards for the Pharmacy Profession (pharmacist level), with additional questions on communication skills included. The instrument contained 16 items and was mailed to preceptors (n=141), interns (n=72), and newly-registered pharmacists (n=101). Microsoft Excel (pivot tables) was used to analyse the quantitative responses. The final question asked respondents to provide free-text comments about the questionnaire, graduates and the program and responses were analyzed quantitatively and thematically.

Results

The response rates were 54.6% (n = 77) for preceptors, 100% (n = 72) for interns and 45.5% (n = 46), for newly registered pharmacists. The majority of responses (87.6%; n=2,562) were in agreement that the degree had prepared graduates for practice. Overall, preceptor perceptions of graduates'' preparedness for practice were less favorable than graduates'' self-perceptions of their preparedness. Four themes were identified from the free-text comments: the need for improved skills, more professional attitudes, better English communication, and additional training in extemporaneous compounding.

Conclusion

Feedback elicited from graduates and preceptors was helpful in identifying the strengths and weaknesses of a new bachelor of pharmacy (BPharm) program and proved useful in both the accreditation and curriculum revision processes.     

Canadian Pharmacy Students' Knowledge of Herbal Medicine

Objective

To determine fourth-year Canadian pharmacy students'' knowledge of herbal medicine and whether that knowledge is associated with mandatory instruction in herbal medicine.

Methods

Standardized multiple-choice tests assessing students'' herbal knowledge were distributed to all fourth-year BSc pharmacy students at 5 pharmacy schools in Canada.

Results

The Quebec response rate was too low to include in the analysis. Herbal knowledge test scores were positively associated with having previously taken an herbal medicine class and completion of a pharmacy practicum. However, postsecondary education, age, and gender were not associated with herbal knowledge test scores. Students at the University of British Columbia had the highest score, followed by Alberta, Nova Scotia, and Ontario.

Conclusion

Pharmacy students'' knowledge of herbal medicine varies depending on the school attended and higher herbal knowledge test scores appear to be most closely related to mandatory herbal instruction.     

Remote library access for pharmacy preceptors

Objective

To institute and evaluate the response to a program providing access to electronic library resources for pharmacy preceptors.

Design

The pharmacy experiential office and the library collaborated using existing programs and technology to provide and market secure remote access for preceptors.

Assessment

Preceptor participation was tracked in the experiential office, and response to the program was assessed using an online survey instrument that included questions about use of and preference for specific library resources. Three hundred thirty-four adjunct faculty members registered, representing 34% of all preceptors with active e-mail accounts.

Conclusion

Preceptor participation in the program exceeded expectations. Some minor flaws in the logistics of delivering the service were identified and remedied.