1. Pharmacy Precepting Pearls of Practice Teaching Clinical Problem Solving/Adapting to Different Learning Styles DEBBIE WAGGONER, PHARM.D., BCNP ASSOCIATE PROFESSOR, HARDING UNIVERSITY COLLEGE OF PHARMACY SEPTEMBER 29, 2016

2. Objective Summarize effective approaches to teaching clinical problem solving and tailoring to the individual learner.

3. Prepping the critical thinking landscape ~Attitude check ~Sincerity ~Introduction to the preceptor/student relationship ~Define training and developlment

4. What is Critical Thinking/Problem Solving? Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action.

5. Critical Thinking

6. Pharmacists’ Patient Care Process

7. Pharmacists use a patient-centered approach in collaboration with other providers on the health care team to optimize patient health and medication outcomes. Using principles of evidence-based practice, pharmacists: Collect The pharmacist assures the collection of the necessary subjective and objective information about the patient in order to understand the relevant medical/medication history and clinical status of the patient. Assess The pharmacist assesses the information collected and analyzes the clinical effects of the patient’s therapy in the context of the patient’s overall health goals in order to identify and prioritize problems and achieve optimal care. Plan The pharmacist develops an individualized patient-centered care plan, in collaboration with other health care professionals and the patient or caregiver that is evidence-based and cost-effective. Implement The pharmacist implements the care plan in collaboration with other health care professionals and the patient or caregiver. Follow-up: Monitor and Evaluate The pharmacist monitors and evaluates the effectiveness of the care plan and modifies the plan in collaboration with other health care professionals and the patient or caregiver as needed.

8. Snapshot of Clinical Problem Solving Development on an Acute Care Rotation 1. Student/Resident independent work – should increase and improve as the month continues 2. Team interaction/collaboration is a MUST 3. Patient/family interaction – should proceed with supervision on the front end and have a goal of independent interaction as the month continues 4. Scheduled AND unscheduled topic discussions – mixture of student/preceptor input 5. Insist upon explanations for recommendations with evidence based back up 6. Ask WHY? – data collection parameters, disease states to consider, etc. 7. Encourage respectful independence 8. Lead through example – not just words

9. Adapting to Different Learning Styles

10. Learning Styles Incorporate as many methods as possible when teaching: Standard lecture vs. interactive Use graphs/charts/whiteboard Student/Resident teaching Hands on instruction

11. Visual Learner *Preference for things seen or observed including pictures, diagrams, demonstrations, displays, handouts, films, flip-charts, etc. *Uses phrases such as “show me” and will be best able to perform a new task after reading the instructions or watching someone else do it first. *Works best from lists and written directions and instructions. Tips for Accommodating * Use diagrams, charts, images, graphs * Provide written instructions * Use a whiteboard * Flashcards/highlighting * Demonstrate * Ask the student/resident to summarize topics in writing

12. Auditory Learner *Preference for the transfer of information through listening: to the spoken word, of self or others, of sounds and noises. These people will *Uses phrases such as ‘tell me’, ‘let’s talk it over’ and will be best able to perform a new task after listening to instructions from an expert. *Happy being given spoken instructions over the telephone, and can remember all the words to songs that they hear! Tips for Accommodating *Engage the student in conversation about the subject matter *Question students/residents about the material *Ask for oral summaries of material *Have them put material to a rhythm or tune and rehearse it aloud

13. Kinesthetic or Tactile Learner *Preference for physical experience - touching, feeling, holding, doing, practical hands-on experiences. *Use phrases such as “let me try” and will be best able to perform a new task by going ahead and trying it out, learning as they go. *Like to experiment, hands-on, and never look at the instructions first! Tips for Accommodation *Student/resident can write down key words during topic discussion and/or take notes *Allow hands on patient assessment with the permission of the patient and/or family *Imagine symptoms experienced when discussing a disease state *Recommend (subtle) body movement to incorporate rhythm when reciting notes/ topic discussion material

14. Recognizing Specific Learning Styles 1. Ask 2. Observe 3. Trial and Error 4. Never condemn differences 5. Overlap of various styles

15. Adapting to Different Learning Styles and Personalities *Recognize the learning style(s) *Suggest tools and direct the learning process to enhance success *Adjust the teaching delivery method *Adjust your delivery style *Plan for various personalities *Address any negative issues immediately in a private setting *Provide positive reinforcement *Allow the student/resident to start the month with a “clean slate”

16. References Council on Credentialing in Pharmacy. Scope of Contemporary Pharmacy Practice: Roles, Responsibilities, and Functions of Pharmacists and Pharmacy Technicians: J Am Pharm Assoc (2003). 2010;50:e35-e69. Joint Commission of Pharmacy Practitioners; Pharmacists’ Patient Care Process; May 29, 2014. Critical Thinking. Retrieved September 23, 2016, from critical thinking, www.criticalthinking.org

17. Q & A

18. Presentation Question Which of the following is the correct sequence of events in the Pharmacists’ Patient Care Process? A. Plan, Assess, Collect, Implement, Follow-up B. Collect, Assess, Plan, Implement, Follow-up C. Collect, Plan, Implement, Assess, Follow-up D. Assess, Collect, Plan, Implement, Follow-up