1. Overview of Experiential Education
Gerald E. Meyer, PharmD, MBA, FASHP
Associate Professor and Director of Experiential Education
Jefferson School of Pharmacy

2. Objectives
Describe the driving forces behind changes in pharmacy experiential education

3. The Roadmap to Change – What is driving us?
JCPP Future Vision of Pharmacy Practice
CAPE Educational Outcomes 2004
IOM: Health Professions Education
ACPE Standards 2007

4. Joint Commission of Pharmacy Practitioners – 2007 Position Statement
Vision: Pharmacists will be the health care professionals responsible for providing patient care that ensures optimal medication therapy outcomes
Pharmacy Practice in 2015
Foundations of Pharmacy Practice
How Pharmacists Will Practice
How Pharmacy Practice Will Benefit Society
Foundations: Pharmacy Education will prepare pharmacists to provide patient care…(so this is about “us”). Need to develop and maintain a commitment for and about patients, an-in-depth knowledge base and the ability to apply evidence to decision making.
How Pharmacists will practice. Pharmacists will have authority and autonomy to manage medication therapy and will be accountable for outcomes.
Benefits: Will achieve public recognition that they are essential to the provision of effective health care.

5. AACP: Center for the Advancement of Pharmaceutical Education (CAPE)
Provide Pharmaceutical Care
Interprofessional, Evidence-based…
Patient-centered or Population based
Manage and Use Resources of the Health-Care System
Human, medical, informational
Medication use systems
Promote Public Health

6. Institute of Medicine (IOM) Health Professions Education: A Bridge to Quality
Core Competencies
Provide patient centered care
Work in interdisciplinary (Interprofessional) teams
Employ evidence-based practice
Apply quality improvement
Utilize informatics

7. ACCREDITATION COUNCIL FOR PHARMACY EDUCATION
ACCREDITATION STANDARDS AND GUIDELINES FOR THE
PROFESSIONAL PROGRAM IN PHARMACY LEADING TO
THE DOCTOR OF PHARMACY DEGREE
ADOPTED: JANUARY 15, 2006
RELEASED: FEBRUARY 17, 2006
EFFECTIVE: JULY 1, 2007

8. ACPE Standard 14: Curricular Core- Pharmacy Practice Experiences
… must provide a continuum of required and elective pharmacy practice experiences throughout the curriculum, from introductory to advanced, of adequate scope, intensity and duration to support the achievement of the PROFESSIONAL COMPETENCIES presented in Standard 12.

9. ACPE Standard #10 The Curriculum
“… required & elective courses and experiences must effectively facilitate student development and achievement of professional competencies”
Introductory pharmacy practice experiences (IPPEs): 5% of curriculum
Advanced pharmacy practice experiences (APPEs): 25% of curriculum

10. Standard 14: Preceptors Guideline 14.1
“… must insure preceptors receive orientation…, ongoing training, and development”
“Preceptors should provide close supervision of and significant interaction with students.”
“The student-to-preceptor ratio for the pharmacy practice experience should be adequate to provide individualized instruction, guidance, supervision, and assessment.”

11. Standard 11: Teaching and Learning Methods
“… produce graduates who become competent pharmacists by ensuring achievement of the stated outcomes, fostering…. critical thinking and problem-solving skills… and enabling students to transition from dependent to active, self-directed, lifelong learners.”

12. Provided by and used with permission of Peter Vlasses: ACPE

13. Preparing for A Student

14. Preparing for a Student
Experiential Manual / Preceptor Orientation
Create a schedule for the individual student
THINK of ways to integrate student into site/practice/duties
WIN-WIN Student gains practical knowledge/skill, Preceptor/Site gains value of the task or result

15. Preparing for a Student
Gather other orientation materials
Organizational charts, maps, required readings, policies and procedures, computer training, etc
Help make student feel comfortable and welcome

16. Preparing for a Student
Assessing student’s prior experience
Resumé
Student’s own verbalization
Student portfolio
Especially important in later rotations
Faculty rotations completed – key information!

17. Preparing for a Student
Set clear expectations
Learning contract
General description of activities
Clear breakdown of grading
Other important documentation, such as confidentiality
Signed by preceptor and student Day 1

18. Preparing for a Student
Types of learners
Auditory
Visual
Somatic (tactile, kinesthetic)
Motivating factors

19. Giving Feedback and Conducting Evaluations

20. Evaluations Informal vs. Formal
Based on expectations which have been clearly articulated

21. Informal Evaluations Generally Verbal Should be:
Continuous and Ongoing
After presentation
End of project
Constructive

22. Formal Evaluations Types Should be:
Project-related (journal club, cases, pt interviews)
Summative
Should be:
Written - using form(s)
Routine (at least twice per rotation for summative)
Direct and Succinct
Honest
Specific
Meaningful (include a plan for improvement)

23. Evaluation Instrument
Provided by SOP
Linked to outcomes
Prone to subjectivity and bias
Need to evaluate not only knowledge and skills but also attitude.

24. 6 Step Approach to Completing Evaluation Form
Observe – Need to observe several times during period. Ask others.
Record – Use index cards or PDA.
Retrieve – Organize all documents
Analyze – Look for patterns of performance (consistency, assistance needed?, prompting needed?)
Self-Assessment
Evaluate

25. Pitfalls in Evaluations
Harshness or Leniency based on personal relationships
Central Tendency
Proximity Error
Contrast Error
Grading on improvement/effort
Grade Inflation

27. How to Deliver Evaluation
Have documentation ready (including a review of the student’s self-assessment)
Use quiet private place for evaluation
Review comments and ratings
Provide examples from documentation
Highlight strengths and areas for improvement
Identify improvement plan

28. Difficult Students
Why are Students Difficult? What are the indicators of the difficulties?

29. Difficult Students: Things for Preceptor to Consider
Were objectives and expectations clearly outlined?
Is patient care potentially compromised?
Is this the first time for the student in this practice environment? Is this a first rotation?
Has feedback been given to the student?
Am I approachable?
Have other members of the staff been helpful to the student?

30. Strategies for Dealing with Difficult Students
Conduct self-assessment (preceptor)
Determine the underlying problem
Document problem
Inform the student
Outline a plan
Communication !
With student
With site
With school

31. Meeting with a Problem Student
Agree on a private time – inform the student about the nature of the meeting.
Be objective and clear about your assessment of the problem
Let student know about the seriousness of the problem (to patients, to grade)
Give the student an opportunity to present their views. Is there something you are unaware of?
Don’t interrupt or get defensive.
Document and Communicate!

32. Students Can Fail
Preceptors do not assign failing grades – students earn them!
Often very difficult situation.
Ask yourself?
Would I want this individual working in my environment? Providing patient care?
Could a pharmacist get fired for such behavior (tardiness, absences, unprofessionalism, major medication error)