Frequently Asked Questions

Answer: Prepare yourself with the following:

1. Setting expectations
   • Establish expectations early and often.  Make clear what goals are to be achieved, how they are to be accomplished, and when they are to be completed. 
   • Provide a written course outline, syllabus, calendar or detailed rotation description as a reference point.  Make note of expectations established through verbal interactions, and use these notes as reminders for follow up.
   • Remember that the student has expectations as well.  Ask the student for personal goals for the rotation and inquire about the student’s preferred communication and learning styles.  Incorporate this feedback into the learning experience where possible.
2. Holding the conversation
   • Stick to the facts.  Be specific and ensure that feedback is based on direct observations. 
   • Ask questions and be prepared to listen.  Avoid making assumptions about the student’s thought process or intentions.
   • Stay focused on the issue at hand.  Know in advance what you really want to accomplish with the conversation and stick to the topic.  Redirect the conversation when necessary.
   • Establish a mutual purpose, where both preceptor and student can agree on the outcome.  Where reasonable, ask the student for ideas for resolution of the issue at hand.  Brainstorm strategies together to develop a plan.
3. Anticipating responses
   • Always provide feedback in private.  Students may become embarrassed about the feedback they are receiving and you want to make sure they are getting it privately.
   • Pay attention to the student’s response.  Silence, sarcasm, avoiding, labeling, attempting to control, or attacking are signs that the student may be defensive about the feedback you are giving them.  Provide concrete examples to demonstrate your feedback and ask for their thoughts.  Restore safety when these cues are recognized. 
   • Expect students to ask how they can improve.  Make sure you provide them with goals and a timeline to achieve those goals. 
   • Always end on a positive note. Include the positives and what they are doing well.
   •  It helps to make the student feel that they can achieve the goals/metrics set in the meeting.
4. Following through
   • Make sure that you follow-up with the timeline and goals that you provided the student. Consider scheduling a meeting on your calendar to make sure that you have dedicated time to address. A student will respect that you are sticking to the plan as well.
   • If a student does not meet the expectations that were laid out and agreed upon, make sure that the consequences are clear.

Answer: Consult with the school/college of pharmacy as soon as you determine that there is a problem. They may be able to provide additional information about the student’s history, learning style, and ways to better engage the student. Recommend maintaining regular communication with the school. Agree on a plan for the student including goals and a timeline on when you will assess progress.  It is important for the school to know you are having difficulties early in the rotation so that personnel from the school/college of pharmacy has time to intervene if necessary.

References and sources for more information:

• Grover B, Hayes B, Watson K.  Feedback in clinical pharmacy education.  Am J Health-Syst Pharm 2014; 71: 1592-6.
• Lloyd M, Watmough S, O’Brien S, Hardy K, Furlong N. How to give and receive constructive feedback.  The Pharmaceutical Journal. 2016.
• Patterson K, Grenny J, McMillan R, Switzler A.  Crucial Conversations: Tools for Talking When Stakes are High.  2nd ed.McGraw Hill: New York, 2012.

How can I best facilitate learning for my students?
Provide assignments that reinforce major learning topics including journal clubs, topic discussions, and guideline reviews, and promote discussion with relevant questions on the topic. Avoid ‘busy-work’ that has no intrinsic value. Establish a teaching environment.

How can I promote my student’s overall well-being?
Ensure that students feel safe voicing their concerns and create an opportunity each day for discussion. Provide appropriate feedback using the ‘compliment-sandwich’ method, compared to a ‘what you did wrong’ method. Understand that life happens and give students appropriate levels of freedom.

How can I be an efficient and effective preceptor?
There are six areas that preceptors should focus on to be efficient and effective in this role. Preceptors should establish a teaching environment, communicate with everyone involved, tailor teaching to the student’s needs, share teaching responsibilities, keep observation and teaching encounters brief, and broaden student responsibilities.

How do I have a conversation with an underperforming student?
Discuss areas of improvement for student and provide clearly defined examples of how they can improve. Discuss some areas that they are competent in, as well as perceived areas of development. Make it clear that rotations are for the benefit of the student and provide opportunities for students to work on growth.

What can I do to support my student during a patient encounter?
Tailor the experience to the student’s needs, educational desires, and abilities. Perform a patient encounter in its entirety with the student observing, then allow the student to perform the next one under supervision. Assist with questions as they develop. Make your practice a teaching environment.

How can I successfully communicate as a preceptor?
Communicate with everyone involved! Express expectations and goals to students, their educational program, and fellow clinicians and staff members. Students and preceptors should communicate early and frequently regarding expectations, goals, and learning and teaching styles. This saves time and prevents frustration. Continually talk to students about their progress and the extent to which they are meeting their goals. Be sure to provide students with continuous feedback and ask them about their experience. Because students become part of the clinical team, it is essential that preceptors and students communicate with fellow clinicians and staff members. Preceptors should elicit the attitude that students add value to the practice.

How can I tailor my teaching to the student’s needs?
You should assess the student’s strengths and weaknesses early by observing the student’s interactions with patients. Then adjust your approach as needed based on your findings. Your teaching method may also be influenced by how much time you have and available opportunities. Some examples of different teaching strategies include: “see one, do one, teach one” method, have the student observe an entire encounter between a patient and you in situations where you can demonstrate specific techniques or styles, and allow the student to work independently before presenting to you what they plan on saying to the patient/team.

What are my responsibilities as a preceptor?
Students do not need to spend every minute of the day with their preceptor. Partners, staff, patients and students themselves can be part of the teaching team so that the weight of advancing their education does not fall entirely on the resident preceptor. Students can also teach themselves by building clinical knowledge through independent research. You can encourage students to be more involved in their own learning by having them teach you more about a subject you would like to study, knowing when to answer a student’s question and when to have the student find the answer on their own, and any other ways to encourage self-directed learning.

How can I handle a student who lacks motivation for the experience?

Simply dismissing students as unmotivated or giving up on students is not an option. External motivation can be useful when internal motivation is lacking and may help trigger internal motivation. Preceptors can think of the following formula to help evaluate their student’s motivation: expectancy x value = motivation, where motivation is viewed as the product of two forces. If either one is absent, the motivation product is zero. High expectancy and value predict high motivation and engagement, whereas a combination of high expectancy and low value predicts little to no motivation, which may be characterized by minimum effort.

How can I evaluate students I am precepting?
Often preceptors want to evaluate everything the student does while on rotation. It can be overwhelming for new preceptors to decide on specific evaluation criteria. Some institutions will set criteria for evaluating both individual assignments and overall rotation performance. In those cases where specific criteria is not provided, make it challenging to assess students consistently and fairly. Once preceptors decide how to assess students, whether it be a list they develop on their own or a list of desired skills and traits provided by the institution, they still must determine how this will factor into the overall rotation performance evaluation. Using sample syllabi and evaluation forms developed by the pharmacy school is a great starting point. Having specific requirements for assignments and the overall rotation that can be reviewed with students at the beginning of each rotation often helps prevent misunderstandings. Clear expectations and evaluation criteria help ensure that everyone is on the same page and, if questions arise, there is a clear reference to consult.

References:

1. Biagioli FE, Chappelle K. How to be an efficient and effective preceptor. Fam Pract Manag. 2010;17(3):18-21.
2. Medina MS. Assessing students' motivation during advanced pharmacy practice experiences. Am J Health Syst Pharm. 2011;68(23):2230-2235. doi:10.2146/ajhp110275
3. Kelley KW, McBane S, Thomas T, Karr S. Serving as a preceptor to pharmacy students: tips on maintaining the desire to inspire. Am J Health Syst Pharm. 2012;69(10):826-831. doi:10.2146/ajhp110292

What are some activities or experiences that you could offer to Introductory Pharmacy Practice Experiences (IPPE) student pharmacists on community or institutional rotations in the first week to help orient them to the workspace?

• On the first day, have students create a concept map of how a prescription is processed and filled at your site. This context into the workflow of the pharmacy.
• Practice layered learning with interns: have pharmacy interns help train IPPE students about workflow and laws surrounding pharmacy practices
• Have your student practice navigating your company’s prescription filling program.
• Create a pharmacy scavenger hunt to better orient students to the pharmacy.
• Have the student work with one of the staff members to learn the computer system.

What are some activities that would be appropriate for IPPE student pharmacists on community rotations to complete to help ease the workload on you and your staff?

• Have students counsel patients on methods to optimize adherence (e.g., pillboxes, calendars, phone or device reminders, journals or medication logbooks).
• Have students walk your OTC isles and offer recommendations to patients looking for symptom relief for ailments such as allergic rhinitis, nausea/vomiting, diarrhea, constipation, pain relief, headaches, and vitamin supplementation.
• Answer phone calls regarding prescription refills and other medication related questions.
• Call provider offices for medication refill requests
• Call insurance companies regarding issues.
• Put away medications from the order to learn the different strengths or dosage forms of medications.
• Print verification screen shots that highlight drug interactions/drug related problems.  Require the student to determine what to do next.

How can preceptors create a successful learning environment for IPPE student pharmacists on institutional rotations?

• Task the student with the responsibility of answering and following up with drug information questions from pharmacists, nurses, and providers. This allows for students to independently work and problem solve, while developing skills including critical thinking, communication, and research.
• Have the student perform medication reconciliation on newly admitted patients. Have students review any unfamiliar medications, determine if an indication for therapy exists, if the medication should be continued on admission and assess for drug interactions to present to the preceptor for further investigation. Through these, students will further familiarize themselves with medications and have an opportunity to interact with patients.
• Assign new drug presentations with project time during slower hours to offer a modality to both educate the student as well as the pharmacy staff. Encourage students to present over medications that have the potential to be added to the formulary.
• Offer students workbooks that can be completed throughout the rotation. Incorporation of patient cases promote discussion and teaching opportunities for the student.
• Utilize pharmacy residents and APPE students in teaching concepts and work flow to IPPE students. This collaboration also serves as a mentorship opportunity for residents and APPE students.
• Share preceptorship between pharmacists and technicians to offer students exposure to a variety of different areas of pharmacy and essential functions, such as rounding, dispensing, and/or compounding.
• Provide shadowing opportunities with other healthcare professionals, such as surgeons, respiratory therapists, etc., to offer students a larger understanding of the healthcare team and the health-care system as a whole.
• Assign students to research a topic that comes up most during the day.  Then ask the students questions about what they discovered.
• Observe during rounds with different pharmacists as part of inter-professional collaboration.
• Provide discharge counseling for patients.
• Shadow clinical pharmacists to see how they assess and develop a plan for the patient.

How can you ensure that an IPPE student pharmacist is engaged throughout the rotation?

• On the first day of rotation, it is helpful to be clear with students about expectations and how they are to communicate these with other pharmacists. As a primary preceptor, ensure other pharmacists are aware of daily student activities.
• Share on-going projects with students and encourage them to get involved with these efforts (antimicrobial stewardship data collection, quality improvement projects, etc.) as they are a great way to orient students to how institutional changes are made.
• Encourage students to practice self-learning in order to prepare them to function independently as they grow in their careers.
• Give students daily responsibilities, allowing them to actively learn and become involved in the daily workflow in the pharmacy (examples: clinical monitoring, patient follow up, inventory).
• Create a schedule for the student, so they know what tasks they will be completing during their rotation and can be prepared for those tasks.
• Require students to keep a journal of new things they learn and discuss them with preceptor.