The richness of experiential education derives from the diversity and uniqueness of each practice setting. This same diversity presents challenges in delivery of the educational experience. Added to the complexity are differences in student content knowledge and skill set, readiness for practice, attitude, and motivation. Nonetheless, there are a number of best practices that can be universally employed to ensure that both preceptor and student alike benefit from a positive experience.
The following is a list of the top 10 approaches that can be used by community pharmacy preceptors to increase the odds of providing a rotation experience that is worthwhile and satisfying. This list was composed from more than 20 years of personal experience in the field as well as an analysis of more than 3500 comments derived from students engaged in both introductory and advanced pharmacy practice experiences.
Be a Role Model
One of the most important contributions that a preceptor can make toward the professional development of the student is to serve as an exemplary role model. Although students gain substantive content knowledge and practice skills through didactic courses, it is within the practice setting that students acquire professional behaviors. Students learn how to interact with patients, other healthcare professionals, and staff by observing how their preceptors perform. A positive disposition toward the profession on the part of the preceptor is critical as students ready themselves to enter practice. Disgruntled pharmacists who have a negative attitude toward their employer or the profession should think twice about serving as a preceptor. Students need to be encouraged, not discouraged, as they prepare to enter their chosen profession.
Perform a Prerotation Assessment
Each student comes to the practice site with varying levels of content knowledge, previous experience, and career goals. Although each practice setting has its own standard offerings that are inherent to the site with pharmacy schools contributing a set of learning goals and objectives, it is nonetheless important to provide some flexibility within these constructs to meet the needs of the individual student. Preceptors should make it a habit to sit down with students to conduct an assessment of their content knowledge, past pharmacy experiences, and learning gaps at the beginning of the rotation. Students should be asked to share any self-assessment instruments as well as learning portfolios that are required by their schools. In addition, preceptors should determine any specific goals that the student has for the rotation. In preparation for the practice experience, preceptors need to be familiar with expectations of the school regarding assignments and activities.
Although it is important for students to assume responsibility for their learning, it is difficult for them to know what they ought to be pursuing, particularly when confronted with a new practice environment. As one student commented, “I wish there was a set schedule of things to do each day. I am not one to ‘slack’ so it made me feel as though I should be busy/working on something, but I literally could not do anything. This was my first…experience, so there wasn’t anything I know how to do to self-start.” Preceptors should not assume that students know how to insert themselves into the workflow, until evidence proves otherwise. The challenge is to provide structure with sufficient flexibility to accommodate the individual needs of the student.
Give Meaningful Work
Students are adept at recognizing when the preceptor assigns “busy work.” Having students on rotation should not be burdensome, but rather should result in a “win-win” situation. The most effective preceptors identify work for students that offers a meaningful educational experience while making a positive contribution to the practice site. Students are most discouraged with practice settings that simply place them in an observation role. Students are most satisfied when they feel that they have provided a positive benefit to the site. Students need to be involved in the real work of the practice setting.
Share Your Knowledge and Expertise
Students should benefit from the knowledge and expertise of their preceptors over the course of the rotation. This can be accomplished by traditional methods such as conveying key concepts, offering explanations, and demonstrating skills and techniques. Employing questioning and quizzing techniques that keep the student engaged can also be quite effective. Sharing the preceptor’s own reasoning skills and the problem-solving thought process in the midst of resolving an issue can be particularly illuminating for the student. Finally, encouraging students to ask questions motivates students to remain actively involved.
Be a Coach
A good preceptor does not simply provide students with all of the answers. Rather, an effective preceptor also functions as a coach. The preceptor can accomplish this by prompting students to identify problems, seek the necessary information to resolve the given situation, and propose solutions. The ability of students to accomplish these activities varies greatly. Some students will need more direction, while others can perform the majority of these tasks independently. It may be helpful to break down a complicated task into smaller units for those students who need a bit more direction along the way. Preceptors can also assist students in meeting their goals and objectives by identifying opportunities for engagement such as patient counseling, medication therapy management, interaction with other healthcare professionals, identification of medication-related problems, self-care interventions, and drug information questions.
Give Context to Future Practice
It is important for students to understand how their experience will contribute toward their future practice. This may be particularly challenging when the student has no interest in pursuing a career in community practice. For example, students who will be applying for a postgraduate residency may view the community pharmacy rotation as simply a school requirement that must be met. In these instances, it is critical for the preceptor to assist students in understanding how the community pharmacy plays a role in the transition and continuum of care. Students need to recognize that community pharmacies are also responsible for assisting patients with the long-term management of chronic conditions, disease management, and prevention. Equally challenging are students who have spent a preponderance of their time as community pharmacy employees. In this situation, it is especially important for the preceptor to ascertain student needs and learning gaps to prevent redundancies.
Students need to understand how they are performing. Schools of pharmacy provide mechanisms for formal assessment, most typically at the midpoint and conclusion of the rotation. However, it is also important for students to receive regular and consistent formative feedback regarding their performance both from a pharmacy practice and behavioral perspective. Feedback should be targeted, specific, and, when applicable, offer recommendations for improvement.
As one student commented, “I would have liked to have known if I was doing anything wrong or if more was expected from me and I needed to work harder, or if I was performing tasks efficiently.” It is frustrating for students to discover for the first time that they did not meet the expectations of the preceptor at the end of the rotation. Students need to understand areas of improvement early in the rotation and be given the opportunity to address any deficiencies.
Spend Time with Your Students
Time spent with the preceptor is held in high regard by students. Its value is expressed by the following comment, “I would have liked to spend more time with [my preceptor] because I learned so much when I was around her.” Students are eager to learn from their preceptors. Yet, there are times when spending significant time with students is just not possible. In those instances, preceptors should schedule a dedicated meeting time with students on a regular basis to provide feedback and ensure that learning goals and objectives are being met. Having the ability to adjust activities and learning opportunities in response to student needs is most appreciated and beneficial. In situations where responsibility for students needs to be delegated to other pharmacy staff members, preceptors should ensure that the responsible parties are aware of student learning needs and expectations.
Open communication is one of the most essential components of any rotation. Students consistently cite the support, willingness to help, and caring attitude of their preceptors as some of the most important attributes that made the learning experience valuable. Demonstrating respect for students, concern for student progress, and providing positive reinforcement enhances student motivation and engagement. Sharing the preceptor’s story regarding his or her own professional journey can open the door for further discussion. Effective communication can head off many problems and cure a multitude of misunderstandings.