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University of Colorado Denver

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Education

Preceptor perspectives – change is good, but getting there can be challenging


 

In response to the Accreditation Council for Pharmacy Education (ACPE) and its revised standards for practice experience, the School began rolling out a new curriculum a few years ago to help students become ‘practice ready’ earlier in the program.  

In the past, the curriculum was very linear in nature – lecture and classwork and a focus on clinical practice and medication distribution during the first few years, culminating in rotations and practice experience during the final year of the program. The education reflected the profession and as such placed more emphasis on dispensing than on direct patient care. Throughout the years the profession has changed. Now, direct patient care and inter professional collaboration are core components of pharmacy practice, necessitating a change in the way pharmacists are educated.  “But change, even though recognized as necessary, can be challenging,” says Office of Experiential Programs’ Assistant Director Eric Gilliam, PharmD. “Our preceptors have become much more integral to the whole learning experience. They are essential in our student’s development. “

Making students better prepared to practice earlier in the curriculum requires they get a taste of what pharmacy is like in a variety of settings and be exposed to the clinical side during their first and second years of schooling, not just their final year. “Providing our students with ‘real world’ experience earlier in the program allows them to make mistakes and grow and really be ready to be pharmacists upon graduation,” says Eric.

For years, the Introductory Pharmacy Practice Experience (IPPE), which occurs during the first three years of training, consisted of shadowing pharmacists and observing them on the job. “Shadowing is just not good enough for either the students or preceptors. Students need an opportunity to apply what they learn in the classroom in order to develop skills and behaviors needed to be successful on the job. And preceptors also play a more active role than just a host,” says Eric.

The new curriculum does that.

In addition to exposing the students to real world experience sooner, the curriculum has been re-sequenced so important core subjects align with the experiential program. For example, students learn about self-care and diabetes while they are completing community pharmacy IPPEs and learn about infectious diseases while they are in hospital settings. Students are introduced into clinical practice during their P-3 year with an Advanced IPPE (aIPPE) rotation. “This is where they see what fourth-year rotations truly require before they have to do them for real,” says Eric. After the aIPPE rotation they then return to the classroom for their final semester of electives and the capstone course. “This allows them time to polish the skills they might have otherwise struggled with while out in the field during their final year.”

What preceptors are saying

“Exposure to the real world of pharmacy sooner helps build a better pharmacist,” says alumnus John Flanigan (PharmD ’03), clinical pharmacy specialist with Exempla Good Samaritan Medical Center. According to Flanigan, in years past students coming to the hospital focused primarily on observing pharmacists. “Sometimes assigned activities did not apply to our setting. Now, the activities are tailored and applicable to the day-to-day duties I face as a pharmacist … like helping nursing respond to codes and ensuring patient safety through education, counseling and reconciliation. So the students learn more and I get more from them.” Flanigan says that students get a dose of reality. “They get to see how it works in the real world and take what they learn in class and try to apply it to that world.  It’s active learning at its best.” Alumna Holly Tancar (PharmD ’10), a pharmacy manager with Walgreens, says that there is a big difference in the experiential program compared to when she graduated just four years ago. “Students are learning how to be a part of a realistic scenario. It’s not just about standing out in the OTC aisle. The assignments are more structured and as a consequence more effective.” As a community pharmacist, she is the care team and the students get a reality check when they are behind the counter and interacting with patients. “It is an eye opener, which is very important for students to realize.” For Mistie Nguyen, PharmD, pharmacy manager for Centura Health Pharmacy at Porter Adventist Hospital, “Real life isn’t nicely packaged like a case that you’re given in class. You have to think critically and understand what is and isn’t important and the right questions to ask -- all while applying what you’ve been taught. That type of interaction isn’t necessarily taught in class. It’s something you learn on the job.” And sometimes waiting until the P-4 year is too late. “When I was a student we were required to work in the field and hold both externships and internships. That helps build confidence and a communications skillset that can’t be taught in a classroom.”

Nguyen acknowledges that precepting is work, but “it’s not all one way – give, give, give.” Through precepting she has been able to grow the services she offers and increase revenues for the hospital, helping her do her job better. “In the real world you earn your keep. You have to produce. At Porter, we now have a hospice program which includes pain consults, an immunization program for travel health and have expanded our discharge program – all made possible because of students.”

In addition to the extra hands on deck that allow her to expand services, Nguyen says she’s always learning new things from her students. “One of the real benefits is that I don’t have time to keep up on all the latest research, but the students have to for their classes. I learn something new every day, which keeps me current.”  For Tancar and Flanigan precepting provides them with an opportunity to share their love of pharmacy while giving back to the profession. “Students are our colleagues of the future and I want to return the favor,” says Flanigan. 

For these preceptors, the changes have been good. While it’s uncomfortable and sometimes inconvenient to change how things are done, Tancar says that changing the curriculum helps the program stay relevant. “It is inevitable and a good thing.”  

Office of Experiential Programs

The work performed by preceptors in supervising and training pharmacy students is integral to the education that the school provides our students.  Without the support of the practice community in providing practice sites and preceptors we could not meet accreditation standards. Thank you. And, remember that as a resource, the OEP and its staff can assist you in maximizing your precepting experience. Should you have a question, concern or just need information, please contact us at 303-724-2655 or email Experiential.SOP@ucdenver.edu