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McCleary et al
specific requirements for preceptor development.4 The most
commonly reported methods of preceptor development were
self-study (61.1%) and continuing education sessions at professional meetings (56.2%).4 Based on summary responses
from established PT programs, a prior commentary has
offered recommendations regarding the administration of
these PT programs from an institution-wide perspective.5 It
has been acknowledged that the optimal way to administer
these PT programs is unknown, including at the level of the
individual PT, and innovative approaches to PT development
offer the opportunity for knowledge sharing and a future path
toward standardization.5
Critical care pharmacists at University of Kentucky
HealthCare sought to expand on the idea of a preceptor
development plan by introducing a coprecepting model with
PTs to provide experience and feedback in an observed setting. University of Kentucky HealthCare is a 945-bed academic medical center that serves as the tertiary referral center
for the state and surrounding areas. The residency program is
comprised of 13 different residency programs encompassing
approximately 25 residents annually. More than 80 preceptors are classified as full preceptors across the PGY1 and
PGY2 residency programs.
For our particular service line in the Medical Intensive
Care Unit (MICU), we identified 5 PGY2 trained critical
care pharmacist new hires as PTs. A team of 4 clinical pharmacists, including the current PGY1 RPD, PGY2 Critical
Care RPD, and full preceptors for both residency programs,
developed a plan to help onboard these new pharmacists and
incorporate them into the residency programs as preceptors.
Program Description
Our coprecepting plan focused specifically on precepting
skills in action. Each PT was paired with an experienced
mentor for their overall preceptor development training, who
was a qualified preceptor according to ASHP standards. Each
PT was then assigned 3 scheduled MICU months to coprecept alongside a full preceptor. The primary full preceptor of
the MICU rotation (for which the PT was assigned) may or
may not have also been the assigned mentor for the overall
preceptor development plan. If the mentor was not coprecepting that particular learning experience that month with
the PT, they were encouraged to attend daily patient and
topic discussions as desired. This program was implemented
over the course of 1 year, with 3 distinct months of coprecepting opportunities for the PT, interwoven with independent time on service.
Ideally, the PT would have an incremental escalation in each
learner's skill level. The first coprecepting month involved precepting a PGY1 pharmacy resident, the second coprecepting
month a PGY2 noncritical care resident, and finally, the third
month coprecepting a PGY2 critical care resident (Figure 1).
The full preceptor and mentor utilized the 4 precepting roles
(direct instruction, modeling, coaching, and facilitation) as the
backbone of providing this learning opportunity.6 For example,
the first few days of the first coprecepting month were characterized by full preceptor direct instruction and modeling, which
quickly evolved to coaching and facilitating during the remainder of the coprecepting experience. The full preceptor retained
the preceptor of record responsibility for the learning experience and served to support the PT, provide feedback, and to
help grow their precepting skills.
The focus of this preceptor development training was primarily on precepting pharmacy residents. However, when
students were on rotation, they were integrated into the layered learning model and interacted with the pharmacy resident and/or PT during rounds as well as patient and topic
discussions. The PT directly observed and coached the resident, where applicable, on their precepting of the student
within the layered learning model.
Expectations
From the PTs perspective, the coprecepting model served as
an opportunity to practice precepting skills while benefiting
from the expertise and mentorship of an experienced preceptor. It was anticipated that the full preceptor support the PT in
learning the nuances of the institution, as well as the established precepting model. PTs expected to identify many
growth opportunities in this role given most had greater
experience precepting students rather than residents. It may
be a challenge for a new practitioner PT to precept a resident
just 1 year junior in experience. The coprecepting model was
expected to be especially helpful in this regard, ensuring that
students and residents at different experience levels were
engaged and challenged appropriately while the PT gained
more experience.
From the full preceptor's standpoint, the coprecepting
model allowed for additional time spent with the PT to serve
as a continuation of orientation. It was anticipated that this
additional time spent together would uncover variations in
practice among pharmacists, while also serving as an informal setting to learn more about the local practices and protocols present for various clinical scenarios. From a precepting
standpoint, it was anticipated that navigating the layered
learning model, particularly ensuring students and residents
were engaged at an appropriate depth during patient and
topic discussions, would be the most challenging aspect of
precepting for the PTs.
Roles and Responsibilities
The role of the PT was to take the lead in precepting the
pharmacy resident and pharmacy student, assuming the functions of a primary preceptor for rotations. The PT met with
the full preceptor prior to the start of the rotation to discuss
the oncoming resident's goals, strengths, and challenges, and
to create a schedule for the month. The PT responded to
immediate patient care issues and completed full patient
Hospital Pharmacy - July/August 2019
Table of Contents for the Digital Edition of Hospital Pharmacy - July/August 2019
TOC/Verso
Utilization of an Order Panel to Encourage Safe Ordering and Administration of Amphotericin B
Implementing Smart Pumps to Enhance Patient Safety
Characterization of oral anticoagulant use among extremely elderly patients hospitalized at a tertiary academic medical center
Formulary Drug Review: Sufentanil Sublingual
New Medications in the Treatment of Acute Migraine
Implementation, Evolution, and Impact of ICU Telepharmacy Services Across a Health Care System
ISMP Adverse Drug Reactions
Development of a Coprecepting Model for a Preceptor-in-Training Program for New Practitioners
Facilitators and Barriers to Antibiotic Stewardship: A Qualitative Study of Pharmacists’ Perspectives
Development and Implementation of a Standardized Sterile Compounding Training Program
Transformation of Hospital Pharmacist Opioid Stewardship
Hospital Pharmacy - July/August 2019 - Cover1
Hospital Pharmacy - July/August 2019 - Cover2
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Hospital Pharmacy - July/August 2019 - TOC/Verso
Hospital Pharmacy - July/August 2019 - 211
Hospital Pharmacy - July/August 2019 - Utilization of an Order Panel to Encourage Safe Ordering and Administration of Amphotericin B
Hospital Pharmacy - July/August 2019 - 213
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Hospital Pharmacy - July/August 2019 - Implementing Smart Pumps to Enhance Patient Safety
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Hospital Pharmacy - July/August 2019 - 219
Hospital Pharmacy - July/August 2019 - Characterization of oral anticoagulant use among extremely elderly patients hospitalized at a tertiary academic medical center
Hospital Pharmacy - July/August 2019 - 221
Hospital Pharmacy - July/August 2019 - Formulary Drug Review: Sufentanil Sublingual
Hospital Pharmacy - July/August 2019 - 223
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Hospital Pharmacy - July/August 2019 - New Medications in the Treatment of Acute Migraine
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Hospital Pharmacy - July/August 2019 - Implementation, Evolution, and Impact of ICU Telepharmacy Services Across a Health Care System
Hospital Pharmacy - July/August 2019 - 233
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Hospital Pharmacy - July/August 2019 - ISMP Adverse Drug Reactions
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Hospital Pharmacy - July/August 2019 - Development of a Coprecepting Model for a Preceptor-in-Training Program for New Practitioners
Hospital Pharmacy - July/August 2019 - 247
Hospital Pharmacy - July/August 2019 - 248
Hospital Pharmacy - July/August 2019 - 249
Hospital Pharmacy - July/August 2019 - Facilitators and Barriers to Antibiotic Stewardship: A Qualitative Study of Pharmacists’ Perspectives
Hospital Pharmacy - July/August 2019 - 251
Hospital Pharmacy - July/August 2019 - 252
Hospital Pharmacy - July/August 2019 - 253
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Hospital Pharmacy - July/August 2019 - 258
Hospital Pharmacy - July/August 2019 - Development and Implementation of a Standardized Sterile Compounding Training Program
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Hospital Pharmacy - July/August 2019 - 262
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Hospital Pharmacy - July/August 2019 - Transformation of Hospital Pharmacist Opioid Stewardship
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Hospital Pharmacy - July/August 2019 - Cover3
Hospital Pharmacy - July/August 2019 - Cover4
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