Pharmacy and precepting: You can’t have one without the other

Lynette Bradley-BakerMost pharmacists remember the preceptors who had an impact on them, and they recognize the

Craig Coxvalue of precepting. This value permeates the profession - from student development during pharmacy school to the enhancement of patient care services provided during their experiential rotations, to the lifelong learning of preceptors. As with healthcare and the practice of pharmacy, precepting continues to evolve and provide a strong foundation for our profession.

See also: The oversupply of pharmacists

Value proposition

In addition to the value that precepting provides to the profession, students, and schools/colleges of pharmacy, we need to consider the value proposition for the preceptor.

A value proposition is realized when a customer receives a product or service from a provider who promises value. For preceptors, there are many benefits and considerable value.¹

The obvious benefits include giving back to the profession and serving as an integral part in the development of future pharmacists.

Additional benefits include being challenged by students to keep current on medication and disease state knowledge; this leads to personal satisfaction and professional growth.

A more tangible outcome of precepting is the ability to engage student pharmacists in developing and maintaining new or expanded clinical services at practice sites.

Deriving from schools/colleges of pharmacy are preceptor rewards such as free continuing education, preceptor training, tuition credit, and academic appointments.

Perhaps the most pertinent benefit is found in the last vow in the Oath of a Pharmacist: “I will utilize my knowledge, skills, experiences, and values to prepare the next generation of pharmacists.”²

^{See also: Pharmacy residents find competitive edge}

Evolving profession

The profession of pharmacy has evolved over the past few centuries. Pharmacists’ roles are less tied to the product and more focused on patients and their outcomes.

The education of pharmacists has also changed. In the 18th and 19th centuries, pharmacist training consisted primarily of apprenticeships - “experiential” training. Individuals interested in pharmacy would spend time with a single pharmacist in a single store to learn the business. It was left to the discretion of the pharmacist to determine when a student was ready for independent practice; this commonly took three to four years.

As we entered the 20th century, the requirement for individuals to earn a degree before commencing practice became the norm. Experiential training soon became secondary to classroom training. In addition, any experiential training an individual received originated outside the professional degree program and most often occurred after graduation.

Experiential rotations

Over the past half-century, educational norms have again begun to change. In most states, experiential rotation requirements have become the responsibility of schools/colleges of pharmacy rather than of state boards of pharmacy.

Today, the Accreditation Council for Pharmacy Education (ACPE) calls for approximately 30% of educational curricula to consist of experiential education (Standards 2016).³ These experiences must take place both early (introductory pharmacy practice experiences) and late (advanced pharmacy practice experiences) in the curriculum, and must be completed in a variety of practice settings, under the supervision of different preceptors.

It seems we are coming full circle and placing increased emphasis on “real world” training, much as the profession did with pharmacy apprenticeships in earlier years. With this development comes the need for more preceptors.

Standards 2016

Standards 2016 has also placed an increased emphasis on quality assurance and improvement strategies relating to experiential education.

Simply “checking the box” to indicate that a student has completed a certain number of hours is becoming a thing of the past. Rotation-hour requirements do remain; however, the focus is shifting from the quantity to the quality of these experiences. Comprehensive quality assurance programs are being developed to ensure that staff, students, sites, rotation activities, and preceptors meet established quality standards. In fact, preceptors are now the focus of a single new standard (#20), highlighting the importance of this issue.

Preceptors can be both full-time academic faculty members and adjunct volunteers. Approximately 80% to 85% of rotations offered by ACPE-accredited institutions are delivered by volunteer preceptors, yet many of these individuals have never received formal training in how to teach. This is a big challenge. Schools/colleges of pharmacy have a responsibility to provide training and development opportunities for these preceptors.

Preceptor training

We need to recognize that preceptors learn in different ways. Learning styles can vary among individuals, situations, or learning environments. Therefore programming must cover a wide range of topics and must be delivered through a variety of channels, including live, online, and written presentations, and webinars, videos, and podcasts. Programs should vary in length from 15 minutes to full-day workshops.

A range of preceptor programming exists around the country, including programs developed by individual institutions, collaborative efforts among consortium-based institutions, and programs produced by professional pharmacy organizations and commercial entities.

In many cases, existing programs target a “typical” preceptor and assume that “one size fits all” when it comes to development. A better approach would be to enable preceptors to choose their own experience - to determine their learning needs and seek programming that directly meets these needs. A targeted training approach rather than a general one should become the norm.

This is the cornerstone of continuing professional development, a model that is gaining increased recognition and importance around the country.

CPD

Continuing professional development (CPD) is defined by ACPE as a self-directed, ongoing, systematic, and outcomes-focused approach to lifelong learning that is applied in practice.⁴

The continuous process of CPD includes the following elements: reflection, planning, learning, evaluation, and recording and review.

CPD and CE

CPD is not a replacement for Continuing Education (CE); rather, CE is an integral and essential part of CPD.

A key difference between the CE and the CPD process is that with the former, pharmacists often just check off the box to indicate that they completed a certain number of hours for a program, while the latter requires pharmacists to document why they selected the program and how the program will affect their professional development.

Many schools/colleges of pharmacy, as well as state and national pharmacy organizations, are exploring the role of CPD in the pharmacy profession.

Practice sites

CPD can also serve as a core component of practice-site and student-pharmacist development, and can become an effective model for future professional training.

In addition to preceptors, pharmacy practice sites are evolving to meet the needs and expectations of patients in a changing healthcare system. These practice sites provide the training environment for future pharmacists to become more competent in their professional roles.

The CPD process is critical to the continued success and evolution of the pharmacy profession.

Present and future

To our current preceptors - thank you! Your dedication adds value to the profession and contributes to the development of our future practitioners and our professional practices, and, most important, to better outcomes for our patients.

To those pharmacists who are not preceptors and wish to learn more about becoming one, please contact a school/college of pharmacy for more information. (All schools/colleges of pharmacy can be found on the AACP Pharmacy School Locator web page, http://bit.ly/locateschools). Our profession depends on dedicated, lifelong learners and teachers who understand the value that precepting brings to pharmacy.

Lynette R. Bradley-Baker is a registered pharmacist and vice president of public affairs and engagement, AACP.

Craig D. Cox is associate professor and vice chair of experiential programs, Texas Tech University Health Sciences Center School of Pharmacy. He serves on the AACP board of directors.

References

1. Skrabal MZ, Kahaleh AA, Nemire RE, et al.  Preceptors’ perspectives on benefits of precepting student pharmacists to students, preceptors and the profession. J Am Pharm Assoc 2006;46:605–612.

2. Oath of a Pharmacist. http://bit.ly/pharmoath. Accessed Jan. 25, 2016.

3. ACPE: Accreditation standards and key elements for the professional program in pharmacy leading to the Doctor of Pharmacy degree (“Standards 2016”). http://bit.ly/standards2016. Accessed Jan. 25, 2016.

4. ACPE – Continuing professional development (CPD). http://bit.ly/ACPEcpd. Accessed Jan. 25, 2016.