Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Evaluation of new preceptor experiences at a large medical center Primary Author: Danyel Adams, PharmD, Clinical Pharmacy Specialist, Emergency Medicine, Baystate Medical Center, Springfield, MA; Email:
[email protected] Additional Authors: Gabriela Macias Purpose: Describe the challenges new preceptors experience when transitioning into a primary preceptor role at a large medical center and identify opportunities for improved resources in order to better facilitate the transition for future preceptors. Methods: Two clinical pharmacy specialists, new to the institution (employed less than one year) who now serve as preceptors for pharmacy students and PGY‐1 and PGY‐2 residents, met with a pharmacy department manager to discuss their initial experience as preceptors. They were asked to recall previous precepting experiences and to discuss resources made available to them initially, and what they found useful about the initial preceptor introductory period. In addition they were asked to identify challenges they have encountered thus far as new preceptors and what additional information, resources or opportunities would have been helpful to improve the transition to primary preceptors. Results: Both new preceptors had completed a teaching certificate program which they considered useful and drew upon this previous experience while precepting their initial students and residents. Resources initially provided during the orientation period were preceptor CEs assigned by the residency program director (RPD) and brief meetings with the RPD and student coordinator. Challenges identified were lack of resources and difficulty balancing clinical and preceptor workloads. The two preceptors indicated the following opportunities as those they feel would have been beneficial: more in depth meetings with the RPD/student coordinator initially to better outline expectations, time spent with current preceptors to allow for sharing of advice and precepting styles during the orientation period, and regular meetings with the RPD/student coordinator during the first few months of precepting activities to discuss challenges, revisit expectations and review evaluations if available. A resource identified as absent, but desirable, was a precepting mentor. Additional considerations brought up were a 5‐6 introductory period for new preceptors without students or residents, and evaluation of an appropriate student/resident to new preceptor ratio during the first year. Conclusion: While completing a teaching certificate program and preceptor focused CEs are helpful in building skills for new preceptors, other opportunities and resources are needed during the initial transition into a primary preceptor. Resources made available should include more mentoring opportunities including, but not limited to, collaboration with the RDP and established preceptors to help mold efficient precepting styles of the new preceptors during the first year. Additionally, adequate time to establish oneself in their clinical area and capping a student/resident ratio is also important to adequately acclimate oneself to job demands and expectations outside of precepting.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Development and Implementation of a Preceptor Development Program for an ASHP Accredited PGY1 Residency Program Primary Author: Danielle Auxer, PharmD, Pharmacy Residency Coordinator, Hospital of the University of Pennsylvania, Philadelphia, PA; Email:
[email protected] Additional Authors: Gene Gibson Purpose: To develop and implement a preceptor development program that is compliant with ASHP standards for accreditation of a PGY1 residency program Methods: A preceptor development committee was formed consisting of the RPD, the residency coordinator, and four preceptors. A needs assessment survey for all pharmacists in the department was developed and completed. The survey was placed into Survey Monkey® and sent to all pharmacists in June 2011. A preceptor resource library was created and placed on the department of pharmacy services computer server hard drive. A preceptor orientation module was created for all newly hired pharmacists by preceptor development committee. The preceptor development committee has established minimum standards for becoming a preceptor and developed a required preceptor application that needs to be completed and signed by all preceptors. Precepting pearls presentations have been added for the first fifteen minutes of every monthly preceptor meeting. Lectures and other training sessions will be scheduled at least quarterly. Each preceptor is responsible for developing a portfolio consisting of relevant precepting activities and evaluations. Each preceptor will meet with the RPD annually and present their updated precepting portfolio and discuss their individual development plan for the year. Results: We had 49 responses to the needs assessment survey. We received 35 completed preceptor applications. The results showed us that our preceptors have had a varied amount of precepting experience. This information prompted us to established minimum requirements to precept a pharmacy student or a resident. The requirements are: attending a teaching primer; attending student rotation orientation provided by the local school of pharmacy; attending two topic discussions focusing on topics pulled from the survey: developing, implementing, coordinating, and monitoring an experiential experience and effectively completing a formal evaluation of performance and providing feedback; and creating and maintaining a precepting portfolio. This portfolio will be used in the pharmacist’s annual review and will include consisting of resident and student evaluations, number of preceptor meetings attended, attendance of conferences and continuing education programs, attendance of resident presentations, involvement with resident/ student projects, residency committee membership, as well as number of number of preceptor presentations and articles completed in the preceptors resource library. To date 23 pharmacists have participated in the program. Evaluations have been positive in that the preceptors enjoy the discussions and feel that they are helpful. We have also received feedback about future discussions they would like to have. Conclusion: We developed a plan to orient and continue to educate all pharmacists to precept pharmacy students and residents. We’ve implemented most of our plans and received positive feedback. We found that the preceptors are receptive and engaged in the process. We were surprised by the high number of responses we received to the survey and have found that the preceptors are willing to present pearls and are attending the sessions. Moving forward we hope to get all interested pharmacists involved. Once a majority of the staff has completed orientation we will begin quarterly continuing education precepting lectures for the pharmacists.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Professional and scholarly needs of pharmacists and pharmacy technicians for continuing educational programming Primary Author: Nadia I. Awad, Pharm.D., PGY‐2 Emergency Medicine Pharmacy Resident, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ; Email:
[email protected] Additional Authors: Mary M. Bridgeman Purpose: To describe the process of conducting a survey‐based educational needs assessment of a large pharmacy department staff at a university teaching hospital to assist with the planning of continuing educational programs presented by pharmacy residents. Methods: An electronic survey was developed and distributed via hyperlink to 152 pharmacists and pharmacy technicians employed in the pharmacy department. Multiple‐choice questions related to the demographics of employees included identification of the current position and years of experience as well as the primary shift and location at the institution in which the employee is engaged in pharmacy practice. In order to assess professional and scholarly needs, a five‐point Likert scale was used to determine the level of interest of approximately seven to ten topics in each of the following areas: critical care, internal medicine, infectious diseases, and emergency medicine. Survey respondents were also asked to identify any additional topics not addressed in the survey for consideration as a potential continuing educational program. Results: Out of the 152 invitations distributed, a total of 70 (46.1%) surveys were completed by pharmacists (44, 62.9%) and pharmacy technicians (26, 37.1%). The majority of responses came from staff employed on the dayshift (45, 64.3%) and who were engaged in practice for less than five years (24, 34.3%) or greater than 15 years (24, 34.3%). The top five areas of interest that both pharmacists and pharmacy technicians respectively indicated as being “very Interested” in serving as a topic for a pharmacy continuing educational program were the following: sepsis and targeted antimicrobial therapy (60.5% and 52.0%), common infections in the critically ill (55.8% and 68.0%), new drugs of abuse (53.5% and 54.2%), institutional multidrug resistance (51.2% and 45.8%), and fluid and electrolyte replacement therapy (44.2% and 48.0%). The common areas of interest for topics presented as continuing educational programs among both pharmacists and pharmacy technicians were critical care and emergency medicine. Content within each area varied widely, which is reflective of the types of activities that each group may potentially be involved in on a day‐to‐day basis. The results of this needs assessment survey were utilized by pharmacy residents in strategically planning required staff in‐service presentations. Conclusion: Implementation of a needs assessment process ensures that the educational needs of the audience are met regarding topic selection and covered information. The results obtained from the survey have been used to enhance the future planning of educational programs. The methodology employed to conduct this needs‐based assessment survey can be utilized periodically to determine topics of interest among pharmacists and pharmacy technicians for continuing educational programs, depending on trends in the practice of pharmacy. In addition, this process can be replicated by other institutions seeking to improve the delivery of continuing educational programming to their staff members.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Challenges associated with and ways to improve the transition from resident to preceptor Primary Author: Melissa Thompson Bastin, PharmD, BS, Critical Care Clinical Pharmacist, UK HealthCare, Lexington, KY; Email:
[email protected] Additional Authors: Craig Martin Purpose: The transition from resident to preceptor can be a difficult time for the new preceptor, existing preceptors and residents within the institution. This transition, and challenges associated with it will vary from institution to institution. However, when a Post‐graduate year two (PGY2) Pharmacy Resident transitions into the preceptor role within the same institution in which he/she trained, an additional set of obstacles may exist to make this situation even more difficult than an outsider moving in. The purpose of this study is to describe the challenges associated with transitioning from resident to preceptor, globally and within the same institution, as well as to develop systems to improve this transition period for the new practitioner. Methods: In order to describe the various challenges associated with transitioning from resident to preceptor, as well as suggestions for improving this process, a 13 point questionnaire was developed to elicit the opinions, thoughts and experiences of the faculty at our institution. This survey tool is part of a pilot study intended for national distribution, in order to describe the best practices occurring around the country related to transitioning residents into preceptors. Results: A total of eleven responders completed our survey, response rate of 33% (11/33). The results will be presented in table form, as well as the comments from the individual respondents. Conclusion: With the increasing demand for pharmacy preceptors, many PGY2 graduates may find themselves in a precepting role fresh out of their residency. There are references published in the pharmacy education literature with advice for students moving into a PGY1 role, as well as guidance for PGY1 residents transitioning into PGY2 roles. Ways to incorporate an official precepting experience within the PGY2 residency have also been described. There is not, however, any literature published currently which describes the challenges associated with the transition from pharmacy resident to preceptor, especially within the same institution. It is our goal to add to this body of literature with practical information and advice which can be utilized by new preceptors when taking this important step in their pharmacy career.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Incorporating pharmacy residents into student education: A new approach to experiential education Primary Author: Matt Bathula, PharmD, BCPS, Clinical Pharmacist, University of Maryland School of Pharmacy, Baltimore, MD; Email:
[email protected] Additional Authors: Kristin Watson Christine Choy Lauren M. Hynicka Sandeep Devabhakthuni Purpose: To develop a new educational program that incorporates pharmacy residents into the experiential education of fourth year doctor of pharmacy students completing patient care advanced pharmacy practice rotations. Methods: The University of Maryland residents are required to complete a specific number of teaching hours during their training program; these sessions were added this year an option. These resident‐led topic discussion sessions were designed for students completing Advanced Pharmacy Practice Experiences at the University of Maryland Medical Center. Five pharmacy residents were each assigned one disease state and instructed to develop an active learning session for the disease state assigned. These sessions are scheduled to weekly over the five week rotation block. Student’s participation is left to the discretion of their preceptor. The disease states selected by the faculty for the discussions include those frequently encountered in the adult medicine population. These included=: community acquired pneumonia, inpatient management of diabetes mellitus, heart failure, hypertensive crisis and venous thromboembolism. Each resident was assigned a mentor that aided in the development of this session. This same mentor assesses the residents’ performance through direct observation. Results: These sessions are being delivered four times during the 2012‐13 Academic year. Faculty members provided feedback to residents following each session and changes to the sessions were made, as appropriate, and residents were re‐assessed. Conclusion: This program provides a unique opportunity to engage residents into experiential learning activities. This program may provide students with additional learning opportunities during their rotation and may also provide preceptors with additional time to focus on other responsibilities. Residents may gain clinical and educational experience through this program.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Restructuring the Ranking Process for a PGY1 Residency Program at a Community Hospital Primary Author: Melissa Blair, BS, PharmD, Residency Coordinator, NHRMC, Wilmington, NC; Email:
[email protected] Additional Authors: Holly Snider Purpose: Over the past few years some residents have struggled with program requirements and two residents have left our program prior to graduation. Therefore we determined a need to re‐evaluate our residency applicant evaluation process. Previously, residency candidates were evaluated using a pre‐assessment score, interview score, and skills assessment. During previous years the pre‐rank meeting score was calculated by assigning each component equal weight. This ranking then served as a starting point for final ranking decisions during the rank meeting. The purpose of this project was to compare the results of the ranking process to resident performance during the residency program. Methods: To determine if our residency applicant evaluation process could be refined, the residency director and residency support coordinator reviewed three years’ worth of resident rank data. The review focused on the correlation of pre‐assessment score, interview score, and skills assessment to overall resident performance over the past three years. Additional time was spent reviewing the impact of the rank meeting on the final rank lists, as this meeting was attended by all preceptors and residents who participated in the interview process. To assess rank meeting influence, the final rank lists were compared to the calculated pre‐rank meeting score and resident performance. Resident performance during the residency year was determined by compiling feedback from the residency administration team and reviewing performance improvement records. Results: An average of 46 applicants were ranked yearly by the program. Upon review it was determined the pre‐ assessment score did not highly correlate with resident performance. Pre‐assessment scores were found to be most useful for deciding the need for an on‐site interview. Interview scores were weakly correlated with performance. The skills assessment was found to positively correlate with resident performance. Due to this, weighted percentages were reassigned: pre‐assessment (20%), interview score (40%), and skills assessment (40%). During the comparison of the pre‐rank meeting list to the final rank, it was noted that 50% (6/12) of matched residents moved up a minimum of 10 spots over last two years during the rank meeting. For instance, one resident moved from 29 to 7. Fifty percent of these residents (3/6) required written performance improvement plans. It was discovered that during the rank meeting, objective information was often de‐valued and an emphasis was placed on subjective information, such as applicant interaction with interviewers. The rank meeting was restructured to include an initial rank meeting with preceptors and residents to place applicants in quartiles. Following this meeting the residency administration group met to finalize the list. Conclusion: Utilization of retrospective rank data helped restructure our residency program’s ranking process. Skills assessment scores were found to positively correlate with resident performance. Most significantly, we discovered that subjective information was often reintroduced during the rank meeting and resulted in candidates moving up the final, more objective, rank list. The rank process was re‐designed to limit the influence of subjective information while still allowing everyone to have a voice. In the future we plan to evaluate the impact of these changes.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Implementation of a peer review process to improve the quality of preceptor feedback to residents Primary Author: Anne Denham, PharmD, Clinical Pharmacy Specialist, Kaiser Permanente Colorado, Aurora, CO; Email:
[email protected] Additional Authors: Rachana J. Patel Sheila L. Stadler Purpose: The aim of this project is to improve preceptors’ ability to provide objective and actionable feedback to residents. Methods: During our recent 2013 reaccreditation site survey, our program was found to be in partial compliance in the area of preceptor feedback to residents (Principle 4.2). The survey stated: “preceptors do not provide residents sufficient written feedback that is objective and actionable” Pursuant to this finding, a Preceptor Development Workgroup was established to review and ensure preceptors are consistently providing objective and actionable feedback to residents. This workgroup conducted an assessment of preceptor evaluations to determine baseline performance. This process involved reviewing the previous set of summative evaluations and “scoring” the preceptor’s commentary for each goal. Through this assessment, we identified examples of exemplary as well as deficient feedback. The workgroup then developed a formal preceptor review session that examined examples of feedback that was objective and actionable, feedback that could use improvement, as well as tips on how to provide this feedback to residents. Current preceptors were asked to identify which statements were adequately written. A follow‐up assessment of preceptor evaluation commentary was conducted with the next set of summative evaluations to evaluate the impact of this program. Results: At baseline, preceptors were found to provide, on average, “objective” feedback around 70% of the time and “actionable” feedback 40% of the time. The presentation session reviewed the ASHP Standard requirements for feedback as well as real “blinded” examples of adequate and deficient commentary from their own previous resident summative evaluations .The workgroup then conducted the follow‐up analysis of preceptor evaluations and found significant improvements in the evaluation commentary. At follow up, preceptors now provided “objective” feedback 92% of the time and “actionable” feedback 96% of the time. Conclusion: As a result of this exercise, significant improvements were observed in preceptor evaluations. Follow‐ up evaluations demonstrated >90% of commentary included both objective and actionable feedback. This showed our preceptors value opportunities to improve skills based on feedback. We will continue working with upcoming rotation preceptors and will incorporate a peer review process into the Preceptor Development Workshop. Preceptors will be asked to review blinded sample commentaries and offer improvement suggestions that will bring commentaries up to ASHP standards. This allows preceptors to learn best practices as well as identify areas of opportunity to ensure a high quality resident evaluation experience.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Implementation and benefit of a quarterly newsletter in a pharmacy residency program Primary Author: Amy Doten, Pharm.D., Pharmacy Program Manager, VA Black Hills, Fort Meade, SD; Email:
[email protected] Additional Authors: Kelly Moran Purpose: The purpose this descriptive project is to discuss the benefits of the VA Black Hills HealthCare System (VA BHHCS) pharmacy newsletter. The original intent of this newsletter, was to provide healthcare staff (including: pharmacists, nurses and providers) at VA BHHCS with education on a host emerging medication related topics. Additionally, this newsletter provides pharmacy residents an opportunity to hone writing skills, provide formal drug information, select pertinent topics and meet deadlines. Methods: This quarterly newsletter titled, InPharmation, is published at the end of September, December, March and June. It was implemented in the fall of 2008. Feedback from healthcare staff at VA BHHCS has been verbally requested several times since implementation. Direct quotes regarding the newsletter were collected, reported and incorporated to future newsletters as appropriate. Residents alternate being the lead on the newsletter, with responsibilities including 1. Brainstorming topics; 2. Assigning topics to other residents with a submission deadline; 3. Completing the draft newsletter leaving sufficient time for preceptors to review; 4. Successfully editing and finalizing newsletter for publication by deadline. Results: Direct quotes were all given by provider staff. The feedback included: “It’s the one thing I read”, “Very helpful”, “Concise and helpful”, “Could you expound on the vitamin b12 guidance?”, “Nice newsletter”, “Great job”, “tell your residents they really did a nice job”. While nursing has not provided specific comments related to the newsletter, they have requested that an anticoagulation topic be included in each newsletter for their education purposes. Resident responsibilities have been successfully completed consistently in regard to assigning topics and a submission date and completing the draft leaving sufficient time for preceptors to review. Residents often require assistance in brainstorming topics and successfully editing the final newsletter. Conclusion: The InPharmation newsletter has met the initial purposes as intended. VA BHHCS healthcare staff has consistently provided positive feedback regarding the content and helpfulness of the topics included. It appears that providers are most consistently the staff benefitting. Nursing has appreciated the addition of an anticoagulation topic in each newsletter. Pharmacy staff generally receives the information covered through staff meetings.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Development of a “Co‐Pilot” Preceptor for a CVICU Resident Rotation Primary Author: Jessie Dunne, PharmD, BCPS, Clinical Pharmacist, Zone Leader Adult Heart Unit, OSF Saint Francis Medical Center, Peoria, Illinois; Email:
[email protected] Additional Authors: Jennifer Ellison Nathan Grimes Purpose: OSF St. Francis Medical Center offers a PGY1 Pharmacy Residency Program to two residents. The pharmacy department operates within a mixed staffing model in which pharmacists rotate between staffing and clinical roles on first and second shifts. With the exception of our infectious disease, pediatric, and medical ICU preceptors, all of our direct patient care preceptors work in a clinical/staff role. This poses a challenge for scheduling preceptors with residents within the current staffing model. The purpose of this poster is to describe the development of a co‐preceptor as an approach to this problem. Methods: At our institution, several avenues exist for developing new practitioners who work on the critical care zones. Baseline educational requirements, such as BLS certification, ACLS certification, and Critical Care PSAPs were established before pharmacists could work in these areas. Additionally, monthly critical care “Lunch & Learn” meetings were developed in which critical care pharmacists share and discuss journal club reviews, difficult cases, and new guideline updates. Maintenance educational requirements for critical care pharmacists require active participation in these meetings as well as renewal of ACLS and BLS certification and completion of new critical care PSAP modules when available. The lead CVICU pharmacist identified a new‐practitioner clinical pharmacist with a desire and aptitude for precepting. The lead CVICU pharmacist did one‐on‐one mentoring of this pharmacist in order to develop assistant pharmacist/preceptor for the CVICU zones. Prior to the beginning of the rotation, the lead CVICU preceptor and the assistant preceptor reviewed the resident’s previous evaluations together. Both of them met with the RPD to discuss future goals for the upcoming rotation. Topic discussions and days scheduled with the resident were divided between the lead and assistant preceptors. While the lead preceptor was responsible for entering all evaluations into ResiTrak©, both preceptors worked together to prepare formal, written midpoint and summative evaluations for the resident. Additionally, they met regularly to discuss ongoing, formative feedback to the resident throughout the rotation. Results: This approach to team precepting provided the resident with consistent feedback while allowing both preceptors to work within our practice model. The resident benefitted by gaining different perspectives on pharmacy practice within the CVICU. The assistant preceptor gained valuable experience as a preceptor and has agreed to be a lead preceptor for the Pharmacy Practice Learning Experience for next year’s PGY1 residents. Conclusion: Precepting within a mixed‐model pharmacy practice model can be a challenge for both residents and preceptors. However, with the right approach, this experience can be valuable for residents because it provides them with a “real world” perspective of clinical pharmacy. Development of an assistant or “co‐pilot” preceptor is an effective way to precept within a mixed model because it maintains consistency for the resident while providing an opportunity for preceptor development for new practitioners.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Implementation of a residency selection and interviewing process for the Orlando VA Medical Center Primary Author: Kim Edmonds‐Rogers, Pharm.D., Clinical Pharmacy Specialist, Orlando VA Medical Center, Orlando, Florida; Email: kim.edmonds‐
[email protected] Additional Authors: Elsaris Riefkohl Latasha Miller Purpose: The Orlando VA Medical Center started a PGY1 pharmacy residency program in 2002. The program received additional funding for residency positions, and expanded from two to six slots between 2009 and 2012. Due to expansion of residency positions, the applicant pool increased steadily from approximately twenty‐five candidates to eighty candidates in 2012. In an effort to select top candidates from a sizeable applicant pool, a resident candidate screening tool was developed. The interview process was streamlined to allow multi‐candidate interviews and increase preceptor attendance and participation. Methods: A screening tool was utilized by the residency screening panel to rank candidates for interview slots. The screening tool was divided into four review categories ‐ academics, recommendations, letter of intent, and curriculum vitae. Candidates were allotted a maximum of six points for academic recognition and additional degrees; a maximum of fifteen points for exemplary recommendations using the ASHP recommendation form; a maximum of nine points for their letter including goals and interests; a maximum of twelve points for their curriculum vitae including honors, leadership, patient care rotations, and professional work experience. The total scores for each candidate were entered in the pharmacy online residency centralized application service (PhORCAS). The top candidates were invited for on‐site interviews. They participated in individual interviews with residency and pharmacy administration, and presented patient cases. All candidates received a patient case 48 hours before the interview. After arrival at our facility, each candidate was introduced to their presentation partner, and given 30 minutes to prepare for their case discussion. Residency candidates were ranked based on cumulative percentile scores received during individual interviews and case presentations. Results: The screening panel consisted of four pharmacists and one resident this year (2013). They reviewed seventy‐three packets in approximately two weeks. The assigned packet scores ranged from 14‐34 with a maximum achievable score of 42. Twenty candidates with the highest screening scores (28‐34) were invited for on‐site interviews. Pharmacy administration, residency administration, preceptor, and case presentation scores were submitted after each interview. The candidates were ranked according to point totals which ranged from 65.87‐77.8 with a maximum attainable point total of 80. Conclusion: The residency screening tool and interview process accomplished three main goals. The tool allowed the screening panel to review a sizeable pool of applicants in two weeks versus three weeks. The program was able to increase the number of applicants interviewed from three to four per day. This decreased the frequency of interviews to once a week, and improved preceptor attendance and participation. The case presentation format allowed each resident to be assessed on pharmacotherapy knowledge and application, creativity, and teamwork skills.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Community Partnerships and Innovative Strategies to Expand the Community Pharmacy Residency Program at the University of Mississippi School of Pharmacy Primary Author: Ashley W. Ellis, Pharm.D., Clinical Assistant Professor of Pharmacy Practice, University of Mississippi School of Pharmacy, University, MS; Email:
[email protected] Additional Authors: Laurie Warrington Leigh Ann Ross Cheryl Sudduth Justin Sherman Purpose: Prior to 2008, Mississippi did not have an accredited postgraduate (PGY1) Community Pharmacy Residency Program (CPRP). Increasing national demand for residency opportunities and local impact of many University of Mississippi School of Pharmacy (UMSOP) graduates choosing community practice guided residency development efforts to PGY1 community pharmacy residency (CPRP). The program began with one resident in 2008 as a partnership between the UMSOP and an independent pharmacy, which expanded to two positions and includes a chain pharmacy partner. Further expansion to a multi‐site program with an additional position required a strategic approach to site identification, development, and funding. Methods: The CPRP position was originally funded as a partnership between an independent pharmacy and the UMSOP, through the Community‐Based Research Program (CBRP). In the second year, additional support from Walgreens Pharmacy allowed the CBRP to expand to two positions. In 2010, The National Associations of Chain Drug Stores (NACDS) Foundation announced the availability of $1.5 million in grants from the Community Pharmacy Residency Expansion Program (PREP) for the creation of 30 new community pharmacy residency programs ($50,000 per program) to encourage community pharmacy partnership and increase sustainability of a new program. In 2009, a full‐time faculty practice site was established at Funderburk’s Pharmacy through the CBRP. This allowed expansion of clinical services offered at this pharmacy and provided an ideal learning environment for a community pharmacy resident. In 2012, the UMSOP and Funderburk’s Pharmacy submitted an application for the NACDS Foundation Community PREP grant. Results: UMSOP, in partnership with Funderburk’s Pharmacy, was awarded a Community PREP grant. This allowed the existing CPRP to expand to 3 positions, as well as expand to a multi‐site program with this position geographically distant from the initial positions. Learning experiences include academia, community based rural health, community pharmacy practice, practice management and research. The learning experiences customized specifically for the new residency position include Funderburk’s Pharmacy practice experience and orientation. After the Community PREP grant was awarded, an application was made to ASHP to expand to a multi‐site program and with approval of this additional position. This approval provided for applications through the Pharmacy Online Residency Centralized Application Service (PhORCAS) system, interviews conducted in the same manner as the original site, and utilization of the Residency Match Program for placement. Conclusion: Record residency applications demonstrate a critical need for residency expansion. CPRP specifically address increasing market demand for clinical skills and growing student interest in this area. Health care reform initiatives provide emerging opportunities for the community pharmacist to sustainably provide preventive services and primary care within their practice. Community pharmacy training equips the pharmacist to step up to this role and fill a significant gap in the healthcare system. Innovative strategies are needed to provide funding for CPRP. Public, private and non‐profit partnerships can be useful in overcoming this barrier to residency expansion or implementation.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Progression of post‐graduate year 1 (pgy‐1) resident teaching and precepting skills through a year‐long structured curricular method Primary Author: John S. Esterly, PharmD, Assistant Professor/Infectious Diseases Pharmacist/PGY‐1 Residency Program Coordinator, Chicago State University College of Pharmacy/Northwestern Memorial Hospital, Chicago, IL; Email:
[email protected] Additional Authors: Noelle RM Chapman Hannah Brooks Despina Kotis Michael J. Postelnick
Purpose: The American Society of Health‐System Pharmacists (ASHP) accreditation standard for post‐graduate year 1 (PGY‐1) pharmacy residency programs states that providing medication and practice‐based education and training for others should be included in the outcome competencies residents will be held accountable for acquiring. To this end, the Northwestern Memorial Hospital (NMH) PGY‐1 residency program has integrated structured experiences into the training curriculum that focus on a year‐long process of instilling and reinforcing critical thinking skills, precepting concepts, teaching techniques, and presentation command to help residents achieve this goal.
Methods: NMH PGY‐1 residents participated in a year‐long Resident/Preceptor/APPE student seminar series requiring twice monthly presentations by residents with a format that evolved quarterly. Residents started the year with informal case‐based presentations to program preceptors and administrators to develop baseline presentation and analytical skills. Informal presentations then transitioned to the execution of formal Power Point presentations that included an expectation of higher level subject matter analysis and evaluation. During Quarter 3, residents provided student‐focused presentations geared toward the education of APPE students with an emphasis on breaking down high level concepts into easily understandable form using active learning techniques. Lastly, in Quarter 4, residents formally presented their major project in multiple forums, and also independently developed and delivered one certified continuing education (CE) presentation for licensed pharmacists. Throughout the year, teaching skills were reinforced through a pharmacy practice model that required PGY‐1 residents to precept APPE students on concurrent rotations after receiving appropriate examples of instructing, modeling, coaching, and facilitating from advanced level post‐graduate trainees and pharmacist‐preceptors. Finally, residents had the option of participating in a formal, year‐long teaching certificate program emphasizing training in didactic coursework. All of these components were designed, conducted, and evaluated using a systems‐based approach.
Results: Seminar series presentations by PGY‐1 residents were preceptor evaluated and resident self‐assessed using the ResiTrak system. Five criteria were used for evaluation and assessment purposes including relevance of topic choice, appropriateness of content for specific audience, clarity of presentation, resident presentation style, and resident understanding of topic. Responses were recorded using a scale of strongly agree, moderately agree, slightly agree, slightly disagree, moderately disagree, and strongly disagree. Over the course of the year, 4 out of 6 residents showed a consistent improvement trend in evaluation responses from preceptors, while 2 residents scored consistently high throughout the year with little room for noticeable improvement. Self‐assessments of seminar presentations by residents showed markedly improved evaluation responses by 5 out of 6 residents over the course of the year, with 1 resident showing consistently critical self‐assessment scores. There were 4 of 6 PGY‐ 1 residents who completed the teaching certificate program; however there was no discernible association between either preceptor evaluations or resident self‐assessments and earning a teaching certificate.
Conclusion: Preceptor evaluations and resident self‐assessments showed that a formalized, PGY‐1 resident‐led seminar series provided residents with ongoing and consistent longitudinal opportunities to acquire and refine skills in the areas of analytical thinking, teaching, and formal presentation. Coupled with a practice‐based model that consistently exposed PGY‐1 residents to training APPE students, both preceptors and residents felt that resident precepting proficiency was achieved over the course of the year. It remains unclear from this study whether knowledge and didactic experience gained through a teaching certificate program further optimized residents’ capability to effectively provide medication and practice‐based education and training for others.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Development of a pharmacy informatics residency program Primary Author: Paul Evans, PharmD, Clinical Pharmacy Specialist, Marshfield Clinic, Marshfield, Wisconsin; Email:
[email protected] Additional Authors: Luanne Malsin Sara Griesbach Gary Plank Blake Carley Purpose: The Marshfield Clinic is a large physician group practice, which is very actively involved in the development, commercialization, and deployment of clinical IT solutions. As the use of clinical informatics has continued its expansion into the medication use process (including prescribing, transcribing, dispensing, administering, and monitoring) both the American Society of Health System Pharmacists (ASHP), and the Healthcare Information and Management Systems Society (HIMSS) have published white papers on the evolving role of pharmacy informatics as a subspecialty within medical informatics. Our purpose was to develop a pharmacy informatics residency program at Marshfield Clinic. Methods: Using literature searches (MEDLINE), textbooks, internet resources, and professional opinions from organizations and individuals this endeavor helped create a concise and accessible definition of pharmacy informatics by describing how this field fits into the modern healthcare system. A Residency Advisory Committee (RAC) was formed to further develop the design and structure of the program. Core preceptors also participated in preceptor development and ASHP Residency Learning System (RLS) training. Results: The pharmacy informatics residency program was successfully implemented in 2012. The program has helped improve patient outcomes and our system of care by providing opportunities for the resident to meet the Informatics related outcomes highlighted in the ASHP Informatics Accreditation Standard. The resident assisted in the implementation of standardized order sets in the ambulatory office space, and this helped the system ensure accuracy of documentation and communication of orders. In addition, the program helped foster effective decision support for all members of the healthcare team. The resident also completed a project life cycle project through involvement in implementation of a new outpatient pharmacy software system. The residency program promoted safe and effective use of technology by contributing to the development of a standardized in‐office prescribing platform, bar code medication administration, and had a leadership role in key safety initiatives including a scorecard to filter drug safety communications. Conclusion: The resident and the informatics residency program helped to define the role of pharmacy informatics through interactions with Information Technology staff, other health care staff, technology vendors, and Marshfield Clinic leadership. Marshfield Clinic continues to further develop the pharmacy informatics residency program and is seeking ASHP accreditation of the program.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Criteria for success: correlations within a pharmacy post‐graduate year 1 (PGY1) residency selection process at a community health‐system Primary Author: Jerry Gonzales, PharmD, Residency Program Director, NorthBay Healthcare, Fairfield, CA; Email:
[email protected] Additional Authors: Jennie Liu Jackie Ho Purpose: The PGY1 residency selection process has become increasingly competitive given the growing number of applicants every year and the introduction of Pharmacy Online Residency Centralized Application Service (PhORCAS). It has become more challenging to identify the most qualified candidates for the interview process. Students often ponder what qualities would make them an outstanding PGY1 candidate. Most studies done so far have pertained to medical school residency, but this study aims to determine which individual characteristics are associated with a candidate’s success when applying and interviewing for pharmacy residency programs. Comparison between the selection criteria and interview performance will be assessed. Methods: In this ambidirectional cohort study, 50 potential PGY1 candidates who applied to our institution were followed. Selection criteria which include Curriculum Vitae (CV), Grade Point Average (GPA), and Letter of Intent (LOI) scores were compared between the interviewed and non‐interviewed applicants for significant differences. The interviewed candidates’ CV and LOI scores were correlated to the panel and pharmacy director interview scores, while GPA was correlated to their written score on a clinical case. Finally, interviewed candidates obtained an overall score which was based on the selection criteria, interview performance and written scores. A comparison was made to see whether these individuals were selected into other residency programs and whether their selection was comparable to this institution’s according to our scoring of the applicants. Statistical analyses were completed using a 95% confidence interval and STATA software. Results: Of the 50 PGY1 candidates reviewed, 39 were offered an interview. Interviewed candidates had significantly higher mean CV scores (1‐sided p = 0.016), higher mean LOI scores (1‐sided p = 0.010) and higher mean GPA scores (1‐sided p = 0.005) than candidates that were not interviewed. Comparison of characteristics between interviewed candidates revealed that CV scores are positively correlated with panel (r = 0.31, p = 0.05) and director (r = 0.39, p = 0.013) interview scores; however, no significant correlation was seen between LOI and panel (r = 0.19, p = 0.24) or director (r = 0.23, p = 0.15) interview scores. No correlation was observed between GPA and written score (r = 0.04, p = 0.83) among the interviewed candidates. Finally, the overall score of 34 interviewed candidates (5 candidates were lost to follow‐up) was compared to their selection into residency programs. Candidates who were matched into residency programs had a significantly higher overall score (1‐sided p = 0.0005) and higher LOI score (1‐sided p = 0.001) than candidates who were not match. No significant difference was seen between the two groups for CV score (p = 0.12) and GPA score (p = 0.21). Conclusion: Individuals who were offered interviews scored higher on CV, LOI and GPA than applicants who were not offered an interview. Of those interviewed, individuals with a higher CV score performed better in the panel and director interviews, but no difference was seen between LOI and interview performance and GPA and written score. Candidates who had a higher overall score from our institution were offered residencies in the national match service whereas candidates with lower overall scores were not matched.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Improving the quality of preceptor input into the resident applicant selection process Primary Author: Eric Harvey, PharmD, MBA, Pharmacy Quality Manager and Pharmacy Residency Program Director, Seattle Children's Hospital, Seattle, WA; Email:
[email protected] Purpose: Selection of resident candidates is a time‐intensive process with a great deal at stake for both the applicants and the program. Like many departments, the face‐to‐face interview is a key component of every job hiring decision we make. After two years of solid input, we noticed a decline in the utility of preceptor input from preceptors who did not consistently participate in the scheduled resident candidate interviews. The purpose of our intervention was to improve the quality of preceptor input into the resident applicant selection process without increasing the overall preceptor time spent on interviews. Methods: This intervention was considered to be a quality improvement activity and we used a quasi‐ experimental, pre‐ post‐ intervention design to measure the effect. Our PGY‐1 program was accredited in 2007 and during the first three years of participation in the National Matching Service, our resident selection process included voluntary participation by preceptors in a half‐day on site interview for each invited applicant. On the recommendation of preceptors, a short patient case discussion was added to the preceptor interview session in 2010. Following a noticeable decline in consistency of preceptor participation in applicant interviews, the program director solicited preceptor volunteers that were willing to commit to attending as many of the interviews as possible, and to insure that at least three preceptors attend every interview in 2012. A morning session of shadowing on one of our decentralized services was also added to the now day‐long interview in 2012. Shadowing was limited to two services to allow preceptors on those services to assess multiple applicants. Our primary outcome measure was the number of preceptors who attended all interviews or missed only one. Results: In 2007, only two preceptors attended all interviews or all but one. This rose to five and six preceptors attending all or all but one interview in 2008 and 2009 respectively. A sharp decline was seen in 2010 with only one preceptor attending all interviews and none attending all but one. Some improvement was noted in 2011 when four preceptors attended all interviews or all but one. After the intervention took place in 2012, seven preceptors attended all interviews or all but one. Participation remained at this level in 2013. Many preceptors have voiced their support for the revised approach and have commented how much better prepared they feel for discussions about ranking candidates for the match based on their interactions with the candidates during shadowing and interviews. Conclusion: Preceptor input into the resident application selection process was improved by increasing the consistency of preceptor participation across all applicants during formal interviews and possibly through an increase in contact time with each applicant.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Utilization of a “cloud” calendar for preceptor coordination and resident duty hour monitoring Primary Author: Margaret Heger, PharmD, BCPS, Residency Program Director, Children's Hospital of Illinois, Peoria, IL; Email:
[email protected] Additional Authors: Aaron Harthan Julie Kasap Jennifer Mitchell Sarah Engberg Purpose: Scheduling can be overwhelming for a resident with longitudinal and rotational learning experience obligations. In addition, residency program directors need to monitor the resident’s duty hours in order to be compliant with pharmacy resident duty hour requirement. The preceptors and residents have a calendar program within the institutional email, but it requires sharing of the calendar by the preceptor or resident to assess availability. The PGY2 pediatric residency program at our institution implemented the use of a “cloud” calendar to resolve preceptor scheduling issues and to track resident work hours. Methods: A “cloud” calendar was set up for the residency program with a log‐in and password that was distributed to the resident and all preceptors. Longitudinal and rotational preceptors were encouraged to use the calendar for scheduling standard meetings, presentations, and topic discussions. The resident was encouraged to record as many scheduled meetings and activities as possible on the calendar. Utilization of the calendar for scheduling was not required. The calendar was also incorporated as part of the duty hour compliance policy for the residency. The resident was instructed to record his daily hours in the calendar as an appointment. The residency program director was then able to access the calendar and review the reported hours for compliance. At the end of the month, the residency program director entered an appointment with her initials indicating her review of the duty hours. Results: The calendar was trialed by the majority of preceptors at the site. The resident expressed satisfaction with the calendar due to ease of use and accessibility. Some preceptors preferred to use the system already available via the hospital email program, while other preceptors used the calendar extensively. The calendar was successful at recording duty hours and ensuring compliance with duty hour standards. The program was recently surveyed for accreditation and received a rating of “full compliance” for meeting the standard regarding duty hour compliance (2.2). Using the calendar allowed for a paperless system of duty hour tracking and allowed for an easy access common calendar to review for the resident’s planned activities. Since this was a “cloud” calendar, the system could be accessed by the resident, preceptor, or residency program director from anywhere at any time. Conclusion: Use of a “cloud” calendar is an easy and effective paperless method of meeting the ASHP standard for ensuring compliance with resident duty hour restrictions. Use of this calendar for other needs, like preceptor scheduling, has been trialed. Further evaluation of the calendar for preceptor scheduling needs to be completed.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Implementation of a non‐traditional PGY1 residency program through a collaborative partnership between a rural, community hospital and a school of pharmacy. Primary Author: Anastasia Jenkins, PharmD, Clinical Assistant Professor, University of Mississippi, University, MS; Email:
[email protected] Additional Authors: Jillian Foster
Purpose: Baptist Memorial Hospital‐North Mississippi (BMH‐NM) is located in Oxford, Mississippi; which is also home to the University Of Mississippi School Of Pharmacy (UM‐SOP), Mississippi’s only pharmacy school. Prior to 2012, only 1 PGY1 residency program was available in North Mississippi. Pharmacy administrators at the hospital and faculty at the University had long agreed upon the need for additional residency training in the area; however BMH‐NM, a 217‐bed institution, had limited preceptors and options for learning experiences. The Director of Pharmacy at BMH‐NM identified the school of pharmacy as an ideal collaborative opportunity for expanding PGY1 residency training in the area.
Methods: BMH‐NM Director of Pharmacy and University Liaison (UM‐SOP Clinical Assistant Professor practicing at BMH‐NM) attended RLS and began constructing a residency implementation plan in 2010. The Director of Pharmacy was identified as the Residency Program Director and University Liaison as the Residency Coordinator. BMH‐NM clinical pharmacists were identified to precept the traditional PGY1 learning experiences (adult medicine, institutional pharmacy practice, project management, critical care, practice management, medication management) as RPD began encouraging their development as IPPE/APPE preceptors to UM‐SOP students in 2009. UM‐SOP faculty were well positioned to precept a teaching and learning experience at the university and an ambulatory care experience in their individual practice areas(endocrinology, medication therapy management, travel medicine, indigent care). The structure of the residency was developed by RPD/RC with input from the Residency Advisory Committee. Following orientation, required experiences were structured longitudinally and coordinated with the university schedule in order to maximize residents’ interaction with PY1/PY2 courses and facilitate continuous development of teaching skills. Elective experiences were offered during winter and summer months. In 2011, BMH‐NM was awarded the ASHP Pharmacy Residency Expansion Grant, and BMH‐NM administrators supported an additional position; therefore 2 positions were offered and filled in the 2012 post‐ match scramble.
Results: The BMH‐NM PGY1 residency program began its first two residents and applied for accreditation status with ASHP in July 2012. The residents have had ample exposure to direct patient care, proving their proficiency in clinical roles. They have also been an integral component of the BMH‐NM pharmacy team, leading efforts to implement additional pharmacy services at BMH‐NM. Aside from the traditional PGY1 residency learning experiences, the residents’ have had the opportunity to maximize their exposure to academia through the teaching and learning experience and to multiple other practice areas through the ambulatory care experience. The main strength of the program is its ability to prepare residents for multiple career opportunities as the landscape of pharmacy practice continues to evolve. The challenges encountered in the program’s first year included longitudinal learning experience coordination, preceptor development and providing effective feedback, and expanding elective learning experience options. The program matched both positions and completed an ASHP accreditation site survey in March 2013. Following collaborative efforts with several other sites in North Mississippi, the BMH‐NM PGY1 residency program is now one of 4 training sites (offering 8 positions) in North Mississippi for the upcoming training year.
Conclusion: The number of PGY1 residency program applicants continues to exceed available positions, necessitating the continued expansion of programs. Most large medical centers have established PGY1 programs, however the multitude of community hospitals must devise innovative strategies in order to develop PGY1 programs. These facilities must identify available resources in order to offer unique programs. The BMH‐NM program has succeeded in providing benefits not only to BMH‐NM but also to the university, where the residents have provided early exposure to residency programs and peaked students’ interest in pursuing programs.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Tracking PGY1 progress through mentor‐mediated preceptor hand‐off meetings Primary Author: Brittany Johansen, PharmD, PGY1 Residency Coordinator, HBPC Clinical Pharmacist, VA North Texas Health Care System, Dallas, Texas; Email:
[email protected] Additional Authors: Cynthia Foslien‐Nash Purpose: Traditionally, solely the RPD has access to the continual progress of each PGY1 through the course of the residency year. Our goal; to improve PGY1 progress communications between the PGY1's current and upcoming preceptors, in addition to their assigned clinical mentor, and updating PGY1 development, subsequent to each rotation. Our expectation was to detect any clinical knowledge deficit, professional limitations or strengths earlier, and hone in on those during the upcoming rotation. Methods: The last week of every PGY1 rotation, the resident is responsible for creating a power point slide detailing their current and upcoming rotations, goals achieved with current rotation and personal goals to be achieved on their upcoming rotation. They also update their research project status on the slide. Residents meet with their clinical mentor prior to the resident hand off meeting so the clinical mentor can effectively act as a resident advocate. The meeting participants consist of the RPD, the PGY1 Residency Coordinator, every PGY1's clinical mentor, the PGY1's current rotation preceptor and the PGY1's upcoming rotation preceptor. These hand off meetings take place the last Thursday of every rotation, throughout the PGY1 year. The resident hand off meetings were initiated in 2010; the PGY1 presented their self‐descriptive slide then left the meeting room, after which, preceptors discussed each resident in turn. To ease the anxiety of the residents, the RAC initiated the resident advocate process in 2011; we have continued using this process. Results: Residents report satisfaction with the process of recurring meetings with their clinical mentors in mapping rotational and personal goals. Preceptors voice agreement that the face‐to‐face information gained has improved the delivery of training during the rotations. Noted are improvements in specific deficiencies, also goals that require achievement or need to be met. In addition, progress of our PGY1’s is followed more closely as a team, creating more individualized attention and tailoring of residency training. If a particular problem is noted to be evident in consecutive rotations and sufficient progress has not been noted, subsequent rotations may be altered to afford an elective rotation that focuses on developing non‐talents. Conclusion: This process was noted as a best practice during our April 2013 ASHP Accreditation Visit. We will continue the hand‐off meeting process for each PGY1, which results in positive team buy‐in, along with RAC input, for resident development and improvement.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Teaching Residents and Preceptors to Teach: Evolution of a Collaborative Pharmacy Residency Teaching Certificate Program at Shenandoah University and Beyond Primary Author: Mark S. Johnson, Pharm.D., BCPS, Professor and Director of Postgraduate Education, Shenandoah University, Winchester, VA; Email:
[email protected] Additional Authors: Amber Wesner Richard Pierce Purpose: The Shenandoah University Pharmacy Residency Teaching Certificate Program (PRTCP) is a collaborative program between the School of Pharmacy and School of Education that combines the knowledge and practice of teaching in a comprehensive yearlong program. Now starting its seventh year, the program has been successful in further developing participants’ teaching skills applied in varied practice settings. The purpose of this study is to 1) describe the evolution and components of the PRTCP to residents and preceptors; 2) highlight the measured and perceived value of the PRTCP; 3) describe revisions and expansion of the PRTCP. Methods: Descriptive data and participant surveys were collected for the PRTCP over the past six years. The six components of the PRTCP were evaluated and included: pedagogy seminars, didactic experiences, small group facilitation, experiential education experiences, teaching philosophy statement development, and teaching portfolio development. The majority of data was from residency programs based at nonacademic institutions within a one‐hour driving distance. Through the use of synchronous and asynchronous technology and equivalent practice experiences done at the residency sites, residents and preceptors from distant residency site have been added as eligible participants based on successful piloting to several other residency programs. The program was recently updated with recommendations from the American College of Clinical Pharmacy White Paper on “Guidelines for Resident Teaching Experiences”. Results: The Shenandoah University PRTCP was formalized in 2007 after several years of informal practice experiences in the didactic, small group, and experiential settings. Over 50 participants have completed or are taking the program. The majority of self‐rated past surveys have been positive showing the program to be beneficial overall and abilities and skills in teaching have increased after completion of the program. Participants taking the program have mostly been residents, although several preceptors and new faculty have also taken the program. Positions obtained by residents have been faculty, clinical practice, and joint positions, with the majority of teaching experiences in experiential precepting. Other outcomes from the PRTCP have included perceived value in recruitment of residency candidates for the residency programs, enhanced student interactions with residents, and assistance to faculty in their teaching loads. Based on all of the feedback over the past six years, the PRTCP has evolved through the use of technology in delivery and documentation and enhanced practice experiences. This has included expansion to distant nonaffiliated residency sites that lack expertise or resources, technology refinements with synchronous and asynchronous delivery using the Canvas platform, further refinement of “equivalent” practice experiences at outside, nonaffiliated sites with on‐site mentors. Conclusion: The Shenandoah University PRTCP is a comprehensive, collaborative program between the Schools of Pharmacy and Education in its seventh year to strengthen residents and preceptors’ teaching skills applied in the didactic, small group, and experiential settings. The program has been successful in its primary goal of increasing teaching effectiveness with many other benefits realized. The PRTCP has evolved to include expansion to nonaffiliated residency sites through technology and off‐site mentors, which has further enhanced the accessibility of the program to other residents and preceptors.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Development of an oversight process for quality improvement projects for a Veteran’s Administration (VA) facility without institutional review board (IRB). Primary Author: Karmen Jorgensen, Pharm.D., BCACP, Clinical Pharmacist, Central Iowa VA Health Care System, Des Moines, Iowa; Email:
[email protected] Additional Authors: Frederick Bahls Allison Berkland Natalie Gulbranson Jenny Vander Schoor Purpose: The Ensuring Quality Improvement Performance (EQuIP) oversight process was designed to ensure ethical, innovative, interdisciplinary Quality Improvement (QI) projects that appropriately protect patients from harm while improving their overall health care. The mission of this workgroup is to streamline a safe and effective QI process while ensuring efficient progress of timely patient‐centered QI projects to bring about improvements in patient care. Methods: Following the development of a Post Graduate Year‐1 (PGY1) pharmacy practice residency, our facility strived to guarantee that medical and pharmacy residents were provided with quality residency experiences. As our facility lacks an institutional review board (IRB), it was deemed a necessity to ensure that residency projects involving human subjects were QI, not research per se, and that patient rights were protected. Medical and pharmacy representatives at our facility met to discuss the differences between research and QI, and the ethics surrounding the use of both. As both research and QI are systematic, data‐guided investigations, we felt it necessary to develop a workgroup to pre‐review and designate that a project was in fact QI. Unlike research, QI projects are not designed to contribute to generalizable knowledge, but rather improve clinical practice. Once a project reviewed was deemed to be QI, an efficient process was developed to ensure patient rights were protected while allowing the project to have external presentation or publication. Following Pharmacy Benefits Management (PBM) clarification on the VHA Directive of Operations Activities That May Constitute Research, the EQuIP process was revised to align with the VHA Directive. The EQuIP oversight process is currently undergoing ethical review. Results: Following review of research and QI practices, our facility was able to develop a interdisciplinary QI review process that allows practitioners to participate in QI projects to improve patient outcomes. This process resulted in a streamlined approach which avoided some of the burdens of administrative complexity. Ensuring Quality Improvement Performance (EQuIP) considers both the rights of human participants and the institutional arrangements needed to ensure ethical conduct. Following review by EQuIP, activities that are constituted as QI and may be presented externally, assuming review of privacy practices occurs. Prior to final publication, a second review of the completed project will confirm that human subject information used for the purposes of QI did not harm the patients involved and the rights of all participants were protected. As QI is often presented externally in peer‐reviewed journals, there will be documentation of non‐research status prior to publication. QI projects may vary greatly between disciplines and ethical dissemination of findings is essential, EQuIP directs authors to obtain approval from other necessary workgroups or committees at the facility in certain circumstances. Conclusion: Lack of an institutional review board (IRB) has not negatively impacted the development of our PGY1 pharmacy practice residency program. Instead, medical and pharmacy residents have the opportunity to participate in high quality, data‐driven QI projects designed to improve patient outcomes for our facility. Residents are educated on the differences between research and QI and involved in a variety of QI project such as patient or provider satisfaction surveys, peer reviews, and medication use evaluations. Establishment of a collaborative discipline ethical pre‐review and systematic approach for external presentation and publication has strengthened our facility QI practices.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Improving PGY‐1 resident recruitment via preceptor participation and a resident scoring tool Primary Author: Terri Lim, PharmD, Pediatric Clinical Pharmacist, Lucile Packard Children's Hospital, Palo Alto, CA; Email:
[email protected] Purpose: PGY‐1 residents at Lucile Packard Children's Hospital (LPCH) are screened by a committee consisting of the pharmacy director, residency program director and residency coordinator. Selected applicants are invited for on‐site interview based on their application. The same individuals comprised the interview committee. Residency preceptors wanted to actively participate in the interview process and were added to the interview committee in 2012. Written communication skills are essential for the residents who are required to present to the medical team and hospital committees. In 2012, the committee thought they were not able to assess writing skills based on the current interview process. Methods: Two modifications were made to the residency interview process. At LPCH, resident applicant screening is divided into a two‐step process‐ an initial screening and on‐site interview. In the initial screening, the residency program coordinator scores the applicants on the following: (1) Work history (max 3 points), (2) Letter of intent (max 3 points), (3) Recommendations (max 3 points), and (4) Number of pediatric rotations (max 2 points)‐ 11 point total. Although GPA is not weighed in the scoring, it is considered. In 2012, the interview committee was expanded to include unit based pharmacists who serve as preceptors for the residents. Unit based pharmacists developed unique clinical scenarios and asked questions to access applicant’s critical thinking skills. Prior to 2013, applicants were evaluated on the following: 1) Oral communication skills, (2) Critical thinking skills, (3) Ability to maintain good eye contact, and (4) Maturity. In 2013, the scoring sheet was revised by replacing eye contact score with writing sample assessment (max 3 points). Applicants were asked to provide writing samples in the form of a drug monograph, case presentation or written article to the interview. The maximum score possible was 26 points. Results: In 2013, LPCH received forty‐eight PGY‐1 resident applications through PhORCAS. After the initial screening, 24 applicants were invited for an on‐site interview. Two applicants withdrew their application after the interview invitation. Applicant writing samples ranged from newsletter articles, drug monograph assignments to drug information answers. The writing sample provided by the applicants provided valuable information to the interview committee about the writing skills and candidate’s caliber of work. The total score of each applicant was tabulated. Two applicants had the same score (24 out of 26). The top 13 applicants were ranked by our institution into the ASHP Resident Matching Program. Conclusion: The inclusion of preceptors in the interview committee and request for writing samples proved to be positive modifications to the recruitment process. Preceptors perceived their involvement in the residency selection process was beneficial in making the rank order determination for the ASHP Resident Matching Program.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Implementation of a new interview process for post‐graduate‐one year pharmacy practice residency positions at mount carmel west columbus, ohio Primary Author: Benjamin Mgboh, PharmD; BCPS, PGY‐1 Residency Cordinator/Patient Care Pharmacist, Mount Carmel West, Columbus, Ohio; Email:
[email protected] Additional Authors: Randal Miles Virginia Ruef Deron Lundy Dianna Proulx Purpose: A new interview process was implemented at Mount Carmel West Hospital for the pharmacy department’s two, ASHP‐accredited post‐graduate 1‐year (PGY‐1) Pharmacy Practice Residency positions. Previously interviews were scheduled for each candidate individually. Each applicant had ten to fifteen preceptors in the room interviewing the applicant for 60 to 90 minutes. The feedback we got from the applicants was that the interview process was intimidating. Our goal was to create an environment that is effective for both applicants and the preceptors while being time efficient. Methods: Applications received via the PhoRCAS central application service were reviewed by a panel of nine preceptors. Scores were allotted based on the following criteria: Letters of recommendation, 10%; letter of intent, 10%; curriculum vitae, 5%; and a grade point average 3.0 or greater, 5%. An average score for each applicant was computed and the twelve applicants with the highest scores were invited for an onsite interview. This composite also accounted for 30% of the overall score. On the interview day, each applicant was allotted five minutes each to give a presentation about their background, interests, or a relevant topic of their choice. There were three interview panels consisting of three preceptors per panel. Each panel had a specific focus for which it evaluated the candidates. These included communication/customer service, clinical experience/work ethic, and personality/flexibility. Each of the three panels accounted for 20% of the overall score. Lastly, general professionalism and cultural/institutional fit made up the final 10%. / Results: The three interview panels met together briefly after each interview session to discuss each applicant. While they received a tour of the institution the interviewers were allowed to recall any applicant after the tour if they had additional questions or concerns. Interviews took place four days out of a three weeks period and lasted two hours each interview day. The average of the three interviewers scores were calculated for each panel and totaled for each applicant. Both PGY‐1 resident positions were filled during the match. The department was able to decrease interview days by 67 % and able to conserve pharmacist time and resources. Conclusion: The preceptors felt that the new format enabled Mount Carmel West to adequately assess the applicants and enabled us to determine the best fit for our program. We have gotten positive feedback about the new interview process from our current and future residents. Overall this new interview process was more efficient, saved time and resources, and was well received by all.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Creation of a residency preceptor development coordinator position Primary Author: Dawn M. Miller, Pharm.D., Clinical Pharmacy Specialist, St. Elizabeth Boardman Health Center, Boardman, Ohio; Email:
[email protected] Additional Authors: Kristen L. Longstreth Purpose: Pharmacy practice residencies rely upon a preceptorship model for training new residents. At St. Elizabeth Health Center (SEHC), there are 13 core preceptors with a broad range of specialty knowledge and experience. A Resident Preceptor Development Coordinator (RPDC) position was developed at SEHC to design and implement an ongoing residency preceptor development program. The purpose of the program was to align preceptor development at SEHC with the accreditation standards set forth by the American Society of Health‐ System Pharmacists (ASHP) in order to maintain a high level of competency for all pharmacists involved in PGY1 resident preceptorship. Methods: RPDC responsibilities began with conducting a baseline needs assessment to identify learning needs among the 13 core preceptors at SEHC. The RPDC was then responsible for assisting the Residency Program Director (RPD) in planning Residency Quality Improvement (RQI) meetings held every other month. In addition, the RPDC was to ensure that mandatory paperwork was completed by all resident preceptors including a baseline self‐assessment, preceptor record of continuing education (CE) documenting a minimum of 3 hours , ASHP preceptor academic and professional record, annual preceptor self‐assessment, and the preceptor annual checklist. The RPDC was also responsible for providing CE opportunities to resident preceptors for self‐study along with assisting the RPD in facilitating live CE quarterly. Four live CE programs were offered at SEHC and topics included preceptor orientation, precepting learners in a clinical setting, precepting the resident research project, and ASHP residency preceptor requirements. Each year, an anonymous survey will gather feedback from participants in order to identify areas of improvement and to make necessary modifications to the program. Results: The baseline needs assessment determined which areas that resident preceptors self‐identified as learning needs. Areas where resident preceptors at SEHC expressed the least confidence included: evaluating learners using standardized assessment tools, assessing learning styles, utilizing the four preceptor roles, dealing with conflict, giving constructive feedback, and recognizing learning deficiencies. When asked to rate their level of interest in a variety of methods for obtaining CE credit in the area of preceptor development, the majority of SEHC preceptor respondents indicated a preference to participate in live seminars and group‐based discussions. To assess the effectiveness of the residency preceptor development program, preceptor baseline assessment scores were compared to scores submitted at the end of the first year. Preceptors were asked to rank themselves in the following areas: performance as a pharmacy practice role model, providing regular formative and summative feedback in a timely manner, availability to the resident, arrangement of necessary opportunities to allow for completion of all rotation learning objectives, enthusiasm for teaching, providing clear explanations to questions, ability to ask questions that cause self‐directed learning, and performance of the four preceptor roles. Annual preceptor self‐assessment scores trended towards improvement in all areas. Conclusion: Creation of the RPDC position allowed for dedicated focus on ASHP accreditation standards for training and maintaining effective resident preceptors. The RPDC effectively assisted the RPD in development of a residency preceptor development program that was tailored specifically to meet the needs of hospital‐based preceptors at SEHC. Participating preceptors provided positive feedback on the residency preceptor development program. The program appears to have enhanced resident preceptor self‐awareness of personal performance and provided tangible accountability for continued growth. Based on the success of the first year post‐ implementation, the RPDC position will be permanent and the program will continue for subsequent years. Future CE programs will focus on the remaining learning needs not yet addressed.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Developing and precepting a residency rotation at different levels to meet educational goals and expectations Primary Author: Simone Minto‐Pennant, PharmD, BCPS, Clinical Pharmacist, OVAMC, Orlando, FL; Email: Simone.Minto‐
[email protected] Purpose: The Geriatric rotation at the Orlando VA Medical Center changed from an elective learning experience to a required learning experience in 2010, based on recommendations from the American Society of Health‐System Pharmacists (ASHP) Residency Accreditation site survey. The rotation is based in the long term care facility where pharmacy residents complete patient care activities and assignments. The rotation is designed to provide a focused learning experience for residents at different educational levels. The preceptor customized the rotation to allow flexibility to meet individual goals and expectations. Methods: The SWIG analysis (strengths, weaknesses, interests and goals) and the initial chart review are used to assess each resident’s baseline abilities. A chart review is completed and a rating score is given to each resident based on their performance. One out of a possible six rating is assigned to rank the residents’ knowledge base and determine their ability to manage patient care. A rating of level 1 signifies baseline abilities comparable to a practicing clinical pharmacist, whereas a rating of level 6 signifies baseline abilities requiring maximum preceptor assistance. The resident is asked to write achievable personal and professional goals for the rotation. Once goals are established, specific activities are developed to aid the resident to meet set goals. Goals may range from how to address polypharmacy in the elderly to working on improving time management skills. This is accomplished by providing direct patient care practice problems and clinical interventions to build confidence and speed. A rotational packet is supplied outlining the timeline and expectations. Expectations include, but are not limited to performing nursing in‐services, observing the Bar Code Medication Administration (BCMA) process and attending wound rounds. Results: Fourteen residents have completed the Geriatric rotation since 2010. Upon baseline assessment no residents were found to be at a level 5 or 6. Five residents started and maintained their chart review proficiency at a level 2. Eight residents proficiency level improved from a level of 3 to 2, and one resident was initially assessed at level 4, but improved to a level 3 during the rotation. The midpoint and final evaluation (Resitrak) showed improvement in chart reviewing proficiency in all groups. The resident at level 4 received sufficient coaching enabling progression to a higher proficiency level. The personal and professional goals set during the rotation were achieved by the residents at the end of the 4 week rotation. A debriefing occurs after each expected activity to discuss learning points, what went well or assess opportunities for improvement. Conclusion: The approach of using a variety of tools during the Geriatric rotation equipped the residents to be successful. Initial assessment of residents’ personal and professional goals aided the preceptor in customizing their educational needs. Additionally, designing the rotation to provide a focused learning experience at different educational levels enabled the residents to become more proficient, strive to achieve independence, and make an effort to accomplish set goals and expectations.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Do new practioners feel prepared to act as preceptors? Primary Author: Clarence D. Moore, Pharm.D., Oncology Pharmacy Fellow, Howard University, College of Pharmacy, Washington, DC; Email:
[email protected] Purpose: We take an oath as pharmacists to “…utilize my knowledge, skills, experiences, and values to prepare the next generation of pharmacist.” At what moment in time during our careers are we expected to fulfill that obligation? The purpose of my research is to examine the preparedness of 2011 pharmacy graduates to act as preceptors upon graduation. Methods: A 10‐question electronic survey was prepared and distributed to a 2011 graduating class of an accredited school of pharmacy utilizing SurveyMonkey™. Data not limited to demographics, state(s) of licensure, workplace settings, job satisfaction and preceptor preparedness were collected. The Likert scale was utilized to gather and assess preceptor preparedness upon graduation. Results: Thirty‐three complete responses were included in the analysis resulting in a 58% participation rate. A majority of the respondents (67%) reported they encountered students completing introductory pharmacy practice experiences (IPPE) and advanced pharmacy practice experiences (APPE) while acting as licensed pharmacists within the workplace. Nine percent of all respondents declared to be registered preceptors within their respective state(s) of licensure. Approximately 64% of respondents rated their preparation to act as a preceptor upon graduation as being prepared, well prepared, or very well prepared. Seventy‐six percent of respondents stated the utilization of introductory preceptor activities during APPE may have been valuable in their preparation and development as a preceptor. Conclusion: Experiential education encompasses approximately 30% of the doctor of pharmacy curriculum. Over the past decade there has been a boost in the number of pharmacy schools and graduates annually. In result of the aforementioned, a developing need for quality rotation sites and preceptors to meet the demand has emerged. A large portion of the graduates surveyed feel prepared to act as preceptors however three are registered. Various methods should be developed to encourage new practitioners to register as preceptors. The incorporation of activities into APPE curriculums such as, “preceptor for a day” may ease transitioning into the preceptor role.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Growing preceptors: using veterans health administration (VHA) mentor certification program to enhance preceptor development Primary Author: Kelly L. Moran, Pharm.D., BCPS, Acting Associate Chief, VA BHHCS, Hot Springs, SD; Email:
[email protected] Additional Authors: Amy E. Doten Purpose: ASHP Accreditation Standard 4.3 states: Resident Program Director will devise and implement a plan for assessing and improving the quality of preceptor instruction. Residency programs continue to struggle to meet this standard. In March 2013, 79% of PGY 1 residency programs received a partial compliance on preceptors not adequately applying clinical teaching roles or provide effective criteria based feedback . In addition, 49% received a partial compliance on inadequate preceptor development and the lack of a plan for improving the quality of preceptor instruction. Both of these requirements are critical factors and can impact the length of accreditation. Methods: In an effort to improve preceptor clinical teaching roles and to provide effective criteria based feedback, the Residency Program Director (RPD) and the Associate Residency Program Director (ARPD) utilized the VHA Mentor Certification program in their preceptor development curriculum. As part of the yearly preceptor self assessment, the RPD and ARD added the VHA Mentor Certification Program to the preceptor's customized plan. The VHA Mentor Certification Program provides structured training to ensure employees are skilled certified mentors, coaches and preceptors. The program consist of three levels: apprentice (attended Coach Mentor Training Session); resident (completed 25 hours of practical experience) and fellow (completed 50 hours of practical experience). Each level builds upon the experiential foundation of the prior level. The VHA Mentor Certification Program teaches participates the GROW model, which is: Goal setting for the session as well as short and long term goals; Reality checking to explore the current situation; Options and alternative strategies or course of action; and What is to be done, when, by whom, and the will to do it. The VHA Mentor Certification Program core training is offered once a year at the facility for pharmacy residency preceptors to attend. Results: Thirteen out of nineteen preceptors are completing the VHA Mentor Certification Program as of 2013. Five preceptors are apprentices and eight have accomplished the fellow level. The VHA Mentor Certification program has improved the preceptor's ability to provide criteria based feedback, as well as improve their ability to coach and mentor residents. Preceptor skills have improved in the four preceptor roles as demonstrated by Resitrak™ evaluations. In 2008, residents documented 75% of the time preceptors "always" modeled for the resident, coached their performance, or facilitated independent work as appropriate. By 2012, this Resitrak™ evaluation increased to 95%. Resident evaluations on preceptors providing feedback has improved over the last four years, increasing from 42% to 82%. Preceptors completing the core training considered the training very worthwhile. Each preceptor gave a synopsis of what they were going to implement at a preceptor development meeting. Conclusion: Preceptor development requires a multifaceted approach. Utilizing the VHA Mentor Certification program is one strategy to make preceptor development more meaningful to each practicing pharmacist. Preceptors have utilized the GROW model to enhance criteria based feedback provided to residents as well as augment their precepting skills in coaching and mentoring.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Learning experience development at a non‐traditional new PGY1 program Primary Author: Samuel Myers, Pharm.D., Director of Clinical Services, Vital Care of Meridian, Meridian, MS; Email:
[email protected] Additional Authors: Chris Newlin Jennifer Branstetter Sedji Doxey Len Branham Purpose: The project's purpose was to develop learning experiences that reflect our program's vision for optimal residency training in a non‐traditional pharmacy setting. Methods: The program's Residency Program Director and Site Coordinator implemented a learning experience training series focused on formulating experiential site descriptions. The training series consisted of didactic lectures, small group breakout sessions, and peer‐to‐peer review council meetings. The didactic lectures focused on numerous documents, regulations and standards for PGY1 residency programs specific to the American Society of Health‐System Pharmacists (ASHP). After attending the didactic lectures, each preceptor met individually with the residency program leaders, in order to identify and discuss the various portions of a learning experience. The goal of this meeting was to coordinate the standards and goals of the accrediting organization along with those of each preceptor. Each preceptor then developed a rough draft of his/her specific learning experience description. The residency program leaders reviewed all rough drafts and provided feedback to the program’s preceptors so as to further enhance each learning experience. Lastly, each preceptor presented his/her learning experience description during a designated preceptor development session, as part of a peer review process. Results: All preceptors preferred the centralized learning experience development series, in contrast to performing this task individually and without clear direction. Learning experiences were created for all residency rotations, including those classified as an elective or longitudinal experience. The residency program leaders provided recommendations in numerous areas included in the preceptors’ rough drafts. Presenting the descriptions during the peer review process allowed all preceptors to receive immediate constructive feedback, along with providing a practice session for the learning experience’s orientation. Conclusion: The residency learning experience training series allowed preceptors to incorporate their personal objectives, along with those of ASHP and the non‐traditional residency program, into each rotation design. All of the residency program’s rotations now follow a standard, professional format. This outline will be used to further improve rotational descriptions for the upcoming years of the residency program.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Implementation of a dedicated weekend preceptor program to improve feedback systems for resident staffing Primary Author: Judy M. Olson, PharmD, Clinical Pharmacist, University of Wisconsin Hospital and Clinics, Madison, WI; Email:
[email protected] Additional Authors: Michael Fallon Christi Ann Albert David Hager Philip Trapskin Purpose: The expansion of residency programs at UW Hospital and Clinics (UWHC) has resulted in an increased number of residents staffing in clinical decentralized roles on weekends. Historical resident staffing models lacked direct observation by preceptors resulting in delayed identification of poor performers risking quality patient care. When remediation was necessary, resident rotations were reallocated to weekday staffing with preceptors. The primary objective of this program was to create a dedicated clinical pharmacist weekend preceptor to improve documentation of formative feedback, to ensure resident provision of quality pharmaceutical care, and to improve communication amongst those individuals invested in the residency program. Methods: Weekend preceptor responsibilities consisted of resident direct observation with rubric‐based evaluation tools, in‐person discussion, and feedback documentation. Reports were sent to the resident, resident’s program director, coordinator, advisor, and the staffing preceptor. Staffing preceptor’s responsibilities were maintained and consisted of eliciting feedback from the clinical team and documentation within Resitrak®. Eight PGY1 and six PGY2 residents participated during the thirty‐three week pilot. Four current clinical pharmacists were transitioned to the weekend preceptor role. Each pharmacist observed four to five residents’ work each weekend for a total of 16 hours. Residents were required to route all clinical notes to the weekend preceptor for evaluation and cosignature. Objective rubrics were developed in the following areas: medication histories, discharge counseling, chemotherapy order processing, emergent medication dispensing, and provider interactions. Patient satisfaction surveys and Resitrak® snapshots were also utilized to assess performance. Medication orders that residents verified were reviewed for appropriateness and the preceptor was available in person and via pager for consultation. Quarterly, weekend preceptors met to assess resident progress and the need for ongoing observation. A satisfaction survey was sent to residents to measure their perceived value of the new program at the midpoint and end of the residency year. Results: A total of 313 rubric‐based evaluations were performed, with an average of 22.3 per resident. Seventy‐ eight weekend overview and 235 individual resident reports were reviewed with each resident and 448 emails were sent to the resident’s director, coordinator, advisor, and staffing preceptor over thirty‐three weeks. Each weekend overview report contained actionable feedback for ongoing resident assessment and improvement. Resident access to the weekend preceptor increased patient care based interventions and prevented the need for remediation of poor performers. Of the eleven residents that completed the midpoint satisfaction survey, 72.7% found weekend preceptor feedback very or extremely worthwhile. In a comparison of the perceived value of feedback from various instructors weekend preceptors provided the most objective feedback at a rate of 54.5%, compared to rotation preceptors at 45.5%. None of the residents reported that staffing preceptors provided the most objective feedback, and 72.7% ranked their feedback as the least objective. Conclusion: Addition of a dedicated weekend preceptor is a viable strategy to increase the amount of formative resident feedback. Patient care is improved by providing a clinical resource to residents and through direct observation and immediate interventions by the weekend preceptor. Furthermore, identification of and communication about poor performance improved.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Incorporating elements of the multiple mini interview (MMI) and reverse interview approaches combine to form effective strategies in residency interviewing, ranking and matching. Primary Author: Patricia Parker, Pharm.D., BCPS, Clinical Coordinator/PGY‐1 Pharmacy Practice Program Director, UC Davis Medical Center, Sacramento, California; Email:
[email protected] Additional Authors: Patricia Poole John Grubbs Purpose: Matching with top resident candidates requires the ability to identify the best‐fit candidates during the interview process, as well as the candidate identifying your program as their top choice. The traditional interview process often lacks the ability to predict the candidates potential for success in a given residency, and leaves the candidate unsure of what each program has to authentically offer. It is imperative to conduct the interview process, utilizing numerous key stakeholders, in a manner that is conducive to gaining a greater predictive correlation of future professional performance from that of the standard interview process. Methods: The interview process at the University of California, Davis, underwent a paradigm shift after realizing the increasing number of PGY‐1 residency candidates applying to and being interviewed for the positions were resulting in an inverse relationship in matching success. To allow more time with selected candidates, a significant reduction of on‐site interviews were offered (4‐5 candidate interviews for each PGY‐1 position available compared to 10‐12 candidate interviews per available position previous) on only three separate days. A concerted effort was made to increase the number of exposures to various pharmacy staff members and improve the overall on‐site experience. Various elements of the MMI approach were embedded within the process to provide a better assessment of each candidate’s non‐cognitive skills. Numerous reverse interviewing opportunities were incorporated in both group candidate and one‐on‐one sessions throughout the day utilizing key stakeholders; preceptors, residents, program directors. A small panel interview remained in place to allow for cognitive assessment. Other innovative elements of the interview day included a team based exercise, a short presentation, a one‐on‐one tour with a current resident, and an opportunity to meet with a PGY2 program director if a focused area of interest was determined as a second year tracking potential. Results: Despite a sixty percent reduction in on‐site candidate interview offers, at the risk of positions being left unfilled in the match, the revised interview process has resulted in securing all positions, and doing so with highly ranked candidates for the past several years. This has been done utilizing only three interview days and thus less overall resource expenditures. Using many short independent assessments by a large number of individuals (preceptors, residents, administrative staff) places less overall individual burden on staff and provides an opportunity for a more genuine appreciation for the candidate’s attributes. Candidates spend eight hours on‐site and leave the day with a full appreciation of what the program has to offer, allowing for a better determination as to where it is that the program fits within their career goals, and therefore, on their rank list. This new interviewing approach has been clearly beneficial as is reflective in the enhanced success in the programs match results; matching all positions, matching with highly ranked candidates, matching with candidates that stay on to complete second year residency experiences at our institution, and a high retention rate of hire post training. Conclusion: The best resident pharmacists are not repositories of drug information. They are ethical, caring, committed professionals with excellent communication skills. It is imperative to be able to assess the qualities that lie outside of the realm of grades and rehearsed answers. For the candidate, it is also important they leave the interview with a firm grasp on the programs intangibles that are not apparent from a written residency description, showcase flyer, or information off a website. Incorporating elements of the MMI and allowing for ample reverse interviewing opportunities lends itself well to a resulting well matched resident to residency program.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Growing together: methods for ensuring preceptor development during pharmacy residency program expansion Primary Author: Nishil Patel, Pharm.D., Clinical Manager, Wheaton Franciscan Healthcare St. Joseph Hospital, Milwaukee, WI; Email:
[email protected] Additional Authors: Andrew Ticcioni Lijian "Leo" Cai Mike Gillard Purpose: Faced with several challenges in the leadership structure over the years preceding 2011, Wheaton Franciscan ‐ St. Joseph Campus’s PGY1 pharmacy residency program was cited for three noncompliant and 22 partial compliant standards. A major contributing factor to the citations was the lack of qualified preceptors and residency leadership. The newly appointed residency program director and director of pharmacy focused efforts toward improving compliance with the seven ASHP‐identified markers of professional contribution and commitment outlined in the standards. Using this metric, the program increased the number of qualified preceptors and expanded the program while simultaneously remedying noncompliant standards. Methods: From May 2011 to May 2013 the residency program expanded from two to six PGY1 residents. During that time a preceptor improvement matrix was developed to track the progress and development of preceptors within the residency program. The matrix was designed to include core requirements from principal five of the ASHP residency accreditation standards. Baseline data was collected in May 2011 and was tracked over the following two years. The six key improvement areas tracked included: number of preceptors, average year of practice experience, average year of experience with residency training, total number of publications and presentations in the past five years, total number of residents trained, and preceptors with board certification. An incentive structure rewarding preceptors who attained board certification with exam reimbursement and an educational stipend was also created to encourage professional development. In addition, strategic recruiting and a more robust interview process were established to employ more experienced or specialty‐trained preceptors. Drug policy became a mandatory six‐week rotation for each of the pharmacy residents. A component of this rotation was designated to ensure resident participation in the satisfactory maintenance of the elements of Principle 7, qualifications of the pharmacy. Results: Over the two‐year period, the residency program improved the quantity and qualifications of its preceptors. The number of qualified preceptors doubled from 6 to 12. Average years of experience per preceptor increased from 8.2 to 10.1. Publications/presentations within the last 5 years went from 2 to 54. Total number of residents trained increased from 13 to 130. Board certified preceptors increased from zero to 7. The average number of years of residency training experience per preceptor increased from 2.7 to 5.7. Results do not include the next phase of development, which includes two specialty‐trained pharmacists and an academic faculty member. Conclusion: Rapid residency program expansion is a meaningful initiative given the lack of residency positions available for graduating pharmacists. However, it is essential to ensure preceptor qualifications are not diluted during the expansion. Through the use of strategic recruiting and professional development incentives, expansion of the residency program was achieved in harmony with dramatic improvement in preceptor qualifications.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Development and implementation of a novel leadership experience in a postgraduate year two ambulatory care residency Primary Author: Rachana J. Patel, PharmD, Residency Program Director, Kaiser Permanente Colorado, Denver, CO; Email:
[email protected] Additional Authors: Beverly A. Kroner Anne M. Denham Purpose: The primary goal of this experience is to provide the resident a broad overview of pharmacy and organizational leadership within Kaiser Permanente Colorado (KPCO) to better understand leadership principles. The resident is expected to gain a basic knowledge of leadership topics and meet with individual pharmacy leaders to better understand and appreciate their career paths, what their jobs entail, and the skill set needed to do their jobs. Methods: In an effort to further enhance required residency activities, the Chief of Primary Care Clinical Pharmacy Services created an elective Leadership Exploration learning experience. In this experience, the resident is responsible for directing, evaluating and capitalizing on opportunities that arise during the rotation. Additionally, the pharmacy resident is encouraged to self‐reflect on his/her professional goals, strengths, and areas of opportunity and gain insight from pharmacy leaders to assist in their personal development. Core learning activities include: exploring your personal leadership style, developing a business case, becoming an effective interviewee, and gaining a global perspective on healthcare reform. Results: Since the creation of the Leadership Exploration experience in 2009, 19 of 23 residents have completed this elective rotation. Overall, resident feedback regarding the experience has been very positive. Some example commentary from residents regarding aspects they liked about the experience include: • The accessibility of leadership team members, transparency and openness to opportunities to observe and discuss potentially confidential information, self‐directed nature, and ability to customize/alter the rotation to satisfy my own objectives in addition to a few required by the rotation • This was one of few rotations that allowed me to self‐ assess/reflect both personally and professionally. • I have a better understanding of the vision of pharmacy and challenges within the ambulatory care setting which allows opportunity to strategically and critically think • I have enjoyed working with various people/teams on different projects; this allows for variation and exposure to different areas of leadership. Conclusion: Residents consistently praise the value of this learning experience. They appreciate the exposure to various leaders and leadership opportunities within the organization as well as the sense of independence this experience provides. The end goal of this experience is to develop and inspire future leaders in clinical pharmacy. The high percentage of residents choosing to complete this elective rotation speaks to the need to provide access to pharmacy leadership. Our recent ASHP Site Accreditation visit highlighted this experience as a strength of our program and recommended this experience be required for all residents.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Reflections of residents and project mentors on completing residency projects Primary Author: Sarah Pfaehler, PharmD, Pharmacy Clinical Coordinator, Parkview Health, Fort Wayne, IN; Email:
[email protected] Purpose: The purpose of this survey was to discover and analyze the experiences of residents and project mentors on different aspects of project mentorship. Results are intended to be used to improve the process of project idea generation, mentor selection, and project development and management within the residency program at our institution. Methods: A survey was developed and disseminated to the project mentors from our institution’s residency program for the last 2 years. Included questions targeted project mentor motivation, advantages and disadvantages of being a project mentor, and any anticipated future changes in their approach in mentoring resident projects. A similar survey was disseminated to the current residents in the program in order to determine their perspective on collaborating with project mentors. The survey was an informal questionnaire emailed directly to 13 mentors and 4 residents with an expected reply window of 7 days. Results: Seven of 13 mentors and all residents responded to the survey. The most common reasons mentors stated they participated in resident projects were to pass along the knowledge gained throughout their career (6) and that project mentoring is an expectation of their role as residency preceptor (6). The best parts of working with resident projects include watching the resident grow (3) and the impact on patient care due to project results (3). The mentor’s skill in time management was felt to be important in the success of the project (6). Mentors felt that setting and enforcing deadlines throughout the process were important pieces of advice for future project mentors (4). The most common reasons residents felt colleagues chose to mentor projects were that they are great learning/teaching opportunities (2) and for professional development (2). The best part of working with a mentor was the guidance received on project management (3). The residents felt poor time management from either the resident or mentor was the biggest struggle in completing the project (3). The residents felt that mentors should be aware of the time commitment to mentoring a project including working outside of ‘work hours’ to meet deadlines (2). Conclusion: Mentors are involved with residency projects for a variety of reasons including meeting requirements of their job, gaining learning/teaching experience, and watching residents grow throughout the project. Time management was felt to be an important aspect from both residents and mentors. Residents felt that preceptors should be more aware of the time commitment necessary for mentoring projects, and mentors felt that clear deadlines should be established and enforced throughout the project.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Teaching certificates offered by residency programs in academic medical centers Primary Author: Holly Phillips, PharmD, Acute Care Pharmacy Manager, University of Colorado Hospital, Aurora, CO; Email:
[email protected] Additional Authors: Patrick Fuller James Beardsley Kelly Smith J. Russel May Purpose: Describe the predominance, structure, and impact of teaching certificate programs for pharmacy residents in academic medical centers in order to better direct national guidelines for their content and development. Methods: A 23‐point electronic survey of residency program directors in academic medical centers assessed their inclusion of a teaching certificate program, program features and structures, participants’ perceived program value, and challenges in program design or administration. Descriptive statistics were employed. Results: Of the 44 respondents (17.5% response rate), 27 (61%) offered a teaching certificate, while 41% of the remainder planned to establish one. The majority of programs (35%) were offered in conjunction with other residencies, and most were led by residency directors or pharmacy faculty. Program participation was required for 38% of postgraduate year one residents. Participant competency was infrequently assessed either prior to or following program completion. Submission of a teaching portfolio at conclusion was required in 79% of the programs. Common content included developing teaching outcomes and learning objectives, small group facilitation skills, academic pursuits, presentation and lecturing skills, and active learning techniques. Resident participants found value of participation in 91% of programs. Common program challenges included scheduling conflicts, time commitments, inconsistency of evaluations and precepting provided to participants, and identification of suitable teaching experiences. Conclusion: The disparity in the structure, content, and assessment elements of teaching certificate programs offered in academic medical center residency programs should be addressed by the profession in order to promote pharmacy resident teaching skills.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Support for regional residency preceptor development provided by an academic institution Primary Author: Jamie Pitlick, Pharm.D., Assistant Professor of Pharmacy Practice, St. Louis College of Pharmacy, St. Louis, MO; Email:
[email protected] Additional Authors: Matthew Pitlick Andrew Crannage Ericka Michalski Amie Brooks Purpose: Residency programs are not only responsible for the development of residents, but also development of all preceptors of the program. The American Society of Health‐System Pharmacists (ASHP) requires preceptors to meet qualification standards and receive ongoing development. The St. Louis College of Pharmacy is committed to post‐graduate education and training. One component of the College’s strategic plan is supporting the expansion of both College‐sponsored and regional residency programs, including post‐graduate year one and year two residencies. A vital component of such support is organizing and hosting ongoing preceptor development programs. Methods: The College has implemented a multi‐tier approach to preceptor development including regional conferences, focused on‐site programs, and the creation of a residency preceptor development syllabus. Programmatic needs are assessed each year through a combination of strategies that include an informal survey every July during the College‐sponsored regional preceptor orientation and an open‐ended request as part of the evaluation of continuing professional development activities offered throughout the year, including the preceptor development conference. Programming is designed to address varied perspectives including new preceptors, experienced preceptors, and program directors. The College has hosted one formal Resident Learning System (RLS) workshop. The College has also provided focused on‐site sessions for new and prospective residency programs in the region including programming on the four preceptor roles, qualifications of preceptors, quality feedback, and assigning objectives to learning experiences. Finally, a residency preceptor development syllabus has been created that will be used by College sponsored residencies and made available to regional programs to facilitate planning and tracking of program‐specific preceptor development efforts. Results: Since 2007, the College has been providing a platform for planning and supporting preceptor development for regional residency programs. Participation by regional preceptors continues to expand. Over the last 3 years, preceptor development programs have become more structured, beginning in spring 2011 with a Preceptor Regional Conference attended by 77 participants. Topics discussed included: continuing professional development and pharmacy, preceptor development, and conflict management. In January 2012, there were 95 participants at the formal RLS training session from programs across the region. During the preceptor development sessions in November 2012, 62 preceptors participated in programming designed to highlight key differences across the various learning styles residents might exhibit. Several new residency programs in the region have started and programs have increased the number of residents taken, both of these make it important for the College to continue with more structured programs for preceptor development. Conclusion: Regional conferences hosted by the College assist regional programs with preceptor development, allow prospective new programs a venue to learn more about RLS, seasoned programs a chance to review and enhance current preceptor development strategies, and provide a forum for networking among residency program preceptors and directors. In the future, the program will be further structured/organized and the preceptor development syllabus will be updated.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Implementation of a regional seminar presented by residents for preceptors and clinical pharmacists at an academic institution Primary Author: Matthew Pitlick, Pharm.D., Assistant Professor of Pharmacy Practice, St. Louis College of Pharmacy, St. Louis, MO; Email:
[email protected] Additional Authors: Jamie Pitlick Amy Dre Golden Peters Alicia Forinash Purpose: The purpose of coordinating this learning experience through an academic institution is to establish a platform designed to enrich the resident experience, promote networking between area programs, and provide an opportunity to showcase progressive continuing education (CE) for regional pharmacists. Residents develop ACPE‐ accredited programs intended to critically evaluate primary literature on a focused topic pertinent to the practice of clinical pharmacy. Presentations are given to an audience of pharmacy colleagues emphasizing important clinical/professional applications. Feedback from audience members enables residents to reflect with program directors on individual strengths and opportunities for additional development during the remaining portion of the residency. Methods: Residency seminar is coordinated through a College of Pharmacy committee which serves as a liaison to residency programs in the St Louis regional area. The planning process begins in the spring with establishing presentation dates. During the summer, participating programs are notified of dates and requirements for CE presentations. The resident will choose a controversial or emerging clinical topic in pharmacotherapy, retrieve all pertinent background information and primary literature, analyze the information and prepare a CE level podium presentation for pharmacists from the Midwest regional area. Topics submitted are reviewed for appropriateness and duplication from the previous two years. The residents participating are given a comprehensive review of the principles for developing a quality CE presentation. The seminar’s schedule is organized by topic and residency program. During the fall, all regional pharmacists and pharmacy students are invited to attend. Prior to each presentation the Continuing Professional Development committee at St. Louis College of Pharmacy reviews the programmatic information and slides for appropriateness of learning objectives and bias. Following individual seminars, immediate written feedback is solicited from the audience. Feedback from participating programs is reviewed and, if possible, incorporated into changes for the next year. Results: The seminar programming has been hosted by the St. Louis College of Pharmacy for over ten years. The majority of the resident programs participating are located in the St. Louis regional area with one program located nearly 130 miles away. The seminar program takes place over two half‐days. In 2010, a total of 33 residents representing 11 different residency programs presented. During these two half‐days there was an average of 128 attendants. Since 2010 there has been a steady increase. Overall, a 27% increase was seen in both resident (33 to 42, respectively) and residency program (12 to 14, respectively) participation from 2010 to 2012. Additionally, seminar audience attendance increased 27% from 2010 to 2012 (128 to 163 per half day, respectively). The topics include a range of disease management areas from both inpatient and outpatient clinical perspectives including endocrinology, cardiology, infectious disease, oncology, and critical care. Each resident presenter receives approximately 25 evaluation forms providing feedback. Conclusion: A regional seminar program has been developed for regional pharmacist CE and resident development. Attendance and participation in the programming has continued to grow over the last 10 years. The program continues to be refined with feedback and continued growth. The institution is currently in the process of establishing live webinar capacities for seminar presentations; an effort directly related to recent feedback from participants and individuals unable to attend the event. This will allow the institution to expand the scope of the seminar program’s impact. Residents, preceptors and pharmacists alike will see increased benefit as the program broadens its reach.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Use of a case‐based lunch‐n‐learn series for resident and student preceptor development Primary Author: Jenna Reel, PharmD, Community Pharmacy Residency Program Director, New Hanover Regional Medical Center, Wilmington, NC; Email:
[email protected] Additional Authors: Melissa Blair Lisa Edgerton Holly Snider Purpose: There are increasing requirements regarding preceptor development, at local, state, and national levels. Through Principle Four, the ASHP residency accreditation standard requires organizations to maintain a preceptor development program. Organizations and preceptors struggle to meet these requirements. Per the latest Commission on Credentialing report, almost 50% of PGY1 programs do not meet the preceptor development standard. Previously, at our organization, resident preceptor development was performed one‐on‐one and during resident preceptor meetings. Student preceptors primarily completed mandatory educational sessions offered through the schools. The goal is to streamline preceptor development and to create an interactive experience for all preceptors. Methods: Members of the residency administration group including the education pharmacist, met and brainstormed ideas for topics regarding lunch‐n‐learns, as well as other topics relevant to the organizations new preceptor development program. Based on previous feedback, it was determined that the focus should be on preceptor interaction through case‐based scenarios, and not traditional didactic lecturing. Data collection and analysis was also developed for each session in order to have measureable outcomes. This proposal was then presented to pharmacy administration and a coverage plan was developed in order to maximize attendance and to limit the amount of possible disruptions to the operation of the pharmacy. Results: It was determined to hold two lunch time sessions on the same day each month to optimize the number of attendees and reduce the amount of operational coverage needed. All lunch‐n‐learn sessions will help preceptors meet school of pharmacy precepting requirements, and are part of the residency preceptor development program. Two sessions have been held to date; one addressing plagiarism, the other discussing how to give constructive feedback. There was an average of 50% attendance out of 26 preceptors. Preceptors provided positive verbal feedback and liked the case‐based, interactive approach and the ability to apply information to real situations. Future sessions will include: identifying burnout, handling difficult learners, handling learners with emotional reactions, writing letters of reference, and managing oneself. A formalized survey has been developed and will be distributed to all preceptors to identify other topics of interest. It was decided to change the sessions from monthly to at least quarterly to allow time for session development and to maintain excitement in the program. Conclusion: The use of a lunch‐n‐learn interactive format has been successful in meeting student and resident preceptor requirements. Time commitment for developing session activities should be included in any discussions regarding such programs.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Integrated learning experiences to develop and evaluate precepting skills for pharmacy PGY1 residents Primary Author: Brian J. Sabol, PharmD, Clinical Pharmacy Specialist, St. Elizabeth Health Center, Youngstown, OH; Email:
[email protected] Additional Authors: Kristen Longstreth Purpose: As the number of colleges of pharmacy and pharmacy students has increased, growth in the number of preceptors to provide experiential training is necessary. Post‐graduate residency trained pharmacists will likely serve as preceptors for pharmacy students early in their professional career. Anticipating this need, a required one‐month rotation and a longitudinal teaching certificate rotation were incorporated into the PGY‐1 residency program at St. Elizabeth Health Center (SEHC) to develop experience and skill in precepting pharmacy students. Methods: During a one‐month learning experience, the resident serves as the primary preceptor for an advanced practice experiential pharmacy student. This learning experience incorporates the precepting model developed, refined, and utilized by members of the Clinical Pharmacy Department of SEHC and is integrated within the third Internal Medicine required rotation in April of each year. Many of the learning activities of this rotation, which were developed specifically to help the resident achieve the goals and objectives related to serving as a preceptor include: preparing a rotation calendar and syllabus, orienting the student to the rotation and hospital, modeling, coaching, and facilitating the student’s performance, coordinating and facilitating formal and informal disease state topic discussions, and providing verbal and written evaluations and feedback of the student’s progress. Beginning in 2010, longitudinal participation in a local college of pharmacy teaching certificate program has provided additional training in experiential teaching. Through this program, the resident attends several teaching and learning seminars which cover the following topics: orienting learners to a clinical teaching site, precepting goals and skills, and evaluating learner performance. In addition, the resident completes a preceptor training program at the college of pharmacy. Results: During the third Internal Medicine rotation, experienced preceptors provide coaching on practice‐based teaching and facilitate the resident’s role as the primary preceptor. Feedback is primarily focused on how the resident can improve their precepting skills. At the end of the one‐month rotation, the resident’s performance as a preceptor is evaluated using ResiTrak goal R5.1 (provide effective medication and practice‐related education, training, or counseling) and a custom goal (exercise teaching skills essential to pharmacy faculty). This custom goal contains several objectives related to preceptorship: serve as a preceptor utilizing the four roles employed in practice‐based teaching; develop a teaching experience for a practice setting; and design an assessment strategy that appropriately measures specified educational objectives for the rotation. The resident’s ability to develop and facilitate a formal topic discussion is evaluated with criteria based checklists from goal R5.1. At the rotation midpoint, the pharmacy student assists with completing criteria based checklist R5.1.3 (use skill in the four preceptor roles). The pharmacy student also provides a written evaluation (following College of Pharmacy protocol) at the end of the rotation. The resident receives a teaching advisor for the teaching certificate program and is evaluated quarterly for this longitudinal rotation. Conclusion: Formal learning experiences to provide an opportunity to develop precepting skills were integrated into a required one‐month rotation and a longitudinal teaching certificate program. The advantages of this approach include utilizing a successful preceptor practice model already developed and revised by the site after more than a decade of experiential teaching and the guidance of experienced preceptors who oversee the rotation. This approach has provided valuable experience to the resident and increases their skill and confidence to serve as a preceptor for experiential pharmacy students. Feedback from both the residents and the pharmacy students has remained positive for the rotation.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Mentoring the Next Generation of Pharmacy Leaders Primary Author: Sara Szafran, PharmD, Pharmacy Clinical Manager, Novant Health, Winston‐Salem, NC; Email:
[email protected] Additional Authors: Debra Lindley Purpose: Educational and career mentoring plays a vital role in the successful completion of a pharmacy residency program. It provides the resident a network of support for the challenging transition into higher education and their future workforce experience. From this network of personal developmental relationships the resident is able to gain confidence, essential leadership skills, and key aspects in functioning effectively on a healthcare team. Establishing and ensuring that each resident has the opportunity for support during the learning process may be challenging. The increasing workloads and higher demands on experienced pharmacist have made mentorship more difficult to perform in an effective capacity. Methods: At Novant Health the beginning of each residency year entails a month long orientation process. During that process new residents are educated on various points of the organization and are assigned a mentor. It is also during this phase that the importance of communication is expressed. Communication with their assigned mentor is vital. When questions, comments and concerns arise the mentor is there to address these items which are very essential for the learning process, well‐being of the resident and the continued growth of the organization. Results: Results: As a result of these assigned mentorships, residents are able to establish a personal professional relationship. They are able to freely discuss with their mentor personal and professional topics that occur throughout the year. This helps alleviate stress, maintain focus on patient care and better their educational process. Conclusion: Conclusion: By passing along good mentoring skills now, we are able to achieve good mentors for the future. Having mentors for pharmacy residents produces a pharmacist with more confidence and better leadership skills. The end result is not only beneficial for the educational and well‐being of the resident but also better for patient care.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Integration of community service into a pharmacy residency program Primary Author: Rachel Thomas, BS, PharmD, Pharmacist II, New Hanover Regional Medical Center, Wilmington, NC; Email:
[email protected] Additional Authors: Michael Edgerton Jenna Reel Purpose: As a Studer model organization, there are four standards that every hospital employee at New Hanover Regional Medical Center (NHRMC) is expected to uphold and these same standards apply for pharmacy residents: Teamwork, Ownership, Communication and Compassion. The integration of community service into the pharmacy residency program not only helps the residents achieve these standards, but it also increases their understanding of the needs of the community they are serving, but allows them the opportunity to give back to the community as well. Methods: All pharmacy residents are required to participate in community service events throughout the residency year. The PGY1 and PGY2 ambulatory care residents participate in one community service event every quarter. The PGYC resident participates in one community service event monthly. The community residency director works closely with the hospital outreach coordinator in order to give the residents a variety of community service opportunities throughout the year. Some of these community service opportunities include: blood pressure, cholesterol & diabetes screenings, cardiovascular risk assessments, and medication education. Furthermore, residents can volunteer to participate in additional community service programs that include brown bag events, medication take backs, Habitat for Humanity, or other activities that benefit the community. Results: Pharmacy residents have completed over 112 total hours at 14 different events throughout the 2012‐2013 residency year. Event locations have included: nursing homes, assisted living facilities, senior centers, health departments, elementary or high schools, health fairs, and free community clinics. Conclusion: Pharmacy resident participation in community service events at NHRMC allows the pharmacy resident to broaden their residency experience by exposing them to various patient populations within the area they serve. Community service should be incorporated in every pharmacy residency program as a learning experience.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Incorporating a resident candidate self‐presentation into the interview process Primary Author: Suzanne M. Turner, Pharm.D, Education and Residency Coordinator, Lee Memorial Health System, Ft Myers, FL; Email:
[email protected] Purpose: The purpose of the project was to develop the incorporation of a ‘resident candidate self‐presentation’ during the interview process for a PGY‐1 residency program. Our Resident Advisory Council (RAC) wanted to develop a well integrated interview process for our new PGY‐1 Residency Program. All members of the RAC had input into the design of the one‐day interview. Many of the preceptors felt that assessing the candidates’ presentation skills was a crucial piece of the interview process that would not be captured in personal interviews. The interview process was designed to include a case study to assess a candidate’s clinical base. The RAC agreed that having the resident candidates give a presentation about themselves would prevent the resident candidates from being asked the same questions by different interviewers throughout the day. Methods: We designed our resident candidate interview to include a 15‐minute presentation focused on the resident candidate. The Residency Program Coordinator (RPC) solicited questions for the presentation from the members of the RAC. Questions came from current interview questions used for hiring pharmacists and from other external searches for common interview questions. The resident candidates were provided the finalized list of questions and instructions at least a week prior to the interview. The resident candidate had to provide a powerpoint presentation for their presentation during the Group Interview portion of the day. The questions the candidates were asked to answer included questions regarding their past experiences and expectations of residency. Examples include: What makes you a good candidate for our program? What are your expectations of a residency? What was your favorite rotation and why? Other questions were behavioral questions such as: Describe your two greatest strengths and tell how you have used these to accomplish goals to get to this level of your new career. Briefly describe the most significant responsibility you have had and what it taught you. All members of the RAC were encouraged to attend the presentations, which were scheduled back to back, and lunch was provided. Results: During the first year of interviews, the RAC felt that the resident candidate self‐presentation was the most valuable part of the interview process. We were able to see that many of the responses from the candidates were the same, and those that were different stood out. The consistency of the answers also helped us as a new program to understand the motivating factors for completing a residency and what the candidates expected to gain from the experience. In the second year of interviews, we also added additional questions that we asked each resident so that we could assess their response on a spur of the moment question. The questions asked by the preceptors were: What does failure mean to you? Tell us about a time where you gave someone the benefit of the doubt and you were glad you did. Give us an example of a project where you worked on a team and took on a leadership role. Give us an example of a project where you worked on a team and did not have the leadership role. Conclusion: Including a resident candidate self‐presentation in the interview process for PGY‐1 pharmacy residents adds significant value to the interview process. Our system has identified this section as the most meaningful part of the resident evaluation. We will continue to modify the questions as needed. In the future we will consider limiting the time to allow for more residents to be interviewed in a day.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Who wants to be an academic? learning the in’s and out’s of a career in academia Primary Author: Kristin Watson, Pharm D, BCPS, Associate Professor, Residency and Fellowship Program Coordinator, University of Maryland School of Pharmacy, Baltimore, MD; Email:
[email protected] Additional Authors: Mary Lynn McPherson Purpose: The University of Maryland offers thirteen residency and two fellowship programs. Many of our trainees are interested in learning more about a career in academia or pursuing a career in academia following post‐ graduate training. Residents and fellows may not have a complete understanding of the roles and responsibilities of School/College of Pharmacy faculty. Our objective was to offer our residents and fellows an overview of a career in a pharmacy practice department and to provide them with opportunities to meet various faculty and administrators in our School. Methods: During the 2011‐12 training year, a “Life in Academia” was created and offered to our trainees; this program was offered again in 2012‐13. Trainee attendance was voluntary. Through this program, three one‐hour interactive discussion sessions were offered. In the first session, the Dean and Chair of the Department of Pharmacy Practice and Science (PPS) met with trainees to discuss their roles within the school and what trainees should consider when applying for a faculty position. In the second session, an assistant and an associate non‐ tenure and an associate tenure track faculty member from the PPS department discussed their career paths and their roles and responsibilities. These faculty reviewed the promotion process and the difference between tenure and non‐tenure track positions. The third session differed during each training year. In the first year, the promotion process was reviewed in detail. In the second year, various administrators at the School reviewed their roles and career paths. This session was led by the Associate Dean of Student Affairs, Assistant Dean of Experiential Learning, Vice‐Chair of Academic Affairs and Residency and Fellowship Program Coordinator. In the 2012‐13 training year, faculty mock interviews were offered to trainees actively pursuing faculty positions. Results: These programs were well attended and the sessions were well received by the trainees, administrators and faculty who participated. The trainees attending these sessions were consistently engaged in the discussion. Three residents participated in the mock‐faculty interviews during the 2012‐13 training year. The three “interviewers” were full‐time faculty members at the Associate Professor or Professor level in the PPS department. Conclusion: The “Life in Academia” series provided the residents with experiences to learn more a career in academia. These sessions served as opportunities for trainees to network with administrators and faculty at our SOP. This type of program may assist residents and fellows in determining if they will pursue a full‐time faculty position after completion of their post‐graduate training program.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Development of a combined practice management, drug use policy rotation to improve achievement of PGY1 residency outcomes and distribution of precepting responsibilities Primary Author: Laurie Whalin, PharmD, BCPS, Clinical Manager, New Hanover Regional Medical Center, Wilmington, NC; Email:
[email protected] Additional Authors: Mark Allen Melissa Blair Purpose: The PGY1 residency program was previously structured to include a required, four‐week practice management rotation precepted by the director of pharmacy as well as three elective rotations, one of which was drug use policy precepted by the pharmacy clinical manager. During the practice management rotation residents were assigned multiple projects from the clinical manager including residency requirements such as completion of a new drug monograph, regardless of selection of a drug use policy elective. Issues identified with previous structure included time allotted for assigned projects versus rotational responsibilities, lack of incorporation of feedback from non‐preceptor and coordinated evaluation of rotational objectives. Methods: Restructuring of the residency program was developed and approved by the residency administration group and included combination of the practice management and drug use policy rotations into a six week required rotation co‐precepted by both the director of pharmacy and clinical manager. Elective rotations were decreased to two per resident, and drug use policy was removed as a potential option. For the new, combined practice management/drug use policy rotation a small group consisting of the two new co‐preceptors and the PGY1 residency program director, outlined and identified applicable rotational objectives. Core rotational responsibilities that correspond to each rotational objective were then developed, with individual subject matter varying from resident to resident. Roles of each co‐preceptor were defined and the evaluation process designed. Results: Rotational objectives for the combined practice management/drug use policy rotation consist of developing a systems‐based approach to patient care, understanding and improving the medication use process, enhancing leadership and practice management skills, as well as advancing teaching, problem solving, verbal and written communication, and literature evaluation skills. Core rotational responsibilities were broken down into five core elements and consist of departmental leadership activities, systems based care, formulary process, medication safety and literature evaluation. Examples of projects under each core element include, participation in the manager on call system, computerized physician order management order‐set review and approval, preparation of a formulary review including a formal cost‐analysis and institutional wide educational plan, participation in the adverse drug event evaluation process, and review of a newly published guideline and summarization of relevance and applicability to institution, respectively. Co‐preceptorship of the combined rotation utilizes the clinical manager as the main project based preceptor giving the resident one definitive resource, and the director of pharmacy as the longitudinal, leadership focused preceptor. Evaluation of the resident’s progress towards meeting rotational goals and objectives are assessed collaboratively by both preceptors midway through and at the end of the rotation. Conclusion: Development of a required, combined practice management/drug use policy rotation co‐precepted by pharmacy administrators can assist in meeting leadership focused PGY1 residency goals and objectives while balancing precepting responsibilities. Creation of core rotational requirements and designated preceptor roles is essential for successful implementation.
Poster Abstracts Alphabetical Order by Primary Author Last Name
Title: Improving Qualitative Resitrak Evaluations Utilizing a Rotation Specific Objectives Spreadsheet Primary Author: Roger Yamaguchi, Pharm.D., RPD, Swedish.Medical Center, Seattle, WA; Email:
[email protected] Purpose: Increase the quality and quantity of both resident and preceptor evaluations in Resitrak by providing the goals to be evaluated, the I/O learning objectives, in a portable, storable method and allowing for easy transfer into Resitrak. Methods: A spreadsheet was developed in 2012 combining the Resitrak residency goals crosstab excel worksheet with the RTP PGY1 Goals Objectives document in a newer spreadsheet format. Extra space is given to allow for preceptors/residents to make comments germane to the goals being assigned and evaluated, faster lookup of the instructional objectives, and allow for longtitudinal update. Design simplicity allows for customization by users, then cut‐paste import into Resitrak. Results: Approximately 45% of the preceptors utilized this new tool. The number of blank fields in the Resitrak evaluations dacreased by 35%. One preceptor greatly expanded the spreadsheet to include other details pertaining to her rotation. The major limitation of this spreadsheet based tool is the format ‐ being a spreadsheet design, it is difficult to use spontaneously (requiring at least a tablet PC). Many preceeptors voiced a desire for a smart phone based application. Conclusion: This speadsheet has proven a useful tool for both preceptors and residents to provide better qualitative evaluations in Resitrak, and record ongoing improvement in rotation performance.
