Mid-Point Reflection

Introduction

Although half the time to the deadline has surpassed, I don’t feel like I’ve completed half the work! There is much left to do! I have really enjoyed referencing the “syllabus” for the Teaching Certificate Program. It’s easy to understand and gather what the expectation is and how to accomplish the goal. I look forward to my selective experiences as they are with College of Pharmacy faculty I haven’t worked with before, so I’m anticipating a new and refreshing experience.

Ability to Evaluate/Assess Learners

Up to this point, I have had the opportunity to have teaching experiences with patients and UAMS clinical pharmacy staff. My ability to assess the patient’s learning was very successful. The measurement techniques I used were the teach-back method and a real-time clinical algorithm. This verbalized the patient’s understanding of adherence and the disease state, while also having an answer during “un-rehearsed” moments. The real-time clinical algorithm allowed me to interpret how the patient would react when life was not perfect. This also reinforced the patient’s utilization of resources, which was a positive outcome of the real-time clinical algorithm that I had not expected. This particular patient was of low health literacy, so hearing the gaps when the patient repeated back to me the instructions queued me to continue to repeat and reinforce the important details. I used a counseling tip sheet to remind myself what the patient needed to learn regarding the new medication regimen. For my journal club presentations, my assessment of their learning was quite poor, as the majority of my evaluations were not completed. I provided the group a paper evaluation with a survey regarding my presentation, delivery skills, and what the audience learned. The majority of the learners filled out the ranking or scale portion of the evaluation, but not the open ended comments. This has motivated me to more strictly stick to my learning goals of utilizing a wide variety of teaching strategies. I plan to incorporate more interaction and planted feedback within the journal club presentation in addition to the end.

Ability to Provide Feedback to Learners

Up to this point of my residency year I have not had the opportunity to precept pharmacy or medical students. I also have not been on an interdisciplinary team where members provide a presentation so I could give feedback. I have had three occasions where I’ve been able to provide feedback to my co-residents for their performance on their journal club presentations. This, at times, is a struggle because I feel our relationship must be balanced with the delivery of criticism. I have used the sandwich method, for theses opportunities. I generally provide a positive about their speed, clarity, and overall presentation. I follow with opportunities to grow regarding presentation format, suggestions to make the presentation more concise, or pace, speed, and confidence. I finish the feedback with praise regarding a specific clinical connection that they explained very well.

I look forward to the opportunity to provide learners feedback, but I know it will be challenging. This piece of being a preceptor or teacher appears to be one of the most difficult parts. I plan to implement some of the ideas provided by the Dr. David Caldwell in his recommendation to use documentation. At a half-way point on his rotation, he would provide areas of growth for the student, and then asked the student to design a development plan for that particular deficiency. It was then clear to both the student and preceptor, how the deficiencies would be corrected. I anticipate this interaction to be uncomfortable and possibly difficult to navigate at first. I do believe with more practice and education on the subject, I will be able to clearly express to a student areas of opportunity.

Plans for Improving Teaching Abilities and Progress toward each Teaching Goal

In preparation for my mid-point meeting with my TCP mentor, I outlined my accomplishments and deficits for completion of the program. I have plenty of work to do! The great thing about laying all of the tasks out on one page allows me to make plans to fill in all the holes. I now know I need to schedule two opportunities for observation, and those are the only tasks I have remaining. I was able to brainstorm with my mentor innovative teaching observation opportunities like Internal Medicine Grand Rounds, a drug representative dinner, a presentation during my management rotation, or a webinar. Finding innovative presentations will help me improve my teaching abilities so I can gather many successful ways of communicating presentations, keeping the audience engaged, and how to handle different types of audiences too. Additionally, after I saw what deficiencies I had remaining for the portfolio, I reviewed my progress towards my teaching goals. I reviewed line by line the expectation I wrote out for myself, as well as what I had implemented. I made several notes and plans on which teaching opportunities would have each goal implemented. I made sure to assign which goals would use each specific teaching and assessment technique. Below I have explained my progress and intention for each goal:

Provide multi-dimensional instruction and resources for the purpose of active learning

This goal was specifically designed for my learning opportunity in the spring for UAMS COP Therapeutics I Recitation. I plan to create a survey for the Spring Recitation class to complete at the beginning of the semester which will uncover the students’ favorite methods of learning/teaching, as well as historical examples of most and least effective learning. I will familiarize myself with mobile apps, webinars, online modules, PollEverywhere, and my current arsenal of RxPrep summary materials so I know the variety of formats I have to offer for students. I also plan to provide students a summary of the week’s disease state with additional resources students can access on their own. For the first several weeks, I will also demonstrate via role playing what presenting a patient on rounds looks like. I plan to use a different teaching style every other recitation week, to provide a variety of instruction techniques to the student. I plan for this goal to be evaluated by students at the mid-way point, as well as at the conclusion of the semester.

Deliver effective teaching by providing concise and relevant presentations that bridge audience knowledge from didactic to application

I have made great progress on this goal since beginning my residency. My progress has been in pieces as I have improved on providing concise presentations, and simplifying my explanations to need-to-know only. I feel I have also made leaps and bounds regarding providing relevant information. Especially when I had the patient counseling teaching experience, I realized, due to the patient’s health illiteracy, I had to reduce my explanations and instruction to a level that the patient could grasp. This was difficult for me at first, and had to make decisions on the fly with what to include and what to leave out. This was though a great opportunity to reduce the clutter and focus on the relevant information. I plan to use this goal for my additional teaching experiences and assessment my ability to provide relevant applicative information by using the sticky note method Dr. Franks showed up in the winter seminar, as well as, the one minute paper, the single most important lesson learned, and algorithm guided scenario. For example, at the next journal club presentation, I will use the sticky note method, and ask “How is hypertension relevant to your practice?” and find themes within the clinicians. Then I’ll follow with “How will you implement this new information about hypertension into your practice?” This will hopefully tease out the relevant information I presented and an approach to its application.

Strengths/Weaknesses

I continue to agree with the strengths and weaknesses from my original goals which indicated my strengths as organization, preparation, designing and formatting of visual aids, as well as, energy behind my presentations. My continued weaknesses have been being unfamiliar with technology as a tool to teach with, and providing too much information. These are areas I will continue to strengthen and develop skills to improve. Additional strengths I have seen when it comes to achieving my teaching goals is I am able to create teaching opportunities without being prompted. It has been a lot of fun teaching other health care professionals on the fly, after work, during holidays, or after meetings. This is something I think has grown into a strength because I am not intimidated by the spontaneity of these moments. Additional weaknesses that I’ve seen in my teaching performance, is not providing a detailed evaluation form that reflects the characteristics of my teaching goal. For my journal club evaluation, I created a very generic version that I thought at the time fit my goals. Upon debriefing after the journal club, I realized the feedback I collected did not match my goals. This is something I will change moving forward. I will also commit more time to preparing for teaching opportunities, documenting, and uploading onto my portfolio every month.

Concerns and Challenges

Some concerns I have moving forward are having enough time to allot to the completion of my teaching portfolio. I anticipate that I have underestimated the time it takes to edit, design, upload, and proof the portfolio. This is why I have identified this as a weakness and will hopefully make monthly progress on this. I also have concerns that I will not have an opportunity to precept pharmacy students by the end of my residency. My last two months of my residency are currently tentative and unsure of which preceptors currently are assigned students. Once my final two rotations are scheduled and I can determine if I have an opportunity to provide feedback to a student on rotation; if I don’t have the opportunity I will likely have to practice this skill during recitation. It is important to me to get many opportunities to provide feedback to students, because I know it will take lots of practice to execute the skill effectively. I also want to useful to my future students and employees and know how to provide effective feedback.

Summary

Overall, this mid-point reflection has helped me realize I am making progress towards my pre-determined goals, I have encountered additional obstacles, and have deficiencies to work toward improving. Organizing all my expectations and making sure I have an opportunity scheduled was probably the most helpful piece of knowing what I have left to accomplish a completed portfolio. I will move forward knowing I must allot time toward these goals, and stay on top of the documentation required for each portion of the portfolio. I look forward to facilitating recitation as I know I will enjoy working with the same group of students each week and continuously evaluating their growth. I also look forward to utilizing technology with teaching as this is something I’ve never utilized.