Individual Activities

Date: November 2020

Length: 30 days

Learners: 1 APPE pharmacy student from UAMS

Preparation Time: 1 hour each morning developing a plan for the day, preparing materials, as well as daily interactions with the student. Adapted each day based on the amount of patients on our service.

Comfort Level: Since this was my second month of internal medicine, I was comfortable with the rotation but I was also aware of how busy the month could be. I was a little stressed out trying to think of how I was going to handle keeping up with the team while also trying to make sure I was being an involved preceptor and providing the best learning experience.

Teaching Materials:

• Example notes

• Topic discussions

• Frequent open-ended questions

• Patient charts and medication lists

Methods to Assess Learner Understanding: I was working in the same office as my student so every morning we would discuss the patients that we worked up prior to talking with my preceptor or the team. I would ask open-ended questions based on the information in the charts and on the medication lists which would allow for discussions. The student would also ask me questions throughout the day which would sometimes lead to the student looking up the answer and giving a mini topic discussion.

Teaching Goals Addressed:

• Goal 1: Promote the engagement of learners in active discussion and critical thinking by using a variety of learning activities.

• Goal 2: Develop effective communication skills to deliver information to small and large groups.

• Goal 3: Effectively provide constructive feedback to learners including strengths and areas for growth.

Reflection:

This was my first experience being a co-preceptor and I was given lot of autonomy which was appropriate due to the sharing of my office with the student. My student had previous rotations at the VA which was a benefit as she was already familiar with the computer system. This allowed for her to start working up patients on the first day and as the month progressed I would add a couple more patients to her list as long as she felt comfortable. Since this was her first internal medicine rotation, I provided her with note examples for the variety of notes we would be writing (discharge, anticoagulation, medication reconciliation, etc.). I would edit her notes prior to my preceptor reviewing them and I used this as a way to assess her understanding to see if she had incorporated previous feedback.

One challenge that I experienced during this rotation was that in the beginning my student did not view me as one of her preceptors since it was also my first day on the rotation and I was not her initial point of contact. She was unsure if she should go to me or my preceptor with questions or concerns, which led to some miscommunication and awkward situations. This was a struggle that took a little over a week to work out because I did not want to cause any confrontation but eventually we were all able to have a conversation and clarify our roles. As I move forward in my career, I plan to spend more time on the first day introducing the rotation, explaining what the expectations are, and defining the roles of both myself and the student.

Although there were some challenges in the beginning, this was a very valuable teaching experience for me. I had to learn to adjust my teaching style every day based on how busy the team was. For instance, when we were extremely busy I had to make sure that all the work was being completed and sometimes time would only allow for small topic discussions based on what was seen in the charts. On days that we had more free time, I was able to ask more open-ended questions and have more in depth discussions in order to assess the student's understanding. In the future I also wish to incorporate a pre/post survey in order to evaluate the overall progress of the student throughout the course of the month.

Diabetes

Date: September 25, 2020

Length: 1 hour

Learners: 2 APPE pharmacy students from UAMS

Preparation Time: 1 hour reviewing material

Comfort Level: Diabetes is a disease state that I have been working with since pharmacy school. I had two rotations as a fourth year pharmacy student in a family medicine clinic that provided me with multiple opportunities to provide disease state management to patients with diabetes. Due to my experience, I felt very confident leading this topic discussion.

Teaching Materials:

1. Patient case

2. Handout outlining classification, treatments, and prevention strategies

3. Additional questions not provided to the student

Bugs & Drugs

Date: October 22, 2020

Length: 1 hour

Learners: 2 APPE pharmacy students from UAMS

Preparation Time: 1.5 hours reviewing material

Comfort Level: This particular topic discussion covered a large variety of infectious diseases and I feel like to topic as a whole is also very broad. Due to this, I was not as comfortable leading the discussion compared to the one covering diabetes. I was concerned that I may not be able to answer all of the questions that the students had in a clear and concise manner. However, knowing that this topic was not a strong suit of mine, I prepared for a little bit longer in order to become more familiar with the cases to help increase my confidence.

Teaching Materials:

1. Patient cases (3)

2. Handout summarizing guideline recommended treatment for the different infectious diseases

3. Additional questions not provided to the students

Reflection

These one hour activities, conducted through Microsoft Teams, are provided by the pharmacy practice residents at the Central Arkansas Veterans Healthcare System. The residents choose prevalent disease states and provide students with cases to work up in order to facilitate a discussion. The cases used were developed by previous pharmacy residents and were updated in order to make them current and relevant.

There were a series of questions at the end of each case used to guide discussion and assess the learner’s understanding of the topic. Some of the answers were clear but others had multiple correct answers which led us to have a more detailed discussion on treatment options. The responses provided by the learners helped me gauge how knowledgeable they were and then direct the discussion based on knowledge level.

Through these activities I was able to address my first teaching goal of promoting the engagement of learners in active discussion and critical thinking by using a variety of learning activities. I would ask the students to read the cases aloud and if I noticed that one student was not participating as much I would call upon them by name to help get them engaged in the discussion. The patient cases were a great way to promote critical thinking because they provided real life examples in which the learner had to decide which parts were relevant. Some cases also needed the calculation of CrCl, LDL, ASCVD risk score, and more which required critical thinking in order to determine which treatment would be best for the patient.

Another goal I was able to address was developing effective communication skills to deliver information to a small group. I had to come up with ways to deliver the information to students and keep them interested, especially since the discussions were held virtually. I used direct questioning and gave examples of what I have seen in practice. For the first topic discussion students vocalized their growth in knowledge through this topic discussion and stated that the cases were very helpful in reviewing these particular disease states. For the topic discussions thereafter, an evaluation form was provided to assess the effectiveness of the activity and provide a way for learners to give recommendations for continued improvement.