Transcript Slide Set 2 - Arkansas Pharmacists Association

Pharmacy Precepting Pearls of
Practice
Providing Criteria-Based
Feedback
LANITA S. WHITE, PHARM.D.
ASSISTANT PROFESSOR, DEPARTMENT OF PHARMACY PRACTICE
DIRECTOR, 12 TH STREET HEALTH AND WELLNESS CENTER
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Objective
Explain how to provide timely, constructive, and
criteria-based feedback effectively.
What is it and why do
we do it?
A Few Definitions…
Provide
Supply; Make adequate preparation for; Make available for use
Criteria
A principle or standard by which something may be judged or decided
Base
Have as the foundation for; Use as a point from which development can occur
Feedback
Information about reactions to a product, a person's performance of a task, etc., used as a basis
for improvement
What is Criteria-Based Feedback?
Making available for use, by the student or resident,
information about performance of assigned tasks to be used
as a basis for improvement guided by the principles and
standards set forth by the college or residency program.
It is not…
Encouragement – Vague and does not focus on students’ skill development
Evaluation – Renders judgment, often occurs at the end of an activity
(summative) and hinders remediation, is often expressed in a normative fashion
comparing students, and can be vague
Constructive criticism – Describes the negative behaviors or actions of another
and the effects that this behavior has on others; is grounded in empathy but it
can emphasize the negative and ultimately create communication barriers
Self-reflection – Without feedback may not help students notice behaviors that
they need to improve
Reminder – It is…
Making available for use, by the student or resident,
information about performance of assigned tasks to be used
as a basis for improvement guided by the principles and
standards set forth by the college or residency program.
Why is it necessary to do this?
ACPE – Accreditation Council for Pharmacy Education (2016)
(Released February 2015)
Didactic Curriculum:
◦ Standard 24: Assessment Elements for Section I: Educational Outcomes
◦ Standard 25: Assessment Elements for Section II: Structure and Process
Advanced Pharmacy Practice Experience:
◦ Appendix 2: Expectations within the APPE curriculum
◦ Colleges and schools assess student achievement of APPE competencies within their assessment plans
using reliable, validated assessments. Formative feedback related to specific performance criteria is
provided to students throughout the experience. At a minimum, performance competence is
documented midway through the experience and at its completion.
Why is it necessary to do this?
ASHP – American Society of Health-System Pharmacists
(Released September 2014)
Standard 3: Design and Conduct of the Residency Program
◦ Standard 3.4: Evaluation
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Initial Assessment
Formative (on-going, regular) assessment
Summative Evaluation
Resident’s Development Plan
Student vs. Resident…
What’s the difference?
Student or Resident – Where should they
be, what should they know?
STUDENT
RESIDENT
 Learning where to find the information
 Should know where to find or how to find it
 Reviewing basic concepts of disease states
 Should be able to teach basic concepts of
disease states
 Learning how to put pharmacy school
knowledge into a usable format
 Should be able to manage several
patients/tasks with practice
 Learning how to put pharmacy school
knowledge into a usable format
 Should be able to manage several
patients/students/tasks
Providing Feedback
Tips for successful feedback sessions
Be prepared with clear examples and
notes for clarity
Problem solve together, provide
suggestions as preceptor
Open meeting effectively
Assess recipient’s understanding and
acceptance of the feedback
Encourage participation and selfassessment
Allow for questions and clarification
Reinforce desired behaviors
Acknowledge perspective and feelings
Clearly define undesired behaviors
Close the meeting effectively
Tips for successful feedback sessions
Be aware of yourself and how you are perceived:
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Demonstrate positive regard for recipient
Involve recipient in process
Focus on specifics, not generalizations
Use descriptive, non-judgmental language
Label subjective data as such
Focus on remediable behaviors, feasible solutions
Limit amount of feedback to three or fewer observations
Be aware of own subjective feelings and assumptions, and manage them appropriately
Listen, understand recipient’s perspective and feelings
Addressing Performance
Issues
Addressing Performance Issues
Acknowledge
awkwardness and
discomfort
State performance
Issue
Elicit and listen to
individual’s self
assessment
Acknowledgment
or Dismissal of
Problem
Addressing Performance Issues
Acknowledgement of the Problem
Step 1
Step 2
• Define and analyze the problem together
• Problem solve together
• Make a plan to address with defined outcomes and timeline
Step 3 • Document feedback, plan and time to re-address
Addressing Performance Issues
No Acknowledgement of the Problem
Step 1
Step 2
• Recognize/control your own emotional reaction
• Acknowledge individual’s emotions and perspective
• State your perspective, make a plan to address with defined
outcomes and timeline
Step 3 • Document feedback, plan and time to re-address
Let’s Practice
P4 Student on APPE Rotation
You require students to obtain a complete medication history
from patients as part of their fourth-year advanced pharmacy
practice experience at your site. During the discussion of the
patient, one of your students clearly only documented the
medication names and did not evaluate the dose, timing, reason
for use, patient adherence or patient understanding of the
medications, which was a vital component of the instructions.
You are upset because this student has neglected this
information in the past, and you have told him or her to include
it in the future. You abruptly end the conversation and tell the
student to go figure out what is missing and return to you when
they are ready to have an informed discussion.
P4 Student on APPE Rotation
Review student’s understanding of expectations to ensure clarity
Ask what elements the student/resident thinks should be included and why
Discuss elements preceptor thinks should be included and why
Reconcile the differences and reasons
Point out exact missing elements and discuss what should be different –
problem solve
If possible, re-attempt and re-evaluate the exercise as soon as possible and
reinforce positive behaviors
Document and compare periodically and at the end
PGY1 Resident on Rotation
You are a residency preceptor at your hospital. You ask the
resident on your rotation to develop a plan for a new
service you plan to start. The resident submits the plan to
you, but it does not include the specific features that you
asked for. You perceive this resident to be sensitive, and you
do not want to sound unappreciative or critical. So you tell
the resident, “Thank you for working on this. There are a
few things missing, such as how patients can be referred to
us, but it looks good.”
PGY1 Resident on Rotation
Review the specific elements you asked for and what has been
presented
Encourage self-assessment
Determine which elements are missing and why
Problem solve to get the desired results
Assess understanding
Be open to comments
Review and Redo
Consider how you would evaluate…
Student/Resident that does “everything right”.
Student/Resident that “knows it all”.
Student/Resident that seems to need additional help or even remediation.
Residents and students on rotation at the same time.
Students on rotation at the same time.
Evaluating presentations and in-services.
Evaluating personal behaviors that are inappropriate.
Students/Residents with medical/mental complications.
Question
All are tips for successful feedback sessions except:
A. Encourage participation and self-assessment
B.
Provide vague examples of expectations
C.
Reinforce desired behaviors
D. Acknowledge perspective and feelings
References
Accreditation Council for Pharmacy Education Standards 2016 - https://www.acpeaccredit.org/deans/StandardsRevision.asp
American Society of Health-System Pharmacists Accreditation Standard PGY1 http://www.ashp.org/DocLibrary/Residents/ASO-PGY1-Residency-Accreditation-Standard.pdf
Providing feedback to enhance pharmacy students’ performance. Am J Health Syst Pharm December
15, 2007 64:2542-2545; doi:10.2146/ajhp070316
Chur-Hansen A, Koopowitz LF. Formative feedback in teaching undergraduate psychiatry. Acad
Psychiatry. 2005; 29:66–8
Kern DE. Confronting Individuals About Performance Problems. Johns Hopkins Faculty Development
Program for Clinician-Educators. (Supplement to Handout)
Eliciting Feedback. Johns Hopkins Faculty Development Program for Clinician-Educators. (Supplement
to Handout)
Staying Alive in Principle Five: Ideas on Where to Begin;
http://www.ashp.org/DocLibrary/Education/Webinars/Pearls-Residency-Preceptors.aspx
Pharmacy Precepting Pearls of
Practice
Providing Criteria-Based
Feedback
LANITA S. WHITE, PHARM.D.
ASSISTANT PROFESSOR, DEPARTMENT OF PHARMACY PRACTICE
DIRECTOR, 12 TH STREET HEALTH AND WELLNESS CENTER
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Questions?
KIM YOUNG, PHARM.D., BCPS
DEBBIE WAGGONER, PHARM.D., BCNP
LANITA WHITE, PHARM.D.