A Preceptor's Top Tips to Other Preceptors for a Successful Rotation

FEBRUARY 28, 2017
There are several ways that preceptors can ensure a successful and rewarding rotation for students. 

Foster an environment of mutual respect and learning. Remember, not only will these students be pharmacists soon (often in under a year), but they will go on to do great things, complete other graduate degrees/residencies, become directors, etc. They could be your boss someday! There is nothing worse than a preceptor that tries to give the impression they have nothing to learn from the student. The first day of rotation, I like to tell the student that I will teach what I know and have learned from experience, I hope to learn from them, and if neither one of us knows then we can look it up and both learn. The most important thing is that we know what we need to know before it reaches the patient. By starting in this way, you can ensure the student feels comfortable speaking up, trying to answer questions even if they might be wrong, and developing the skills to make conclusions on their own – not relying on others for answers. I think role-modeling this behavior is important too so that we can produce pharmacists who search for the right answer for the patient and doesn’t ‘shoot from the hip’ when answering questions.
Encourage impromptu topic discussions: I personally don’t like formal topic discussions at all – I think when they are isolated, once-weekly discussions the student not only gets bored (they have been doing this on all of their rotations before you!), it is not relevant and doesn’t feel real so it makes retention difficult. Instead, try discussing topics or medications with them as you see them in practice – for example, let’s say we are doing the final check on lisinopril, and your student has just looked at the pills prior to handing them to you for the final pharmacist check. This is a perfect time to ask 1) what is this medication? 2) what is it used for? 3) how does it work? 4) what other medications could also be used for blood pressure/heart failure? 5) what would you tell the patient when you counsel them?
On rotations with me, this is the majority of the learning experience. They are in the last stages of ‘learning the language of pharmacy’ and, just like learning a language, what they need is repeated, relevant exposure to the most common medications and disease states, in a way that they can best retain what they have learned. Another advantage to this is that you will inevitably come across topics/medications they are not familiar with, don’t know enough about, etc. I ask them to keep a notepad with them so they can write those things down, look it up during their downtime, and come back and discuss the topic afterward. It still ties the topic to a real-life event and patient, which I think increases retention.

Encourage student binders: This idea I actually got from a preceptor of mine in pharmacy school. It was during my compounding rotation, and the binder was full of incredible resources for both non-sterile and sterile compounding. I adapted this idea to community pharmacy (as well as LTC pharmacy, when I was practicing in that area) by adding some of my favorite articles on topics such as OTC use, proper administration of eye and ear drops, guidelines related to management of hypertension, cholesterol, and diabetes. I added articles on OTC’s I think aren’t often covered well in pharmacy school – infant formula, sunscreen, etc.
In addition, I wanted to make sure to include resources for topics I think are under-taught and under-appreciated, like mental health. As an example, I like to discuss MOA of atypical antipsychotics including their individual binding characteristics for serotonin, histamine, and dopamine receptors and the resulting side effect profiles.
This binder is for the student to keep and use during our time together, and I encourage them to add articles of interest to the binder as well so that students in the future have even more resources at their fingertips. Students appreciate having a great resource, it provides material for impromptu discussions, and it gives them readily-available, relevant reading material for those times when it is really busy in the pharmacy and you don’t have time to teach.

Facilitate career and licensing discussions: For the past year, I’ve decided to block off 1-2 hours, without distractions, to talk to my students about how to get licensed and how to find a job when they graduate. From the feedback I have received, this has often been the highlight of the entire rotation. I typically meet them in the morning at Starbucks with my laptop and ask them to bring a notebook to write down things as we go.

For licensing, I talk about applying to the board, making sure you have enough hours, receiving the Authorization to Test, and scheduling the exams. In particular, I warn them to be careful about the number of hours required. When I was getting licensed in South Carolina, I even called the board and asked if the hours from pharmacy school would be enough and was told it would. I found out after taking a job in that state that not only did I need 500 more hours outside of rotations, but that I needed to have a notarized letter of attestation from every pharmacist I worked under (and they wouldn’t take the district supervisor’s signature, who was a pharmacist)! Because I had worked in 15-20 stores by the time I had the hours, I had to hire a mobile notary to drive around with me to collect signatures. It was a painful lesson and I don’t want my students to have to learn it the hard way too.
For jobs, I show them my favorite websites for finding employment and discuss networking, board certification, non-traditional skills that will help them stay competitive, managing finances, etc. I also answer whatever questions they have along the way. In this way, I am trying to reduce the black hole known as ‘I’ve graduated – now what?’

Cater to their interests: If you can make the material on your rotation relevant to the field that your student wants to pursue after graduation, it makes for a more enjoyable, rewarding rotation, and as I said earlier, also is likely to improve retention of the material. For example, I recently had a student who was interested in managed care and pharmacoeconomics (he had just come off a rotation with Xcenda). I work in a hospital outpatient pharmacy and we were just expanding our discharge program. I had him create a presentation for nursing leadership that went over both the economic benefits and quality data of similar programs implemented across the country.

Alex Evans, PharmD, CGP
Alex Evans, PharmD, CGP
Alex Evans, PharmD, CGP, works in community pharmacy in Jacksonville, Florida, and is preceptor at the University of Florida and Florida AM University. He graduated from the University of North Carolina-Greensboro with a BS in Biology and graduated from the University of North Carolina-Chapel Hill with a Doctor of Pharmacy degree. He has worked in both the community and long-term care settings. He can be reached at alex.evans.pharmd@gmail.com
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