Experiential education is a key component of the pharmacy curriculum, comprising approximately 30% of the professional curriculum. The experiential component of pharmacy education currently relies heavily on volunteer and adjunct faculty to provide practical experience in health care settings. It has been estimated that about 82 percent of schools/colleges use faculty who are jointly funded with practice sites and up to 60 percent of the total APPE rotations nationally are provided by adjunct or volunteer faculty.2,3
The need for qualified preceptors is increasing due to new schools/colleges of pharmacy and enrollment growth in existing programs,4
the increased experiential load in the pharmacy school curricula,5
and the necessity of having preceptors available in a variety of pharmacy practice settings.6
This report will focus on volunteer preceptors, defined as individuals who are not full-time employees of a school or college of pharmacy who are responsible for experiential education of student pharmacists.
Several entities have established requirements for pharmacy preceptors. According to the 2011 National Association of Boards of Pharmacy (NABP) Survey of Pharmacy Law, 23 (44%) of the 52 boards of pharmacy require pharmacy preceptors to register or communicate with the board in some matter regarding their role as a pharmacy preceptor.7
In addition, some boards have criteria that specify a minimum number of years of licensure prior to becoming a preceptor and specific training/continuing education or professional development requirements that must be met to remain a preceptor.
Schools/colleges of pharmacy are provided direction regarding preceptor qualifications and preceptor development. Elements of the Accreditation Council for Pharmacy Education (ACPE) Standards and Guidelines8
that pertain to experiential education include Standard 14 (Curricular Core-Pharmacy Practice Experiences), Standard 15 (Assessment and Evaluation of Student Learning and Curricular Effectiveness), Standard 24 (Faculty and Staff—Quantitative Factors), Standard 25 (Faculty and Staff—Qualitative Factors), Standard 26 (Faculty and Staff Continuing Professional Development and Performance Review), and Appendix C (Additional Guidance on Pharmacy Practice Experiences). All faculty should be evaluated as to their teaching abilities, communication skills, and effectiveness related to pharmacy education. These areas can be documented and evaluated utilizing review committees, experiential site visits by trained individuals, and student pharmacist feedback. ACPE Standard 26 states that schools/colleges of pharmacy must have an effective continuing professional development (CPD) program for full-time, part-time, and voluntary faculty. Guideline 26.1 states that schools/colleges of pharmacy must have or provide support for programs and activities for faculty and preceptor CPD commensurate with their responsibilities. It is therefore imperative that schools/colleges of pharmacy develop and maintain preceptor development programs.
While accreditation and other entities have established criteria for preceptor training and development, the perceptions and needs of the preceptor should also be taken into consideration. AACP’s institutional research department gathers, analyzes and summarizes data related to schools/colleges of pharmacy accredited by ACPE.9
The institutional research department has surveyed preceptors, via the administration by schools/colleges and the AACP centralized survey system, annually since 2009.10
While the preceptor response rates have averaged 32% over the past 3 years, the strongly agree and agree responses to questions regarding resources and support received by preceptors have increased during this time.10
Namely, the strongly agree and agree responses for 2009, 2010, and 2011 for ongoing contact with the office of experiential education were 78.7%, 80.5%, and 84.1% respectively, support received from the office of experiential education was 80.5%, 81.9%, and 85.6% respectively, and the college/school having an effective CPD program that is consistent with preceptor responsibilities was 76.4%, 78.4%, and 81.4% respectively.10
Though the differences were modest and the response rate low, the results may indicate some improvement over time.
Accredited pharmacy residency programs have the responsibility for assuring required preceptor qualifications and professional development. Key areas of preceptor development named in the American Society of Health-System Pharmacists (ASHP) accreditation standards for postgraduate year 1 (PGY1)11
pharmacy residences and postgraduate year 2 (PGY2)12
pharmacy residencies include the teaching and professional skills of the residency program director (RPD) and preceptors. Pharmacy residency accreditation standards require that the RPD and preceptors should have a record of contribution and commitment to the profession of pharmacy (Requirement 5.9); they must demonstrate a desire and aptitude for teaching that requires mastery of the four preceptor roles (instructing, modeling, coaching, and facilitation) when used in teaching clinical problem solving; and they must also demonstrate the ability to provide criteria-based feedback and evaluation of the residents performance (requirement 5.10).11,12
In addition, the RPD should assess and provide preceptors opportunities to enhance the quality of their precepting skills (Requirement 4.3).11,12
According to data reported by the ASHP Commission on Credentialing (COC) in August 2011, 72% of PGY1 and 64% of PGY2 pharmacy residency programs surveyed were cited for not having adequate preceptor development.13
ASHP has multiple sessions for the development of residency program directors and preceptors at the ASHP midyear clinical meeting and other designated programs, such as the biennial national ASHP residency preceptors conference.
A study was conducted to determine the training needs and interests of volunteer pharmacy preceptors of six regional APPE programs throughout California.14
Approximately 74% of the study respondents indicated an interest in obtaining additional training. The preferred areas for preceptor development included engaging and motivating students (69%), update on teaching/precepting strategies (60%), questioning students effectively (59%), communicating effectively with students (49%), working effectively with different adult learning styles (49%), assessing student performance (47%), and effectively integrating students into day to day workplace activities (42%). Respondents who had received formal preceptor training were significantly more confident in their abilities to clarify expectations, evaluate a student’s knowledge, and foster skills related to critical thinking and problem solving. This information provides potential areas for future preceptor development programs.
A recent study suggests that being an active pharmacist preceptor is associated with increased job satisfaction among pharmacists, but is not necessarily associated with increased career satisfaction.15
The job satisfaction associated with precepting student pharmacists was independent of the type of pharmacy practice setting. This information may assist schools/colleges of pharmacy as well as pharmacy practice sites in the recruitment, engagement, and retention of pharmacy preceptors.
While the benefits of precepting to preceptors5,16,17
and to practice sites5,16-19
have been well documented, the issue of quality precepting continues to be of paramount importance and discussion in pharmacy and other areas of health care training. Experiential office faculty and staff members are striving to meet quality assurance standards as well as preceptor development needs.6
The responsibility for ensuring quality pharmacy practice experiences for students, defined as a well-planned, outcomes-focused training experience with adequate supervision and assessment by a qualified preceptor within a learning-rich practice environment, resides with schools/colleges of pharmacy.20
Schools/colleges of pharmacy should have requirements established for preceptors and practice sites where precepting occurs that lead to quality pharmacy practice experiences.
Quality in experiential education is pursuant to the preceptor (practitioner-educator), the learning experiences (collaboratively designed by college, preceptor, and student pharmacist), and the practice environment.3
A common thread within this triad is the preceptor. While the focus of many schools/colleges of pharmacy experiential departments is on identifying and sustaining an adequate number of quality preceptors and practice sites, it has been suggested that the goal of every experiential program should be to identify, train, develop and maintain quality preceptors.3
The 2004 AACP PAC report provided the following preceptor characteristics that were thought to be conductive to effective learning:
- • Is approachable and establishes a good learning environment
- • Is available to the student for interaction and discussion
- • Treats the student with trust and respect in their interactions
- • Demonstrates interest and enthusiasm in teaching
- • Explains the decision-making process to the student and asks questions that promote learning
- • Stimulates the student to learn independently and allows autonomy that is appropriate to the student’s level of experience and competence
- • Regularly provides meaningful feedback to the student, both positive and negative, in a timely manner
- • Is a good role model for the student and inspires student confidence in preceptor’s technical skills
- • Is aware of the clerkship goals and objectives and seeks to meet them
These preceptor characteristics are just as germane in today’s pharmacy academic environment as they were at the time of the 2004 AACP PAC report.
Summary of PAC Proposed Policy Statements, Recommendations, and Suggestions
Policy Statement 1 (as amended and voted upon by the 2012 AACP House of Delegates). AACP affirms that preceptor development is essential to enhance the quality of experiential education and believes that preceptors should possess competencies that include, but are not limited to, leadership/management skills, embodiment of the development of a practice philosophy focused on improving patient outcomes, role modeling as a practitioner, commitment to excellence in scholarly teaching, effective communication skills, and encouragement of self-directed learning.
Recommendation 1. AACP will periodically update resources in the Academic-Practice Partnership Initiative (specifically the Professional Experience Program Library of Resources).
Recommendation 2. AACP will explore establishing and reaffirming formal relationships with nationally available pharmacy preceptor training development programs.
Recommendation 3. AACP supports the development of a national master preceptor recognition program.
Recommendation 4. AACP will develop a resource/communication vehicle to enable practitioners designated as a “master preceptor” to communicate best practices/development opportunities with one another and schools/colleges of pharmacy.
Suggestion 1. Schools and colleges of pharmacy should institute and continuously review a preceptor development program and ensure that they include the competencies of leadership/management skills, embodiment of practice philosophy, role modeling as a practitioner, commitment to excellence in scholarly teaching, effective communication skills, and encouragement of self-directed learning.
Suggestion 2. Schools and colleges of pharmacy should make preceptor development programs available via a variety of mechanisms to facilitate various learning styles.
Suggestion 3. Experiential Directors should consider collaborating with other schools/colleges of pharmacy in the local/regional area to develop common approaches to preceptor development, that allow for consistency in communicating performance expectations to preceptors and the potential for sharing resources and training opportunities.
Suggestion 4. AACP encourages schools and colleges of pharmacy to develop and maintain mechanisms for preceptor recognition.
Suggestion 5. Schools and colleges of pharmacy should develop or refine their current recognition system for preceptors based, in part, on objective criteria.