Best Practices in Preceptor Training and Development

by Natasha Lewis, PharmD,  PGY1 Pharmacy Practice Resident, Mississippi State Department of Health Pharmacy

A preceptor is a teacher who facilitates practice-based learning. They serve as an instructor or coach for students and residents, providing them with support as well as direct instruction that facilitates their professional development. Preceptors practice in a variety of settings and have different teaching styles and expectations. New and experienced preceptors may inquire about ways to start or improve their teaching skills as a preceptor. Others may feel that they lack time or resources to be an effective preceptor. Successful preceptor development and training should include educational activities and resources to meet the diverse needs of all students. Many of these qualities, such as assessing a learner’s clinical skills, developing relationships with other healthcare professionals, and being a positive role model should all be part of the preceptor’s professional development. Since preceptors play a vital role in a student/resident’s clinical learning, preceptor training programs are essential to keep them up to date on learning theories and practices to prepare future health professionals with the knowledge and critical thinking skills to be successful. The purpose of this article is to evaluate the literature pertaining to pharmacy preceptor development activities.

A recently published article entitled “A Scoping Review of Pharmacy Preceptor Training” identified and evaluated the literature pertaining to preceptor training programs. This article provided evidence-based options for colleges and schools to use in their preceptor training program.¹ Many of the preceptor training programs were face-to-face sessions and web-based modules, combined with written materials such as a preceptor manual, pre-session assignments, and self-study readings.¹ The responses to these programs were generally positive and described as beneficial.  The participants indicated that easy access to the training was important.  They also found that preceptor training was a great opportunity to share ideas, could illicit positive changes in behavior and attitudes, and a great way to gain insight into learning science.¹

In the scoping review, the authors suggested using online preceptor self-reflection/self-assessment tools as part of their training programs.¹ One program provided preceptors with a computer-mediated support network following a development workshop.^1,4 This workshop covered ways to provide feedback and teaching skills in patient care settings, and rotation design.⁴ After several of these programs, preceptors reported feeling adequately trained to be effective educators while still meeting their employment responsibilities.⁴

The University of Iowa College of Pharmacy’s constellation of preceptor development and training programs is a great example of a comprehensive program that follows best practices.² Their program includes four development tools: live events, printed documents, one-on-one experiences, and web-based programs.²

 

Preceptor Development and Training Programs
Live	Print	One-on-One	Web
Regional events On-campus programs State association educational seminars	Preceptor manual Preceptor newsletter National organization resources	Practice site visits Student feedback Available experiential faculty and staff	On-demand CPE webinars On-the-fly training videos Monthly journal club

Web-based programs were developed to provide preceptors with the convenience of learning and developing skills at their own pace. The program created a web-based development tool with four 30-minute modules for initial preceptor development.² They were made available online to be completed at the preceptors’ convenience. Periodically, new modules were added to the website with content relating to learning strategies, ethics, generational learning, continuing professional development, and mentoring.² Several other opportunities were created to complement these program elements, such as clinical topics, monthly journal club, and a preceptor discussion guide to facilitate dialogue with students.² At the end of the modules, preceptors were asked to complete an anonymous evaluation of the program. Preceptors highly rated several of these modules, stating that it helped improve their clinical practice, enhanced their knowledge, skills, attitudes, and values.

Printed documents included newsletters and manuals with guidance on educational philosophies, resources, policies, and curriculum.² The guides were created by faculty and staff members of the professional experience program.² Preceptors were also provided with links to websites with helpful resources.

Live educational events provide preceptors with networking opportunities, discussions, and continuing education credit on specific practice-based teaching skills.² Examples of these events include dinners, annual events, and workshops held for professionals within the field. These events afforded preceptors with a safe space to interact with other preceptors and gain knowledge, or “preceptor pearls” based on successful experiences of others.²

One-on-one training provide preceptors with the opportunity to open their practice site to students and provide quality practice experience while also increasing students’ communication skills with other professionals.² Students gain actual experience on site, while also building a relationship with their preceptors. This type of training provides students/residents with the opportunity to provide an assessment before and after the experience.² Students/residents interact with patients, as well as the staff at these practice sites, to gain a better understanding of what the preceptor does every day and learn more about the preceptor’s role.² After engaging in several of these activities, students rated their preceptors as “good” and “excellent”.^2,4 Several instructors reported that they felt more confident in guiding student learners.

Dental preceptors are encouraged to use the iCARE method for precepting, which stands for Inquire, Cultivate, Advise, Reinforce, and Empower.³ It is used to assist students with gathering and analyzing important information, assessing the patient’s condition, coming to a diagnosis, and developing a treatment plan and course of action.³ This process has been successful in providing students room to reflect on their knowledge and thought process while also providing time for preceptors to assess the learners’ understanding of key concepts and the scientific literature.

1. Inquire: Ask the student about the patient’s history, condition, diagnosis, and treatment plan options
2. Cultivate: What evidence does the student use to support the diagnosis and treatment?
3. Advise: Preceptor discusses information that student did not bring forth or perhaps overlooked. This helps build upon the student’s knowledge for future cases.
4. Reinforce: Preceptor discusses with the student what was completed well and areas for improvement
5. Empower: Students evaluate and reflect on the process. They propose changes they would like to make.

Medical preceptors often use the One-Minute Preceptor method to teach their students.³ This provides open communication between the preceptor and students while also providing time to teach clinical topics.³ When discussing a clinical case, the preceptor and student completed five tasks:

1. Get a commitment: The student is encouraged to commit to the next steps in a patient case. This can range from forming a diagnosis to creating a treatment plan. The student’s knowledge of the subject is applied to formulate a plan for the patient.
2. Probe for supporting evidence: The preceptor asks for evidence that supports the student’s plan. This provides the student an opportunity to explain how they at their plan.
3. Teach general rules: After listening to the student’s thought process and ideas, the preceptor then provides information to address general concepts.
4. Reinforce what was done right: The preceptor reinforces what the student completed correctly when analyzing the case. This creates a positive relationship between the preceptor and student, increasing the student’s confidence.
5. Correct mistakes: The preceptor corrects any mistakes and provides an explanation on anything missed. They can also prompt the student to critique their own process.

Both of these teaching approaches provide a great communication framework.³  Training preceptors to routinely use these communication and questioning strategies can enhance the student’s learning, problem-solving skills, and confidence.

Preceptor development and training programs provide resources and instruction to improve field-based teaching. By offering a variety of methods, preceptors have options to choose from for self-directed learning. Preceptor training and development programs are especially beneficial for new practitioners. With the guidance and assistance from these programs, preceptors can become comfortable and confident, adding their own personal touches to these experiences, demonstrating interest and enthusiasm for teaching, and with a caring attitude. Regardless of the profession, it is important to continuously improve our skills as healthcare practitioners and teachers to prepare the future members of our profession for the benefit of patients. 

References:

1. Knott GJ, Mylrea MF, and Glass BD. A Scoping Review of Pharmacy Preceptor Training Programs. Am J Pharm Educ 2020; 84(10): Article 8039.
2. Vos SS, Trewet CB. A comprehensive approach to preceptor development. Am J Pharm Educ. 2012 Apr 10;76(3): Article 47.
3. Sakaguchi, Ronald L. Facilitating Preceptor and Student Communication in a Dental School Teaching Clinic. Journal of Dental Education 2010; 74(1): 36-42.
4. Bolt J, Baranski B, Bell A, Semchuk WM. Assessment of Preceptor Development Strategies across Canadian Pharmacy Residency Programs. Can J Hosp Pharm 2016;69(2):144-8.