In this article a pharmacist with experience in didactic and experiential education discusses top five reasons pharmacy preceptors fail.
Authored By: Timothy P. Gauthier, Pharm.D., BCPS, BCIDP
Article posted 28 August 2022
Sometimes the best way to learn is to fail. I have learned a lot, as I have failed my fair share of times while serving as a pharmacy student preceptor, PGY-1 pharmacy resident preceptor, PGY-2 pharmacy resident preceptor, medical fellow preceptor, and pharmacy residency program director.
Since the IDstewardship blog is read by many new preceptors and preceptors in training, I thought it might be helpful to provide a list of reasons why pharmacy preceptors fail. Through recognizing our potential weaknesses, we can avoid blind spots and even work to make these things strengths.
Here are my top five reasons why pharmacy preceptors fail…
1. Lack of planning or adaptation to change
If a preceptor is not ready to receive and manage a learner, it can cause some serious problems. Not that an hour-by-hour plan for the rotation is needed, but it is important to have a general sense of what key tasks the learner will do to have the chance to achieve the objectives for their learning experience.
As priorities change during a rotation, preceptors need to be able to augment the way they manage their learners so they can adequately balance their time while still supporting the needs of the learner.
One pro tip is to always tell your learners on day one of the rotation that sometimes life does not go how we planned, so it is important to be flexible as things may change. Setting the expectations is key, which brings me to the next reason preceptors fail…
2. Failure to communicate expectations
Expectations should be communicated in the syllabus as well as on day one or two of the rotation. Setting an expectation for the outcome of the learning experience, and then giving regular basic good job/ bad job nudges, is the way to get learners to where they need to go. Do not overlook this fundamental preceptor responsibility.
It can take time for a preceptor and learner to develop a good working relationship and be able to communicate. On this front, I have found that time investments early on with relationship building supports more comfortable ongoing communications later on down the road.
As a preceptor, I try to maintain a strictly professional relationship with the learner in the beginning of the experience. This is because I find it keeps that preceptor:learner relationship in a good place with a focus on doing what they are there to do – achieve learning objectives. As the rotation goes on (and depending on the learner) I slowly allow more casual interactions. I have found that communication is not just about talking to each other, it is also about the relationship with the learner. Going too casual too fast can be a problem to beware. With that in mind, communicating is not just the preceptor telling the student or resident what to do, it is also listening to the learner. Do not forget that communication is a two-way street!
3. Providing tasks that are unreasonable
Every learner is different, so preceptors must adjust their instruction to the learner’s capacity.
Giving tasks that are too simple or too complicated can lead to frustration. One way to manage this balance is to give basic tasks and escalate them as the learner proves they are able to do the work. If you are giving a learner a difficult data collection task for example, make sure to check their work after they have done collected data on a few cases so they can get a bearing on the quality of their work. Making the learner feel like they are part of your team (which they are) and explaining the importance of their work can help learners to take ownership of tasks.
As the learning experience goes on be sure to do periodic assessments of what the learner is achieving. You may need to pull back or raise the bar from time to time.
4. Spending too much time doing 1:1 learning
Being a preceptor is an honor and a privilege. We all want our learners to succeed, but there has to be a balance in the time commitment for actively engaging with them. Extensive daily topic discussions might be what is best for the learner, but that is not something most preceptors can commit to.
One way to help learners progress while completing your work is to overlap their tasks (and interests to keep them engaged) with your to-do list. In academia the secret to success is overlapping your research with your scholarship with your professional service with your clinical service. Being a preceptor is the same deal, overlap the topics of your work areas to cover more ground more efficiently.
5. Missing the point of training
Learners are not just there to complete a list of tasks, they are there to learn how to complete the functions of their job as a future pharmacist. Making sure the learner knows you are there to help them become prepared to perform practical functions as a pharmacist will help show them you are there to give them skills they need and will use.
With this in mind, even though a student might want to do a project about an interesting organism or uncommon drug, sometimes we need to direct them back towards more “run of the mill” projects so they are building an adequate foundation. Building fundamentals should improve their confidence to manage the tasks pharmacists have to complete. Giving learners work that they feel will not be useful in the future can cause them to lose trust in the preceptor and impact the quality of the learner’s work. Making the work feel worthwhile will typically cause learners to invest more energy into it.
Even the best preceptors will fail periodically. It is essential we learn from our mistakes and use feedback from our learners to improve the way rotations are managed. Being a good preceptor requires a continuous process of reflection and practice modification.