In this episode, I’ll discuss the 4 clinical teaching roles for residency preceptors.
The 4 teaching roles that ASHP wants PGY-1 residency preceptors to use are:
ASHP expects that PGY-1 residency preceptors have a working knowledge of these roles. During a site survey, this qualification is evaluated by a discussion with preceptors and residents as well as by review of resident evaluations of learning experiences.
The instructing role is used at the beginning of the rotation experience. This role is to ensure that the resident has the basic knowledge required to perform a skill.
Instructing a pharmacy resident should differ from instructing a pharmacy student. With a student, the instruction may take the form of a 1-on-1 conversation. With a resident, a greater degree of independent learning is expected and so the instructing role takes on a different form.
If we take as an example a resident learning the skill of providing pharmacy support during rapid sequence intubation the instructing role might look like this:
“Watch this video about Airway Pharmacology, then read the airway chapter in Rosen’s Emergency Medicine. After that, review the contents of our rapid sequence intubation kit and explain the pharmacology of each medication to me.”
In the modeling role, the preceptor explains a skill to the resident as they are doing it. To fulfill this role you simply need to talk out loud and narrate as you perform the skill. The purpose is to explain your decision-making process so that the resident can reproduce the process later.
“I’m drawing up rocuronium instead of succinylcholine because the patient had a burn injury 7 days ago, then I’m going to get a vasopressor ready because I see that the patient’s starting blood pressure is 92/58.”
In the coaching role, the resident performs the skill while the preceptor provides real-time feedback. In this role, you are like the driving instructor sitting in the passenger’s seat. It is during this step that the resident polishes and refines their skill while you as the preceptor determine if the resident is ready to perform the skill independently.
“Is there anything about the patient’s HPI that makes you want to consider one paralytic over the other? What do you think about the patient’s blood pressure right now?”
The final clinical role is facilitating. This role is used when the resident is ready to perform the skill independently of the preceptor. The preceptor is still available when needed, and may also sometimes debrief with the resident when they are done.
“The patient in room 6 needs to be intubated, call me if you need anything, I’ll be outside room 10 finishing up pre-rounding.”
Members of my Hospital Pharmacy Academy get to make the instructing role easy by granting their residents and students access to the 200+ Masterclass trainings available for clinical skills in critical care, emergency medicine, infectious disease, and general hospital pharmacy.
In addition, Academy members have access to preceptor development resources such as the training on Understanding and Fulfilling ASHP Accreditation Requirements for Residency Preceptors.
From the time of this recording until 10 pm EST on Tuesday, September 13, you can get a special recurring quarterly membership of 3 months for the price of 2 to the Hospital Pharmacy Academy. To get immediate access, go to pharmacyjoe.com/quarterly. Current monthly members of the Hospital Pharmacy Academy can also access this discount by going to their member profile page at pharmacyjoe.com/profile.
If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies.