Mentoring/ Precepting Students and Residents During a PGY2 Residency
Jason Jared, PharmD
PGY2 Oncology Resident
University of Wisconsin Hospital and Clinics
Jason J. Bergsbaken, PharmD
Pharmacy Coordinator, Regional Oncology Services University of Wisconsin Hospital and Clinics
The number of pharmacy learners, including students and residents, continues to increase within our profession. As of 2014, there are more than 130 pharmacy colleges and schools in the United States with an accredited or candidate professional degree program and an estimated graduating class of more than 14,000 students. In addition, more new practitioners are pursuing specialty residency training, including PGY2 oncology programs. According to the American Society of Health-System Pharmacists' Resident Matching Program statistics, there were 121 available PGY2 oncology positions among 75 total programs in 2014, up from 74 positions at 50 total programs in 2010.1 As the number of pharmacy students and residents increases, it is vital that we prepare and utilize these learners appropriately to maximize educational experiences and organizational value.
Layered Learning Practice Model
The Layered Learning Practice Model (LLPM) was developed at the University of North Carolina (UNC) Eshelman School of Pharmacy and UNC Hospitals to enhance patient care and provide new educational opportunities for student and resident learners. This innovative model of pharmacy practice mimics the medical model of active learning and features an attending pharmacist who is responsible for all aspects of a patient’s care and residents (PGY1 or PGY2) and students who function as extenders to provide expanded clinical patient care services. In addition to clinical services, the attending pharmacist oversees student/resident education. In this model, learning is handled in a layered fashion from attending pharmacist to resident to student, providing opportunities for resident and student learners to be responsible for patient care on rotation. In addition, it affords the PGY2 resident opportunities to lead topic discussions and serve as preceptors for PGY1 residents and student pharmacists. Attending pharmacists benefit by gaining dedicated time for leadership, scholarship, and program expansion activities.
PGY2 Resident Precepting Roles
In the LLPM, PGY2 residents can have a large impact on the education and development of PGY1 and student learners while freeing up attending pharmacists’ time for high-level clinical activities. PGY2 residents have the necessary experience to fill all formal precepting roles such as direct instruction, modeling, coaching, and facilitating. For example, PGY2 residents may provide direct instruction by leading topic discussions. Rounding experiences and the subsequent opportunities to provide specific feedback and education allow the PGY2 resident to model and coach desired behaviors. In addition, PGY2 residents can serve as a coach and mentor for residents and students working on case presentations, rotation projects, or journal clubs. Ultimately, the PGY2 resident can facilitate independent experiences for other learners, such as patient monitoring and documentation. Under the LLPM, PGY2 residents develop the valuable skills necessary to serve as strong future preceptors.
PGY2 Resident Benefits and Challenges
The development of nonclinical skills is essential for PGY2 residents to complement their direct patient care experiences. Expanding the skills necessary to function as an excellent preceptor is arguably one of the most important outcomes of residency training and can serve as the foundation of a resident’s clinical practice. Benefits of mentoring and precepting learners as a PGY2 resident include sharpening these skills, freeing time for the attending pharmacist, and providing a high-quality learning experience for PGY1 residents and students. From an organizational perspective, PGY2 precepting can add efficiency to the training of learners. For example, utilizing a PGY2 resident to lead supportive care topic discussions allows an attending pharmacist to focus on patient care while allowing the preceptor to have more time and energy to focus on other projects.
Serving as a preceptor while completing a PGY2 residency can be challenging. Because PGY2 residents lack the same clinical experience as an experienced pharmacist they may be perceived as a less formal educator, which may negatively impact learner structure. Learner proximity of experience and coresident comradery could potentially adversely affect the PGY2 resident’s influence and ability to successfully precept in the LLPM. Setting clear expectations regarding preparation and communication can help ensure a successful professional relationship between the PGY2 and the learner. Another key to successful PGY2 mentoring and precepting of learners is appropriate oversight and mentorship of the PGY2 resident. As a PGY2 resident, receiving feedback on your precepting skills from attending pharmacists ensures continued professional growth and development.
PGY2 Resident Experience
As a PGY2 oncology resident at the University of Wisconsin Hospital and Clinics, an academic medical center that utilizes the LLPM, I have regular opportunities to work with various learner groups. From direct topic instruction to rounding facilitation, I use all four formal precepting models on a daily basis. Pre- and postrounding patient review has been one of the more fulfilling PGY2 residency experiences and allows me to work one on one with learners to sharpen their clinical skills while enhancing my precepting skills. In addition, PGY2 residents serve as formal facilitators for PGY1 residents and pharmacy students for our triweekly “Resident Report” sessions. Resident Report is an opportunity for a learner to present clinical or administrative topics to the learner group via lecture and discussion. As a PGY2 resident, I help the learner with topic selection and delivery while providing formalized feedback for self-improvement. In addition, the learner provides feedback to improve my facilitation and evaluation skills. These are just a few examples of methods the University of Wisconsin Hospital and Clinics uses to allow their PGY2 residents to improve learner training, facilitate attending pharmacist clinical practice, and achieve a comprehensive PGY2 training experience.
1. National Matching Services, Inc. ASHP National Matching Program Statistics. www.natmatch.com/ashprmp/aboutstats.html. Accessed March 25, 2015.