Assessing Learner Performance With Confidence and Consistency

Assessing learner performance is one of the most important and challenging responsibilities of a pharmacy preceptor. This course reviews practical strategies for evaluating clinical knowledge, communication, professionalism, and other key competencies while providing meaningful feedback that supports learner growth. You will be better prepared to assess performance consistently, navigate challenging evaluation situations, and document learner progress with confidence.

 
Host
Kate Newman PharmD,
Director of Experiential Education
Clinical Associate Professor, Pharmacy Practice
Southern Illinois University - Edwardsville

Guest
Shane Tolleson, PharmD, PNAP
Dirctor, Ambulatory Care APPEs; Clinical Assistant Professor
University of Houston College of Pharmacy

Get CE: CLICK HERE TO CPE CREDIT FOR THE COURSE!

CPE Information
 
Learning Objectives
At the end of this course, preceptors will be able to:
1. Describe strategies for assessing learner performance across key competency areas, including clinical knowledge, communication, and professionalism.
2. Explain approaches for providing feedback and documenting learner performance in a fair, consistent, and objective manner.

0.1 CEU/1.0 Hr
UAN: 0107-0000-26-309-H99-P
Initial release date: 8/17/2026
Expiration date: 8/17/2029
Additional CPE details can be found here.

The speakers have no relevant financial relationships with ineligible companies to disclose.

The examples shared in this episode are intended to illustrate approaches to experiential learning, service development, and patient care innovation and are not endorsements of any specific service, product, or practice model. Certain examples discussed may no longer be viable, appropriate, or permissible under current regulatory requirements. Pharmacists should exercise professional judgment and ensure compliance with applicable laws, regulations, payer requirements, and evidence-based standards when evaluating or implementing patient care services.

This program has been:
Approved by the Minnesota Board of Pharmacy as education for Minnesota pharmacy preceptors.

Reviewed by the Texas Consortium on Experiential Programs and has been designated as preceptor education and training for Texas preceptors.

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Transcript

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Welcome And Why Assessment Matters

SPEAKER_02 0:04

Welcome to Precept to Practice, your dedicated resource for advancing precepting through practical strategies, applied insights, and conversations shaping the future of pharmacy education. I'm Kate Newman, and if you've ever wondered how to support your learners, challenge their thinking, or help them step confidently into practice, you're in the right place. Today we are diving into assessment. Let's be honest, evaluating learners can be one of the hardest parts of precepting. We all want to support our learners well, but figuring out how to assess them consistently and fairly can be challenging. By the end of our discussion today, you'll gain practical strategies for evaluating clinical knowledge, communication, professional skills, and other key competencies while providing meaningful feedback that supports learner growth. I'm thrilled to be joined today by Shane Tollison, Clinical Assistant Professor at the University of Houston College of Pharmacy and Director of Ambulatory Advanced Pharmacy Practice Experiences. Not only does Shane come to us with experience as an ambulatory care clinical pharmacist, through his role with the University of Houston, he has expanded experiential learning opportunities for student pharmacists, developed innovative coursework, and become a passionate advocate for student success and professional development. I'm so excited to have you here today. Thank you so much for joining me.

SPEAKER_00 1:26

Yeah, I'm excited to be here too. I can't pass up an opportunity to sit and talk with you.

SPEAKER_02 1:32

Well, thank you. But maybe I should first ask, is that something you would agree with? Do you think it's a hard part too?

SPEAKER_00 1:45

A hundred percent. I can't tell you how many conversations I've had with preceptors of just like, how do I fill out this assessment or how do I fill out this form? Or, you know, I've got a student that's these things are happening, like how can I make sure to assess them appropriately and make sure that's being conveyed in all of the things that I'm submitting to the school. So absolutely, this is something that comes up, I would say, every single rotation plot.

SPEAKER_02 2:08

What do you think it

Why Preceptors Struggle With Assessment

SPEAKER_02 2:10

is about assessment that makes it so challenging for preceptors?

SPEAKER_00 2:16

I feel like there's there's so a few things that go into it. It's really, you know, there's of course the time constraints, right? We've all, as a preceptor, you've got your own full-time job to do, and now we're adding a student to that. Um so there's some time constraints that come in with that. But really, I think one of the biggest challenges is that we're not trained as educators, we're not trained as assessors, we're trained as pharmacists, and now putting on that educator hat and the student role, it's something that we have to learn to do. So I think that's one of the big things. And then making sure that we're keeping track over, you know, four weeks or six weeks, it can be kind of tough to fill out an assessment and take into consideration something that maybe happened weeks ago if you're not careful about documenting things. So I think it's making sure to get into that practice and um kind of learning the skills that it takes to assess someone truly.

SPEAKER_02 3:10

I think you raise a lot of important points. Um, and I I'll add too, another one that I think can make this hard is you really get to know your learners and and we build relationships with them over these, you know, four, six weeks. And then it can be challenging to try to tease apart, like you said, something that maybe happened early in the rotation. How do I take that into account in this final evaluation? Maybe I just really like this learner as a person. And so then it's hard to determine, you know, is this an accurate assessment of their skills and what they've demonstrated? You know, there's also time, of course, like it can feel like a daunting task on top of an already full plate for preceptors to fit into. So I know there's many challenges, um, and hopefully we can unpack some strategies to help help our preceptors uh today. One other thing I want to just kind of to start the conversation with is really figuring out when we are talking about assessment in experiential education specifically, like what are we actually talking about? So

Formative Versus Final Evaluation

SPEAKER_02 4:13

we've talked about already a little bit, there's that final evaluation, but what else is part of assessment in a rotation?

SPEAKER_00 4:21

I think there's the day-to-day assessment too. Really, it kind of comes down to what I feel like are observations and characterizations of the student's performance, especially kind of in comparison to what the standard is or what we expect a student to be able to do by the time they graduate or finish just your rotation or finish the first week of your rotation. Are they progressing? Are they on track to being a competent entry-level pharmacist by the time they leave your rotation or leave uh the four walls of the school? So I think that's kind of when we're looking at assessment. There's the big stuff like we talked about, the formal assessments, but there's also that day-to-day, how are things progressing? What am I seeing from the student? And is that where they need to be in in comparison to my expectations or the school's expectations, or really the public's expectation of us as pharmacists.

SPEAKER_02 5:15

I like that you talked about the ongoing nature because I think that that is an important thing to remember. So, yes, the final evaluation, what is our expectations? Hopefully, we can unpack that a little bit uh later. But also, you know, assessment in my mind is always happening. We're always assessing, just like you do with patient care, right? We're always assessing our patients and where they are in their therapy and what they might need. We're thinking the same thing of our learners. So, where are they in that process? And I also think it's good to remember that experiential learning is learning. And so sometimes we fall into the trap of thinking we're assessing them from day one. And if they do something maybe not as well on day one, that that should then be reflected in their final evaluation. And maybe that's just a formative assessment where we're giving them feedback and giving them an opportunity to try again. But where are they at the end of that experience, really? You know, through that growth that you're going to see, I think is important too. So, yes, it's grades, but not just grades, it's also kind of part of that learning process. We know that there's a lot of different ways, though, when we think about that final grade and the assessment, because that is an important component to consider. Um, you know, there's things like competencies and entrustable professional activities and rubrics, and it's all very different. So, do you have some advice for preceptors about maybe understanding the evaluation tool that they'll be using at the end of the rotation?

Making Sense Of Rubrics And EPAs

SPEAKER_00 6:47

Yeah, definitely. Um, every school does it a little bit different, right? We've all we all meet the same standards and everything nationally, but the way we do that and the the approach that we have to that can vary. Uh, even just here within the state of Texas, you know, there are nine schools, and we all approach, we try to standardize things as much as possible, but we all have different ways that we want to do that, different things to accomplish. So I think the biggest thing is really just to reach out to the school and ask them to walk you through it, or if they have an orientation video or something like that to familiarize yourself with that. Uh, we're here in the world of experiential not just as a resource for the student, but a resource for the preceptor as well. So if you have a question on what to do or how to interpret it or what we want you to do to assess the student in the way that the school needs, just let us know. We're always happy to answer that. There's also lots of literature out there if you want to kind of take a dive in yourself first. If you want to go into that the leak pool of academic pharmacy literature, there's lots of stuff coming out about competency-based education and trustable professional activities. I know there's got to be a whole lot out there about rubrics and narratives and everything. Whatever your school's using, I'm sure there's something out there to support you on top of whatever the school can provide you themselves.

SPEAKER_02 8:04

I love that you're suggesting reaching out to the school. And in full disclosure, both of us work at schools of pharmacy and experiential, and we are always just begging preceptors to reach out for help if they are unsure. Because we don't always know that we're giving that information to them as clearly as we could either. So we're happy to talk about that. So I do think understanding that final evaluation is an important component of assessment. Certainly it's not everything, but it's definitely part of it. So let's maybe dive in now into the role of kind of the preceptor in all of this. And I think, you know, like we mentioned, each school has its own list. But generally, when I think about assessment of students in rotations, I think about we have to assess their knowledge, right? Just their factual recall. We have to be able to assess their clinical skills, including clinical reasoning. So how are they thinking to get to that answer? We're we're assessing their communication. We're also assessing their professional skills, you know, how are they with task management, time management, uh, punctuality, you know, all those kinds of things come into play. So I think it can be challenging sometimes to tease apart if a student, you know, where what part of this are they struggling with? So when you think about that, is there any, you know, maybe strategies or suggestions you might have for preceptors and figuring out, you know, more than just did the student give you the right recommendation, but how did they get there?

SPEAKER_00 9:35

Definitely.

Find The Real Gap With KSA

SPEAKER_00 9:36

Like as an experiential director, whenever preceptors come to me, usually it's things have already kind of gone a little bit sideways by that point. But if they're not sure what to do, the first thing I like to do is try to break it down into the KSAs, knowledge, skills, and attitude, right? The knowledge is their foundational knowledge. Are they is it just that they have gaps in knowledge? It's really trying to identify where the problem is. So is it a gap in knowledge? Or is it a skill of putting everything together, assessing, gathering the right information? Maybe they have all that foundational knowledge, they've got the book smarts, but they're not sure quite how to put the rubber to the road yet. And that's where the skills come in and where the different clinical reasoning and critical thinking all kind of play in. And then the attitudes part, is that really is it something that they're just not approaching things from the right mental aspect? Do they have the wrong mindset going into the rotation? Are they expecting different things? Is it you know, professionalism definitely falls a lot into the attitudes part? Are they what's their motivation? And so the first thing I try to do whenever I noticed any issues or or they're brought to me is break it down into one of those skill categories, or sorry, one of those three different categories, and figure out specifically within that category, what is it? If it's knowledge based, is it genuinely just they have gaps in their knowledge that you know I would expect them to have that knowledge there? Or is it they've got the knowledge and they're just having trouble bringing it forward or retaining it even? Maybe it's something you brought over with them in a topic discussion and it's just now sticking, and there's still this knowledge gap despite trying like having talked about it. And then from there, that can even take you into how you address the problem specifically, because you have to tailor the solution to what the problem is. So I think the key is really using a tool to identify where the issue lies. Another tool that I like to use is called the RIME model. I'm not sure Kate if you ever heard of it. It's an R-I-M-E. It helps really a lot in the world of patient workouts in particular. This was brought to me by a preceptor that I had, amazing preceptor as a student, um, the Rs reporter, uh I's interpreter, M as manager, E's expert. I wouldn't expect any student to be getting the E expert in six weeks or anything like that, but maybe residents are dabbling in. But I do hope that students are dabbling in manager by the time they leave each rotation. And so it kind of mirrors the pharmacist patient care process as well, in that you know, we're gathering information, we're analyzing it, uh, and we're using that to take care of the patients that are there in front of us and make sure we're managing them appropriately. And so there's there's tools out there to help you figure out how I can assess the student and figure out where the issue is. If the issue is with reporting, they don't know what information to gather, which means there's probably a deeper knowledge gap that we have to dig into a little better. You know, so you can use each of these different things to help hone in on the exact problem and then target that with the solution.

SPEAKER_02 12:50

I love a new acronym. So that's a great one uh to unpack. So thanks for sharing that. You know, I think knowledge can be sometimes a little easier to unpack. I think once we start getting into the application and the skills and how are they thinking, that can be tricky unless you're asking the right questions, because we don't always think out loud, right? We're not great about thinking out loud and making that visible. So as a preceptor, you know, one step of that, of course, is modeling it. Um, and as preceptors, we are thinking of a million things every time we're assessing a patient, but we've been doing it for a long time. So that happens quickly and silently, usually. And so one idea is to practice thinking out loud for students and talking through your thought process. But how do you think we could encourage learners to explain their reasoning? Or what might be some strategies you could share with the preceptor to help them get students to think out loud?

SPEAKER_00 13:52

I would say really the same thing at that point. Have them do the same exact thing. Tell me what you're thinking, right? If you give me an answer, you know, explain to me why that answer is, how you came to that answer, what information did you use to get there? Talk your talk your thought process out loud so that I can hear it as a preceptor. And if I catch some either misinformation or wrong information or uh flawed logic, you know, I can correct that. And then really that lends itself to deeper learning, deeper understanding, because now we're correcting the thought process instead of just the answer. The students are very, very focused on let me just give you the answer because their first few years of didactic courses, that's kind of how it is, right? Classes are here's the answer, it's either right or it's wrong. But we know in clinical practice that is not the case. There's so many different shades of you know grade throughout the spectrum, and those little changes in logic or their thought process can lead them to navigating through that while they're with you, but also while they're in practice. So, my biggest thing is have them talk out their thought process because if they're getting to the wrong answer, there are a million ways they could have done that, and you don't know what that is as a preceptor. We all have different backgrounds, you can't assume they know all the same things you do or that you did coming out of school. And so I had the same preceptor who taught me about the rhyme model. He told me he'll never tell me that you should know that. And the reason is because he doesn't know what I've been taught, he doesn't know if what I have already been taught just was taught in a way that I don't understand, that it's something I struggled with. And so I thought that was very supportive, made a big, uh, big impact on me as a learner and a preceptor, too, and then really lended itself to let me tell you my thought process so you can fix that.

SPEAKER_02 15:52

I similarly have heard learners, you know, sharing things preceptors have done that have made them feel more comfortable in this process. Because, like you pointed out, we're not always encouraging them to think out loud for every answer in the typical school environment, right? It's more choice or thinking about and so I think similar things I've heard is where that expectation is given up front. I'm gonna ask you to talk me through how you got here. And not because you that necessarily means your answer is right or wrong. I just want to understand the process. Like you mentioned, things can go wrong in a million ways, but also students can get to the right answer in the wrong way too. And so they're the foundation they're basing that recommendation on may be completely inaccurate, but you don't even know that because their recommendation was technically right. So I think building that environment, encouraging them to talk it out loud, building a culture of safety where they feel okay telling you even if it's wrong, or even if they get stuck. And so I also have heard from learners and preceptors this idea of I want you to tell me when you don't know the answer, because I don't want you to make something up in patient care, but I do want you to talk through as much as you have thought through. So I can understand, okay, where do we need to help guide you next? And so I think that's a nice middle ground between I never want you to guess, don't make anything up, and tell me everything you're thinking. And of course, this is tailored to every learner, but I think that those are great ways to start to figure out where where they're getting their information. And maybe that's it too. What resource did you look at? Where in the resource are you finding that? Which guidelines are you referring to? So I think reminding learners that this is a process and having them talk that out loud can really help you start to pinpoint and assess truly throughout the rotation what's going right and areas where they maybe need to improve.

SPEAKER_00 17:49

And well, what sorry to interrupt you, but one of one of the things, another another thing that has really helped, um, especially from the student aspect of having that conversation with them too, is um letting them know that the questions that their preceptors are asking are not just questions to see if they know something. The preceptor in that moment is sharing their thought process of did you consider this? Because that's something I'm thinking about, and I'm gonna ask you about it because I think it's important you know it. And so I think that also helps with the if the preceptor can introduce that concept to the student of when I'm asking you questions, I'm sharing my thought process with you at the same time. I think that helps the what's the word I'm looking for, helps make the questions feel more genuine, more helpful, and not targeted, and it makes the students less anxious. It makes helps create that safe space of saying, I'm not just asking you to grill you, I'm asking you because I think it's important to that you know it, and this is what I'm thinking about, so you need to know about that. And so I think that's been really helpful too. It reframes the whole questioning, Socratic questioning too, reframes that in the student's mind to let them know these are important things. I want to make sure you took them into consideration.

SPEAKER_02 19:05

I like that you said grilling, because that's the word I came to my mind too. And and it's so hard as a learner, and I'm sure we all had this experience where we felt like we were being grilled and someone was just waiting for us to get an answer wrong, and we're now anxious as a learner, and it's hard to access your knowledge. And and so I think you're right, if you can reframe that up front and say, you know, I'm gonna ask you a lot of questions about this. I'm not trying to, you know, get to a point where you get it wrong. I'm just trying to understand. And so much of it is in the delivery, right, as a preceptor and how we're delivering that. And so I I love that. You mentioned earlier, you know, about expectations and where do we expect a learner to be on whatever type of experience it is, whether that's an IPPE or an APPE, or you have a resident, or you have a new grad that you're training, right?

Setting Benchmarks By Learner Level

SPEAKER_02 19:56

Like, how do you figure out how to benchmark performance expectations or how do you set those as a preceptor?

SPEAKER_00 20:05

That can be really tricky because there's there's so many variables. I think as a preceptor, you have to understand the difference in the levels of the three different types of learners, right? An IP student is probably barely going to have touched into any of the clinical thought process or reasoning, right? They may have just some basic foundational sciences behind their belt. You know, in our curriculum particular, you know, we have the first year is essentially foundational sciences, and then the second year is where they really start getting into uh therapeutics and all that, all of that. And so if you're asking an IPI student who's you know just on their first summer in pharmacy school a therapeutic question, they may be able to put it together, but you can't expect them that they've not been presented that, so you may have to handhold them a little bit more, which is fine. And so it's really about putting yourself back into what was I like as a P1 or where what had I learned by that point in time? And then where are we, you know, in the curriculum? You can even ask the student, what have you learned up to this point? So I know how to gauge things. Again, you can reach out to experientialists as well. Like, what should I expect from this student? That's always helpful. We can help guide you in that realm too. As far as an appy student goes, when they're out there on their fourth year and they're, you know, learning to be a pharmacist, like hands-on every day, your expectations may also vary based on which rotation block it is, how early in the year it is, you may have to make some adjustments from there, about how quickly you take things, or just keeping in mind that if it's the first block, that student is probably a deer in the headlights and they don't know what Appys is all about. And so, you know, they may never have worked up a real patient up to that point, and um, everything is new to them on top of learning a new computer system and all of that. So you have to take all those things into consideration. But But if it's the last block and you're the last thing that they have before they go on to take their NAPLEX and take care of patients, then you know you might be able to expect them to be performing at an entry-level pharmacist, right? That's that's the purpose of pharmacy school is to get them at least to that entry-level purpose, that entry-level point. And during that time, you have to ask yourself, what is a fair expectation or what's a minimal expectation, keeping it as objective as possible to measure the student against. For a resident, like I mentioned earlier in the Rhyme model, you might be expecting them to dabble in the expert, right? They should be able to pick up pretty quickly, and they've already had at least a year of rotations, and so they kind of know what it's about, and they they know where things are going. So they should pick up a lot quicker than an Abby student and come in with that foundational baseline entry-level pharmacist already. And so I think it's really just about thinking where should this student be right now based on their point in their curriculum and their career, and then adjusting your expectations to make sure it's fair for that student when you're assessing them.

SPEAKER_02 23:10

I also think earlier you talked about, you know, KSA being knowledge and skills and attitude. And I found myself, as you were describing that, thinking about that here as well. And so it's maybe easier to think of knowledge across the spectrum of an Ippie student to an appy student, right? That those Ippy students, especially earlier in the curriculum, have been exposed to less of that knowledge. Maybe even the skills, um, you know, they might be just trying them for the first time, or in a, of course, in a real environment. Real patients are much more complex than our cases often, as we all know. Um, but attitude and their approach, maybe we don't expect as much of a shift across. Um I I think maybe that's another way to think about it as you're trying to set benchmarks and expectations is thinking about all three of those categories. You know, maybe if a school has their kind of drug information and drug literature skills early in the curriculum, then maybe you should expect that those IP students can look up that information. Maybe the interpretation of it might not be there yet, depending on their clinical knowledge, but finding, retrieving information, maybe it is. Um I think now is a great time to also highlight, you know, appy curriculums tend to be a little more consistent. They're all typically at the end, right, of the pharmacy school career. Ippies are wildly different because they happen at all different times and everyone's curriculums are very different. So I think setting Ippy expectations sometimes is even harder than appy expectations. And that's really where that partnership with different programs and understanding, okay, what specifically does this student need to be able to do can be helpful. But the more clear we can be in our expectations of those benchmarks, the better for students. So to be able to say, by this week, I would expect a student at this level to work up this many patients and be able to find independently those guidelines and resources and apply them. Like being very specific and concrete can be helpful for students to know what is expected of them. But more importantly, I think it helps you as a preceptor know how to assess, right? If you've already set that benchmark, now I can say, oh, I have a student who's far surpassed that benchmark. That's amazing. I need to make sure to let them know they're doing excellent. And then I'm continuing to question because I can see the potential for more growth. But being clear about that, so students don't feel like they're failing, because that's sometimes what happens. Or if you have a student who's maybe underperforming at first, you can start to identify uh-oh, this is a gap between this benchmark and where they are. I need to give some tailored feedback and maybe contact the program just to let them know what's going on and to get some help navigating this. But without the benchmarks, it's really hard as you're assessing. It sometimes feels like you're starting over every time and trying to figure it out.

SPEAKER_00 26:03

Yeah, those the benchmarks are huge. It also gives the student, you know, that they want to do well. They're not going out there trying to just, you know, see what happens. Like they want to do well. And so that helps them measure themselves. It also spurs that self-reflection of, oh, my preceptor told me I need to be working up three patients a day by the end of week one, and I'm at two, and they're really not that great workups they see, you know, based on feedback. That gives them an opportunity to say, I'm struggling, I need to reach out, whether it's to the preceptor andor the experiential uh team. But it it lets them also trigger that lifelong learning of saying, here's what I'm expected to do, I'm not meeting it, or I have met it, what do I need to do next? I think that's super, super important too.

SPEAKER_02 26:49

I love that you're talking about the student self-assessment as part of this, you know, evaluation and assessment, because that's certainly a really valuable place, I think, for preceptors to fold in the conversation with students. So when we think about assessment, I think it's good to think about it as a conversation between two people and not just, okay, I am the assessor and trying to figure this out, but thinking about, you know, what's the student thinking about this? How do they feel like their performance is going? So it feels like those two things really go together. Which maybe leads into, you know, feedback a little bit. And not that this is a discussion only about feedback. I feel like that's probably its own discussion, but how do we see this marriage between assessment and feedback? Like

Feedback That Prevents End Surprises

SPEAKER_02 27:35

how do these things fit together?

SPEAKER_00 27:37

Ooh, I think they go they go hand in hand. You can't fairly assess a student if you haven't let them know what's not going well or what's going really well because you haven't given them an opportunity to really improve that because they don't know that they need to necessarily. This is, you know, practice is new to the students. They don't have the perspectives that you do as a preceptor to say if something is good or not. They may have an idea, but at the end of the day, they may not understand what the expectations of them in practice really will be. And that's your job as the preceptor to help guide them and say, hey, you know, you're doing great here or you're not doing great here. They need that feedback, and then your role as a preceptor is an assessment is are they incorporating that? Are they improving? Are they progressing to the point where they can meet these expectations? Am I providing what I need to as a preceptor to guide them to do well? They don't have that perspective, they don't know what they don't know, and that's just not it's not feasible for them to be able to solely self-assess without any external input as well, and expect them to, you know, pass everything with flying collars. That's just not gonna happen. It's not fair to a student at that point. Uh, if they don't know they're doing poorly, then you know, when we get to the end of the rotation, surprise you failed the rotation. That's not fair. That's not fair then because they I can't tell you how many times, Kate, I've heard I didn't know I was doing bad. At that point, I have to have a conversation with the preceptor. I'm like, what feedback were you giving them? What how how can they benchmark themselves and you're not telling them what the benchmarks are, you're not telling them how things are going, they're gonna assume no news is good news and things are going great, right? So they go hand in hand. You can't fairly assess a student without giving them constant, consistent feedback at least once a week, but preferably every moment, every time you observe something.

SPEAKER_02 29:47

I think that's important and something we hear a lot when we talk about this, that your final grade shouldn't be a surprise, right? You should you should know where you stand, and and all of us want that. None of us want an annual evaluation with our boss that's a surprise, right? We want to know we've been having these conversations throughout the year, and so yes, of course, this makes sense. So I think it's the same concept here. And a good reminder, especially for experiential learners, our appy learners, they're moving rotations rapidly, and your expectations might be a little different than the expectation of the preceptors they've already had. And that's reasonable. We all work in different environments, we're all different preceptors, but if we're not explicit and clear, students are guessing and they're spending a lot of energy guessing what they're supposed to be doing and not expending the energy on taking your feedback and making improvements to it. So I think your point of are they incorporating the feedback you're giving them is important, and how are we giving feedback on, you know, we're doing this constant assessment we've talked about, right? Our job as a preceptor is to notice when students are doing well or when they're struggling. And then the students, we want them to take that and and move it forward. We talked earlier about some of the challenges though preceptors might have. And I always like to point out time and being in a busy environment is certainly one of those. You're not with the student all the time, or you you don't have the opportunity to give them feedback all the time. So, do you have any suggestions or strategies maybe for preceptors to balance their busy work with the time it takes to assess and give feedback?

Fast Documentation And Feedback Friday

SPEAKER_00 31:25

I think some of the key things are you know, briefly document things when they happen. I'm sure at some point we've all carried around either, you know, our phone that we keep notes in or a little notebook or something like that. Just jot things down as they happen, of like, oh, I need to remember this for evaluation, or I need to remember to get the student feedback about this, because there's not always time to have immediate feedback. Sometimes you need to save it for the end of the day and you don't want to forget something, or sometimes it's the end of the week. So writing it down, making this part just a quick habit of just taking a note, right? The same thing we do for our patients. We document the things we hear and see them doing and saying. I I treat the students a lot like my patients. I just try to remember everything that I can so that I can make a full assessment of them when possible. I think building in time when you have a student and setting a set time either every day, hopefully, you know, end of the day, I really like end of the day feedback of how things went today because it's very timely. But at least something like a feedback Friday, where for the last hour of the week, you sit down with the student, just it's built in, it's dedicated, nothing can disturb that unless there's like a patient emergency, of course. But nothing can disturb that, that's dedicated time for you to sit down and go over things with this student. You can even use the I think this is time saving, you can use the assessment tool that your school uses weekly, right? You can print it out and say, here's where we are now because of these things, right? This this is where you were yesterday or last week. You've moved the needle up a little bit more, here's where we're looking now. And then what that does is also saves you time when you're filling out like maybe the midpoint or final evaluations. You don't have to sit there and think, What was happening? You already told the student just a little bit ago, like, oh, we're at you know, uh six out of ten or something like that. And you can just mark it down. You've already got the examples written, you've got everything. So just kind of taking that time to stay on top of the evaluation itself, the rubric or whatever it is the school has filling out. I think that saves you time in the long run from scratching your head and trying to think at the very last minute, like, oh, what happened and how can I support this particular grade that I'm giving the student or a final e-boil or something along those lines.

SPEAKER_02 33:48

And and I also think when you have a lot of students that come through, I I can't be the only one who sometimes would stop and say, wait a minute, was that this mod or did that happen last mod? Like I can't quite remember. You get in this routine and it's sometimes easy to kind of lose track, or you know, the human memory is is famously unreliable too. So, you know, we might how do we know that what we're doing is consistent? And I think what you talked about with documentation is really helpful for all of us. Another idea maybe is to put some of that documentation expectation on the learner. So to ask them, like, hey, we're gonna have this conversation. Will you summarize that and send it to me? Number one, it helps me know did they hear what I said in the way I meant for it to be taken or whatever the key points are. It helps them build that skill as well. It also might be a way for you to have them do that before you meet. So, hey, before we meet on Fridays, I want you to write down, you know, three things you're really proud of that you did this week that went really well, three things you're working on, whatever that framework might be. But if you want to build something specific that you can use with every single student, that might help you build some of that documentation out so that you can refer back to it, you know, in your evaluation and reflection. Same with if you have really concrete benchmarks, bring those into those feedback Fridays. Say, okay, remember this was the benchmark we were aiming for. I think you've met it here, or you're really close. I think next week, you know, I want to see this so that we can move on to this next thing. So I think bringing those in, it should be a very transparent process. There shouldn't be some secret behind closed doors evaluation that the student's not privy to, right? So I think that's part of it as well. I want to also, oh sorry, go ahead.

SPEAKER_00 35:36

I love having the student kind of do that assessment too. Again, back to you know, self-assessment and things like that, but it also helps point out when what I like to call it is uh students have a warped mirror if they're self-assessing and something's kind of off or they're not seeing things, right? It's your opportunity as a preceptor to say, hey, you know, this is actually what really happened, or something along those lines. Um, but also it gives them again the opportunity to assess themselves and an opportunity for you as a preceptor to see when you might be on different pages of the book or living on different worlds. That happens a lot too when it gets to me, especially. So it's like when I get one story from the student about what's expected, one from the preceptor, and you see that misalignment when the student can do that self-assessment, and you see, like, oh okay, I we can get back on the same page now. I can see where the issues are, I need to re-explain the expectations. So I think that's a great opportunity having the student self-assess, come in and say, here's what I think's going on, and you're like, that's either is or isn't what's actually going on. A very, very good opportunity to redirect.

SPEAKER_02 36:45

And self-assessment is a skill, right? It's a professional skill we all use that, again, is kind of running in the background. But for students, giving them explicit opportunities to self-assess can be helpful. I want to ask you, though, about teams, right?

Team Input And Preceptor Handoffs

SPEAKER_02 37:00

Most most of us are working with other people. We're working with other pharmacists or technicians or other healthcare providers. What is your perspective on getting input in the assessment process from others on a team and maybe what might be some best practices around that?

SPEAKER_00 37:16

Yeah, you know, um, if if you are precepting as a team, and you know, it happened it definitely happens. We have some rotations where we have one main preceptor point of contact, but the preceptor puts together a schedule so that the student can get a wide variety of experiences, which is I think that's great. Um, but at that point, it's up to you as the main preceptor to make sure you're communicating with the people that the student is with for that day or that hour. Get their input, get their feedback. You can potentially put together a tool for them to use to evaluate the student at the end of the day that might be based on the rubric or whatever it is the school has you using to assess them. It could be something homegrown just so you can get a feel. But making sure you're having that handoff, that communication is really important. I've heard students in these situations tell us, like, oh, well, one preceptor says this, one preceptor says that. I don't know what to which one to follow whenever I'm with who, you know, the expectations change and making sure that the student is aware of when they're handing off to the other preceptor, like what the expectations for that day are, uh, and just making sure the communication between the preceptors is is there and it's consistent and structured would probably be the best when possible, just to make sure it's again impartial, their handoff between the two.

SPEAKER_02 38:40

I love the idea of a structured process. And I think the handoff is getting me thinking too about when we set those expectations and benchmarks. If we're working with others that are also working with our learners, it maybe makes sense to get input of others as we're setting those benchmarks to make sure that we're all that we're not all we're gonna be the same, but we can be aligned. I also like to encourage my preceptors and myself too to let students know if you're collecting feedback from others and how it's being used. So to say, hey, I know you're spending half your time with this other person. I want you to know that we're meeting and talking through that. I'm gonna bring that into this evaluation process, or I'm gonna bring this into the assessment and just kind of reiterate what I'm hearing so that you know what is being said and where it's coming from. Again, I think knowing that up front is helpful, but certainly being transparent in the end can be really powerful.

SPEAKER_00 39:33

Yeah, along those lines, one of the things we do, like we we have one site in particular who that always does a team preceptor approach with two preceptors. And so the student is you know essentially half and half between the two, and they may be in different practices or you know, in the same general area, but you know, maybe different teams or something like that. And we actually build into our electronic managed learning management system, we'll have both preceptors listed so they can actually both fill out evaluations, and so then the student is very aware of that up front as both of them are gonna fill out these evaluations. Well, on the back end, we'll average things together as a school when we're calculating grades and stuff like that. But that way they've got they know that formal feedback is going to be coming from both preceptors. Some of them still choose just to fill out one eval together, which is perfectly fine too, whatever works for them. But I think that's a great idea making sure that the student is upfront aware. Everyone involved is going to be providing feedback and it will be brought into the to the evaluations and to the assessment.

SPEAKER_02 40:40

What

Common Pitfalls Like Halo Effect

SPEAKER_02 40:41

do you think are some maybe pitfalls related to assessment and and maybe documentation? We took we touched briefly on that. That you know, you would say, ooh, this is this is one to try to avoid for preceptors.

SPEAKER_00 40:56

I think it's the biggest one that I've seen is probably gonna be using a single example of something occurring, and that's kind of what the whole assessment hangs on, right? Using that one example and saying, well, you can't do this because you messed up one time. When realistically the assessment should be about the entirety of the rotation, the entirety of the experience, their progress, right? Maybe maybe that one time affects how you think about their consistency with being able to perform something. But if the student is doing really, really good for the whole rotation, and then maybe on the last day it's kind of a rough day for some reason, making sure not to let that one day completely overshadow the rest of the effort and progress that the student had has made for the rest of the rotation. I understand it's especially at the end, it's very easy to let that kind of sour things a little bit whenever you go to fill out the evening. The same thing can happen the other way around. If the student is struggling the entire rotation and then suddenly they have a pretty good day on the last day, I talked to preceptors about this quite a bit. That's actually one of the biggest struggles I see them have is how do I grade the student? They did find on the last day. It's like, but there's no consistency there. The whole rotation they struggled and they pulled it together for one day, they had a good day. Like, you know, how do we bring that in? So I think that's one of the biggest pitfalls, and just one way to avoid that or to navigate it is think back about the progress. Where did they start? Where did they end? Have they proven they can do these things consistently? Can you trust them to do this? Would you be fine just peripherally supervising them to do it if it's an appropriate activity for that? And thinking from that aspect of would I want to see this student filling my family's medications based on their consistent or inconsistent performance? And I think that kind of helps frame things a little bit for preceptors. I think that's one of the biggest pitfalls is using that one day or that one instance to hang the whole evaluation on. That could be a big one.

SPEAKER_02 43:10

That's a really tricky situation. And I like that you gave an example in both directions because that certainly happens. And I appreciate you bringing up the idea of consistency. I I would agree that I think we want to see a pattern, right? Of someone being able to demonstrate abilities in a pattern and consistently, certainly, and and not to say it has to be every time, right, from the day one, but you want to see that growth too consistent in what is reasonable for that rotation. Again, if you're in a very high intensity specialty area and you've got years of advanced training, then may maybe that's not the patient case they're gonna get exactly right. And that might be fine in that scenario. But you might expect that they can do some of the other parts of that patient workup consistently. And I think again, that's Clarity around expectations. Another pitfall I see sometimes is both what is known in the literature as failure to fail, where students or learners really are not meeting a passing criteria, but we still fear giving them that failing grade. And that can happen for many reasons. You know, one thing I've I've said myself and I've heard other pre-preceptors say is gosh, I feel like I didn't do enough this rotation, or I don't feel like I gave them the best feedback I could have been giving them. And so we sometimes take responsibility for that. And I appreciate that preceptors feel responsible, but it isn't just about that. So I think being aware that you know feedback is important and we're doing our best, but we don't have to be perfect preceptors because that's not real. So I think that's one pitfall that I have seen as well, that can sometimes trip up our evaluations.

SPEAKER_00 44:54

Yeah, I think uh another another big one I've seen has been like a halo effect. A student who's very, very personable, their soft skills are great, uh they're just their day-to-day, they're delightful to work with. They get along with everybody, you enjoy sitting with them and and like just being together with them, right? But you look at their work and you're like, oh, this is actually objectively really not good, and maybe borderline dangerous for a patient or something like that. It's like, but there's they're so nice, they're so nice, and I want to pass them, and I don't want to be the person to hold them back. But it's it can be really tricky, right? You also don't want to hurt that relationship because you've built you've spent what however many weeks building a good relationship with this person, with this future colleague, and now you're gonna potentially be the thing that holds them back from graduating on time or something along those lines. It can be really tricky. So I think in those cases, if you have to make sure you're assessing them fairly objectively, the same you would any other student. Try your best to remove that internal bias of this is a really nice person, and again, ask yourself would I want to see them taking care of my family members in some capacity? Are they dangerous? Or is there actually an issue coming up here that we need to address and that hasn't met the benchmark yet? They're really nice, but we have to uphold the standards of the profession and again what's entrusted to us is by the public.

SPEAKER_02 46:27

I the thing that came to my mind as you were saying that is clear as kind, you know, and that idea of we want to be clear and we want to help them. And you're right that sometimes we really like a learner, even if they're not doing great. Um, and the opposite. We can have someone who's objectively doing great, but we just don't really, our personalities don't mesh as well. And so I think when we think of assessment, it is important to think as objectively as you can. I think your point earlier about making notes for yourself, we we refer to that as documentation, but don't get, don't let that word sound scarier than it is. It's just consistently taking notes on all of your learners to help you look back consistently and look for patterns. I think those things can really help us navigate some of those pitfalls and just being aware of them, right? And sometimes that can just being aware can help. Um, or asking your team, you know, hey, am I is this overshadowing what I think is going on here or, you know, whatever that might be? So I think those are useful strategies that can help us get through some of those pitfalls.

When To Contact The School

SPEAKER_02 47:35

You know, my last question, well, one of my last questions, I guess, is when would you recommend someone reach out for help? And so we've kind of talked about that a few times, but what's what's the advice there? When do you reach out for help as a preceptor about assessment?

SPEAKER_00 47:47

I'll I'll try to avoid getting on the soapbox, but I'll touch on it a little bit. I would say as soon as you notice something, as soon as you know something is going on, reach out to the school. Even if you don't want us to intervene yet, if you think you've got it, let us know about it as soon as possible. The reason for that is you know, we've got the full scope of the student. You're only seeing them for a short period of time. This may be the same issue that we've addressed with this student on previous rotations multiple times, right? And we know things that have worked and haven't worked with them. Um let us know because we're following the student longitudinally as well, and we need to know what to watch out for for future rotations. Um, you may have it as a preceptor, you may be able to correct it. That's great. I want you to do that. I want you to have that ability, that academic freedom, I guess you could call it. But let us know about it so that we're not surprised, like suddenly it's you know, week five, like week six of the six-week rotation, and you give me a call, like, I tried everything, they're gonna fail the rotation, and this is the first time hearing about it, right? That's a surprise. But the grades shouldn't be a surprise for us in experiential either. So, you know, reach out as soon as you as you notice something is off, and you know, you can let us know these are the things I'm gonna do. I've got it for right now. I'll let you know if I need more help. Perfect.

SPEAKER_02 49:13

Those are my favorite emails, are the ones where you know it's more of an FYI. I I'm happy to let that be an FYI, right? I'm happy to say, great, you know, I I appreciate that. It also allows me to check in on preceptors because it's it can be hard and draining as a preceptor too. Sometimes we need support also in our precepting role. So yeah, I I really encourage preceptors to be in contact early and often about, you know, things they're noticing, because it really helps us give us a lot of information and help us know where we can help the student if we need to help as well. So yeah, I think that's an important place. I also would say, and we mentioned this earlier, but if you're looking at the evaluation tool and you're confused about it, or you're saying, like, gosh, my expectations are one thing and the tool gives me a different answer than what I would expect, that would be another place where I would say reach out to the school and let them know tools are not perfect, right? And and being able to trust a tool is is hard. Uh, and it might be that maybe there's some misinterpretation of the tool or or you know, it wasn't written in a way that's very clear. So reach out about that as well. And I think that that can help us figure out where things are maybe going awry when it comes to assessment. I've really appreciated our conversation about a hard topic. Um, and I hope that anyone listening also feels like they're leaving with some practical ideas. Shane, thank you so much for sharing your experience and your wisdom and your insight. Uh, before we close, I just want to ask what this is my last question. What do you think is one thing preceptors could do today to apply something we've talked about that they can just go ahead and start today and try doing?

SPEAKER_00 51:01

I think putting together a system to document your observations of the students, even the ones that are performing well, get you a little notebook or set of notes in you know in your phone. But just something where you can just quickly jot down, I saw the student do this, it did or didn't meet expectations because of this. We can talk about this on Friday, you know. Just quick jot, that's all it takes.

SPEAKER_02 51:29

I love that. I I love a system, I think it makes it easier to make it work, and you're not reinventing the wheel all of the time. So I I love both the idea of a system and the idea of we talked about consistent student work, but also us as preceptors being consistent about documenting what we're seeing. It really does make your life a lot easier in the end when you're filling out those evaluation tools. So, again, thank you so much, Shane, for joining me today and talking about this. I'm hoping our listeners got as much out of it as I did.

One Action To Start Today

SPEAKER_02 52:04

To continue building on what you've learned today, be sure to explore the companion practice resource included in the course materials. This downloadable resource highlights key takeaways from our discussion today and includes practical tools you can use in your own precepting environment, such as checklists, scenarios, step-by-step frameworks to help support confident practice ready learners. Because don't forget, learning is most impactful when it's applied in practice. Thank you again for joining us for precept to practice. Until next time, keep bridging the gap from precepting to practice.