Developing Teaching Skills during the Pharmacy Practice Residency Program: DISCUSSION
During the residency program, pharmacy residents have opportunities to teach a variety of learners: patients (e.g., through medication counselling), pharmacists (e.g., through case presentations), peers (e.g., through formal presentations), nurses (e.g., through in-service sessions), physicians and medical residents (e.g., through ward rounds or therapeutic discussions), and sometimes the general public (e.g., through community outreach presentations). Despite the resident’s need to employ a wide array of teaching formats and strategies appropriate for these diverse settings and audiences, these opportunities do not allow residents to develop the skills necessary to precept a learner. This is because teaching is not quite synonymous with precepting, a view shared by the respondents to the surveys described in this report, as well as the CHPRB standards and the respondents to Moy and Musing’s survey.
In British Columbia, recent residency graduates, residents enrolled in residency programs in 2004, and program coordinators all agreed that teaching (e.g., delivering a didactic session for undergraduate students on a specific topic) is only one part of the responsibilities of the newly graduated resident who is put in charge of precepting an undergraduate student upon entrance to practice. The more challenging parts are assuming responsibility for the student’s learning, modelling how to prioritize a day’s work while providing pharmaceutical care, handling issues or difficulties that arise in daily practice, providing feedback, and dealing with difficult students.
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The responses to the BC surveys, albeit representative of only a small fraction of the programs in Canada, raised the issue of whether the residency program should be viewed as an opportunity for residents to increase job readiness by developing their teaching and precepting skills.
This dilemma is not unique to pharmacy. A survey of US internal medicine residency programs revealed that only 20% of them featured activities intended to improve teaching skills, despite the fact that residents provided 62% of teaching to medical students at the bedside. Although there are still very few medical programs that teach residents how to be teachers, initiatives designed to improve medical residents’ teaching skills are taking a more prominent place in the educational literature. For example, the Department of Pediatrics at the Massachusetts University Medical Centre developed a “Residents as Teachers” retreat that focused on clinical precepting skills, including evaluation and feedback. The retreat was developed after recognition of the fact that residents are expected to teach and evaluate students, yet only few receive appropriate training. Although there are critical differences between medical and pharmacy residency programs, it appears that both types could benefit from a closer look at the potential benefits and drawbacks of developing these skills while the resident is still in training and how this could be done.
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