A comprehensive approach to an effective training program for new pharmacy residency

preceptors

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Sandeep Devabhakthuni, PharmD, BCCP, University of Maryland School of Pharmacy, Baltimore,

MD, USA

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Carley Castelein, PharmD, BCPS, CPPS, Medication Safety and Systems Innovation, HCA Healthcare,

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Nashville, TN, USA

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C. Whitney White, PharmD, BCPS, FASHP, FALSHP, Samford University, McWhorter School of

Pharmacy, Homewood, AL, USA

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Address correspondence to Dr. Devabhakthuni (sdevabha@rx.umaryland.edu).

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Twitter: @deepdev511
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Keywords: new preceptor, preceptor development, residency accreditation

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© American Society of Health-System Pharmacists 2022. All rights reserved. For permissions, please
e-mail: journals.permissions@oup.com.
The American Society of Health-System Pharmacists (ASHP) has over 75 years of experience

developing and applying pharmacy practice standards to ensure the delivery of quality care in both

practical and innovative ways. Accreditation through ASHP provides a residency program with the

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assurance that the program and its preceptors demonstrate a high level of quality and excellence in

postgraduate training. ASHP’s rigorous accreditation standards provide a necessary bridge between

education and practice and address critical components influencing how future practitioners will

successfully engage in an ever-changing healthcare landscape.

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Current ASHP residency standards across different types of programs require the inclusion of

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a preceptor development plan with a documented schedule of activities for each residency year for a

program to be fully compliant for accreditation.1 These development plans can be designed for

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individuals or groups based on the specific institution. In addition, the current residency standards
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require new preceptors who do not meet eligibility and qualification requirements to have a

documented plan to help the new preceptor meet requirements within 2 years and also be
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appointed a mentor who will cosign the new preceptor’s evaluations. New preceptors who do not

meet the criteria are known as preceptors-in-training in the current standard. The current residency
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standards will be replaced by a single new harmonized standard for all residency programs as of July
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1, 2023, that requires all preceptors who do not meet qualifications to have a development plan to

meet criteria within 2 years.2 Additionally, the term “preceptor-in-training” has been eliminated in
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the harmonized residency accreditation standard as well as the requirement for the assignment of a
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mentor or coach (although the option to assign a mentor will remain in PharmAcademic). Although

the requirements related to preceptors will change with the implementation of the new standard in

2023, the concepts for training new preceptors and guiding them to meet preceptor qualifications

are still applicable.

Outside of requirements established by ASHP accreditation standards, training programs for

new pharmacy residency preceptors have many benefits. Structured programs allow for consistency
in educational and professional development as well as accountability. Moreover, these programs

can include topic areas that meet the needs of new preceptors, with the ability to tailor to areas in

which they may be deficient or less experienced. The mentor/coach relationship can also positively

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impact the overall development of new preceptors by providing much-needed support and insight

from a more seasoned preceptor.

Although training programs for new preceptors can be beneficial, they also come with

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implementation challenges, particularly for smaller institutions or those with smaller residency

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classes. Details such as scheduling, staff turnover, preceptor availability, financial considerations,

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and accessibility to off-campus preceptors can be logistically difficult. Incorporating the program into

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the performance review process and holding preceptors accountable for attending development

activities can also pose a challenge. In addition, fully gauging the needs and interests of your new
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preceptors and fulfilling those specific needs can be complex and requires much planning.
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The objective of this paper is to describe how to successfully develop and implement an

effective training program for new pharmacy residency preceptors that meets both ASHP residency
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accreditation standards and the goals of the residency program and institution.
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Establishing a training program for new preceptors. New preceptors who do not meet the
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qualifications defined by the ASHP residency accreditation standards must have a documented
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individualized preceptor development plan to achieve qualifications within 2 years.1,2 New

preceptors often struggle with meeting these requirements due to the lack of a support system and
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opportunities for ongoing professionalism. Creating an organized process for new preceptors who do

not meet ASHP qualifications will help them be successful. Figure 1 outlines some of the key roles

and responsibilities of those involved in this process.

To successfully implement a training program for pharmacists new to precepting, a clear

action plan needs to be developed to address key components (see Table 1 for an example
checklist). The first step is establishing a preceptor development committee to oversee the

preceptor appointment process and coordinate preceptor development activities. This committee

typically consists of residency program directors and coordinators, experienced preceptors, new

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preceptors, and current residents. This committee should meet at least annually to review policies

and the overall preceptor development plan for the institution.4 The institution’s preceptor

development plan should include the roles and responsibilities of program directors, coordinators,

and preceptors; the committee charges; the needs assessment process; and a schedule of preceptor

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development activities (eg, quarterly seminars).5,6

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Conducting a needs assessment survey can generate ideas for preceptor development

seminars to guide new preceptors.7,8 Truong and colleagues8 conducted a needs assessment of

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preceptors from 31 accredited Canadian general hospital pharmacy residency programs using
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interviews and focus group discussions with key informants, a pilot study, an online survey, and

member checking. In this study, preceptors ranked communication skills, giving effective feedback,
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and clinical knowledge as the top priorities for being an effective preceptor. Preceptors reported

challenges with managing workload, performing evaluations, and managing difficult residents.
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Preceptors expressed an interest in receiving educational support through interactive workshops

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and mentorship programs with experienced colleagues when first becoming preceptors. The

preceptors selected the following as the most important topics to include in the workshops:
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constructive feedback, practical assessment strategies, small group teaching strategies, effective
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communication skills, and setting goals and objectives.

The second step is for the committee to review new preceptor applications and determine

whether a candidate is prepared to precept pharmacy residents. Typically, new preceptors are asked

to submit a statement of interest and complete the ASHP Academic and Professional Record, which

cannot be substituted with a curriculum vitae. The preceptor development committee then reviews

the submitted documents to determine whether the new preceptor meets the qualifications defined
by the ASHP residency accreditation standards.1,2 Preceptors who do not meet the qualifications (eg,

recent residency graduates) would need to develop goals to become an effective preceptor.2

The third step is for new preceptors to create a documented individualized preceptor

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development plan that meets ASHP qualifications. The preceptor development committee should

assign an experienced preceptor to serve as a mentor. While mentorship is not required by ASHP, a

mentor can ensure that the new preceptor is successful in achieving their goals. The mentor and

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new preceptor should work together to create a preceptor development plan for the next 2 years.

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This development plan should include all ASHP qualifications that the new preceptor has not yet

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achieved with a planned timeframe for fulfillment (eg, achieving board certification in 1 year for

recognition in an area of pharmacy practice, contributions to pharmacy practice).1,2 The preceptor

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development plan should then be submitted to the committee for approval.
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The fourth step is to develop a process for new preceptors to complete their preceptor
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development plan. Guidance on the requirements to become a preceptor should be provided. For

example, the new preceptor could be required to do the following: (1) attend preceptor
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development programs, (2) precept a resident on rotation with oversight, (3) mentor a resident
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presentation, and (4) mentor a resident research project. A new preceptor orientation is
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recommended to ensure that new preceptors have the skills needed to precept residents. Suggested
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topics for this orientation include (1) identifying qualities of an effective preceptor; (2) defining

resident roles, expectations, and responsibilities; (3) developing a rotation syllabus; (4) evaluating
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trainees with the use of criteria-based feedback; (5) defining preceptor roles; and (6) reviewing

common precepting challenges. The new preceptors should then meet with their mentors every

quarter at a minimum to discuss progress updates on development goals. When possible, new

preceptors should attend preceptor development activities at the local, state, or national level for

ongoing development and advancement of teaching skills and to ensure clinical and precepting

competence.
 The fifth step is to conduct an annual assessment of the new preceptor until they meet

preceptor qualifications. The new preceptor should submit a progress report annually for the

preceptor development committee to review. The committee should also ask the mentor and

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involved residents for constructive feedback for the new preceptor, including on their ability to

assess performance and precept residents using the 4 preceptor roles (instructing, modeling,

coaching, and facilitating).5 The committee should also have a plan for preceptor remediation if the

new preceptor is not achieving their goals. A designated party to oversee the remediation (eg, a

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pharmacist supervisor, residency advisory committee, or the preceptor development committee)

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should be included in the policy.

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The final step is to implement a continuous review process to ensure the effectiveness of the

program. The preceptor development committee should ask new preceptors and their mentors for
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their feedback. On the basis of their feedback, the committee should develop an action plan to make

improvements for the following year.

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Activities for new preceptors. Both formal and informal proactive learning behaviors help
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an individual grow into an independent preceptor. This section will focus on formal opportunities to
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engage in and document development activities, but preceptors should also practice self-reflection
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and being supportive team members.

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The institution should provide programming for new preceptors to learn the primary

responsibilities of a residency preceptor. Potential topics can include assessment of preceptor skills,
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review of residents’ evaluations of preceptors, peer review, preceptors’ self-assessments, and/or

performance review. Preceptor development activities should go beyond reviewing practice

guidelines or providing continuing education on clinical topics. They should focus on effectively

precepting residents regardless of practice setting (eg, methods for providing effective feedback,

setting clear expectations, instilling professionalism and confidence).1,2

 Giving, receiving, and documenting feedback for learners and themselves is one of the most

important aspects of being a preceptor and thus becoming a lifelong learner. New preceptors should

plan to meet with their assigned mentor to review feedback content and style as well as receive

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coaching before providing verbal and written feedback to the resident. It is advised that this

premeeting be held 1 to 2 workdays before the resident’s feedback session. The mentor should

document their coaching, and this should be reviewed during the next session with the new

preceptor when their reflection is shared. Figure 2 provides an example of this cycle, which should

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occur at the rotation’s scheduled evaluations and as needed.

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When possible, it is advantageous for a new preceptor to work with an established

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preceptor to lead resident research projects, thereby ensuring that the requirements are met. When

using this layered learning approach, it is best for the senior preceptor to orient the new preceptor
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to the established processes and share effective strategies to set the resident up for success. The

new preceptor should then serve as the primary preceptor and establish expectations with the
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resident, following up regularly with the senior preceptor during the longitudinal rotation for

questions or concerns that arise, in addition to the feedback cycle described above.
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New preceptors should work with their employers to pursue learning opportunities that
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improve their skills and support professional growth. When possible, individual preceptors should
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include their precepting goals in regular conversations with their manager and in their annual

performance review documentation to help facilitate synergy between the institution’s goals and
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new preceptor responsibilities, self-growth, and advancement of the pharmacy profession.

Conclusion. Residency program accreditation through ASHP is a rigorous process that

ensures a high level of quality and excellence in postgraduate training. ASHP standards require the

incorporation of preceptor development plans, which include additional support and mentorship for

new preceptors as they work toward the achievement of preceptor requirements. For residency

programs to efficiently and effectively implement a training program for new pharmacy residency
preceptors, thoughtful planning and use of pragmatic processes must be employed. Preceptor

development committee oversight, tailored development plans, and continuous assessment and

evaluation of preceptors and the training program are key components required for overall success.

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This article summarizes the importance of dedicated training programs and provides practical

information and tools that residency programs can utilize to develop and implement training

programs for new preceptors that meet accreditation standards and align with the professional

goals of preceptors.

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Disclosures

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The authors have declared no potential conflicts of interest.
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References

1. American Society of Health-System Pharmacists. Accreditation standards for PGY1

pharmacy residencies. Published 2020. Accessed May 12, 2022.

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https://www.ashp.org/Professional-Development/Residency-

Information/Residency-Program-Resources/Residency-Accreditation/Accreditation-

Standards-for-PGY1-Pharmacy-Residencies

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2. American Society of Health-System Pharmacists. ASHP accreditation standard for

postgraduate residency programs. Published 2022. Accessed August 31, 2022.

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https://www.ashp.org/-/media/assets/professional-

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development/residencies/docs/examples/ASHP-Accreditation-Standard-for-
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Postgraduate-Residency-Programs-effective-July-2023.pdf

3. American Society of Health-System Pharmacists. Preceptor development plan.

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Published 2020. Accessed March 1, 2022. https://www.ashp.org/-

/media/assets/professional-development/residencies/docs/preceptor-development-
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plan-examples.pdf
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4. Weitzel KW, Walters EA, Taylor J. Teaching clinical problem solving: a preceptor’s
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guide. Am J Health-Syst Pharm. 2012;69(18):1588-1599. doi:10.2146/ajhp110521

5. Fuller PD, Peters LL, Hoel R, Baldwin JN, Olsen KM. Residency preceptor
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development and evaluation: a new approach. Am J Health-Syst Pharm.

2013;70(18):1605-1608. doi:10.2146/ajhp120684

6. Ricchetti C, Jun A. Strategies and resources for successful preceptor development.

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7. Hartzler ML, Ballentine JE, Kauflin MJ. Results of a survey to assess residency

preceptor development methods and precepting challenges. Am J Health-Syst

Pharm. 2015;72(15):1305-1314. doi:10.2146/ajhp140659

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8. Truong C, Wyllie A, Bailie T, Austin Z. A needs assessment study of hospital pharmacy

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doi:10.4212/cjhp.v65i3.1143

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Figure 1. Established roles and responsibilities to implement preceptor requirements.

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Figure 2. The recommended process for mentors to provide coaching, including feedback, for new

preceptors.

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Table 1. Action Item Checklist for Implementing A New Preceptor Training Program

Activity Responsible person(s) Progress notes Date achieved

Review ASHP preceptor

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requirements related to new
preceptors
Establish a preceptor
development committee
Create process for review of
new preceptor applications
Identify potential mentors

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Match new preceptors to

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mentors
Create development plan
template using ASHP required

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elements
Construct a process for new

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preceptors to proactively use
the development plan
Coach new preceptors on the
aforementioned process
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Conduct annual assessment of
new preceptors
Solicit annual feedback from
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new preceptors on challenges

and support of the program
Devise a continuous review
process to ensure effectiveness
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of the program and implement

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future change
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Figure 1

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ASHP Preceptor Requirements for the Institution
- Develop a committee for
Preceptor Development Committee
oversight
-Track completion of each -Establishes additional standards
Mentors
academic and professional record for preceptors
-Facilatate new preceptor growth

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-Reviews applications to
determine qualified preceptors and self-reflection

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and preceptors new to precepting -Provide peer to peer support
-Conduct annual assessment of -Continue to grow self
preceptors new to precepting

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-Identify established preceptors as
mentors

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Figure 2

Mentor and new

preceptor meet to
discuss the feedback
that will be given to the

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resident

New preceptor shares

Mentor provides
highlights from their
coaching on content
session and reflection
and style
with mentor

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New preceptor reflects

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New precptor provides
and documents how
feedback to resident
the session went

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New preceptor solicits
feedback from resident
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on rotation and
preceptor style
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