Purpose An elective rotation specifically designed to prepare postgraduate year 1 (PGY1) pharmacy residents for careers in academia is described, with insights on challenges faced and benefits gained during the first offering of the rotation.
Summary Through a collaboration of the University of Florida (UF) college of pharmacy’s St. Petersburg campus and the community-based Lee Memorial Hospital (LMH), a four-week elective rotation was incorporated into an existing PGY1 pharmacy residency program to provide trainees with structured and intensive exposure to the three basic components of a career in academia: teaching, service, and scholarship. Designed to expand on knowledge and skills acquired in a PGY1 teaching certificate program, the academic teaching rotation comprised a variety of experiences, including (1) daily participation in several large- and small-group teaching activities, (2) opportunities for participation in admission interviews of prospective college of pharmacy students and other service activities, and (3) independent scholarship activities such as the preparation of an article suitable for publication in the professional literature. Recent data indicate that nearly 33% of vacant teaching positions at U.S. schools of pharmacy remained unfilled during the 2009–10 academic year due to a lack of qualified candidates. Broader implementation of formal teaching rotations such as the UF–LMH program could help address the faculty staffing shortfall.
Conclusion An academic teaching rotation can provide a PGY1 pharmacy resident with experiences in teaching, service, and scholarly activities beyond those typically offered in residency programs.
All postgraduate pharmacy residency programs include some teaching activities, as required by the accreditation standards of the American Society of Health-System Pharmacists (ASHP).1,2 There are numerous ways to incorporate teaching activities into a residency program, and the literature has described various methods for accomplishing that objective.3–7
One way to provide teaching experience to pharmacy residents is through a certificate program. Although there are currently no set standards for certificate programs in teaching, such programs typically include resident involvement in didactic seminars, various hands-on teaching experiences, and the development of a teaching portfolio.3,4
Another way for residents to obtain teaching experience is by serving as preceptors of Pharm.D. candidates.5 Typically, residents serve as copreceptors, but occasionally they serve as primary preceptors of pharmacy students.6 Yet another method described in the literature is having residents participate in an in-depth experience designed to develop them as future clinical faculty members7; this method provides residents with the opportunity for direct service as student preceptors, as well as a chance to learn to balance attendance at committee meetings and other academic duties with clinical responsibilities.
Before entry into a residency program, there are opportunities for pharmacy students to gain some experience in academia, as many colleges offer advanced pharmacy practice experiences (APPEs) in this area for fourth-year students.
This article describes an innovative approach to academics-focused training: a teaching elective for a postgraduate year 1 (PGY1) pharmacy residency developed by a community-based health system affiliated with a state-funded university.
Program structure and characteristics
The Lee Memorial Hospital (LMH) PGY1 residency program trains two residents within the Lee Memorial Health System, a community-based health system with facilities in Fort Myers and Cape Coral, Florida. Residents are provided with opportunities to participate in a teaching certificate program offered by the University of Florida (UF) college of pharmacy at the St. Petersburg campus. Additionally, the PGY1 residents serve as preceptors of students from several colleges of pharmacy. However, beyond those activities, the residency program offers limited opportunities for residents to prepare for careers in academic pharmacy.
The UF college of pharmacy has four campuses: the main campus in Gainesville and distance campuses in Jacksonville, Orlando, and St. Petersburg. Each campus offers APPE rotations in academic teaching for fourth-year pharmacy students. In June 2010, the LMH residency program director and the assistant dean–campus director at the UF St. Petersburg campus worked together to develop a four-week elective rotation structured to give a PGY1 pharmacy resident exposure to the three basic components of a career in academia: teaching, service, and scholarship. The first resident to participate in the elective rotation completed the rotation during the 2010–11 residency year. While some teaching experiences required within the rotation were similar to other activities completed during the residency program, the goal was to provide a unique and challenging experience for the resident.
The St. Petersburg campus is a 2.5-hour drive from Fort Myers, so participation in the elective rotation was a truly immersive experience as it was necessary for the resident to relocate to St. Petersburg for one month. Assistance with housing arrangements was provided by the residency program and the college of pharmacy. The resident met with the assistant dean to discuss activities and expectations before the rotation began. Throughout the four-week rotation, the resident had the opportunity to participate in a variety of activities relating to all aspects of academic practice, including direct teaching opportunities, service experiences, and independent projects focused on scholarship.
Most residency programs require the completion of a continuing-education presentation, thereby providing trainees with some exposure to one form of lecturing. Traditional residency programs typically emphasize classroom-based activities but offer residents limited exposure to the facilitation of group learning activities. In contrast, the UF college of pharmacy uses a distance-learning model, so while the teaching rotation offered fewer opportunities for the resident to give didactic lectures in the classroom, it provided ample opportunities for course facilitation.
Throughout the course of the month-long rotation, the resident participated in approximately 60 hours of direct interaction with students; one third of that time was spent conducting one-on-one review sessions with first-year pharmacy students regarding their performance in an introductory pharmacotherapy course. In order to prepare for these sessions, the resident was required to view video of all students who were called on to present in the classroom during the preceding week and critically evaluate their performance using a provided form. The resident communicated directly with the students to schedule the meetings, which lasted approximately 20 minutes. The goal was to provide students with praise for their accomplishments and techniques to help them improve future presentations. Each student had an opportunity to evaluate the resident at the end of the review session, and the student evaluations were incorporated into the final evaluation of the resident on completion of the teaching rotation.
The resident’s remaining 40 hours of direct teaching were devoted to classroom observation and grading (10 hours), small-group facilitation (14 hours), and large-group interactions (16 hours).
The first resident to participate in the elective was not a graduate of the UF College of Pharmacy. While this was a benefit in that it exposed the trainee to an unfamiliar teaching philosophy and curriculum, it also posed logistic challenges. By virtue of the college’s distance-learning model, the activities that take place on campus range from small-group discussions to case presentations and oral defense exercises to role-playing scenarios and hands-on laboratory activities. In order for the resident to participate in those activities effectively and to ensure that the pharmacy students received the desired high level of instruction, the resident initially dedicated a certain amount of time to observing and understanding the structure of the students’ curriculum and courses. While this reduced the amount of time the resident could devote to active participation in teaching, in our view it ultimately provided for a better overall quality of instruction and a more beneficial training experience for the resident.
After the initial observation period, the resident participated in several on-campus courses. The 14 hours dedicated to small-group facilitation were split between helping to train fourth-year Pharm.D. candidates to pursue certification in vaccine administration and role-playing in the first-year communications course; the remaining 16 hours of the total of 60 hours of direct teaching activities were spent in a variety of courses in which the entire class participated. The majority of this time was spent in a pharmacotherapy course in which fourth-year students gave hypothetical case presentations and offered a oral defense of their decision-making; the resident initially had a limited role as a faculty questioner but gradually assumed the role of primary questioner by the end of the rotation. Other direct teaching activities included role-playing and serving as a faculty questioner in a first-year pharmacotherapy course; participating in a review session and quiz in the first-year pharmacology course; and facilitating two guest panels on professionalism for the first-year class, an activity that required the resident to obtain volunteer panelists, organize the panel sessions, and keep the discussion moving at the hour-long events.
Service and scholarly activities
Most ASHP-accredited residency programs include some type of experience in pharmacy administration, but these experiences, while beneficial, often entail service-oriented responsibilities very different from those typically required of faculty members. As previously mentioned, one of the authors (the assistant dean of the St. Petersburg campus) served as the primary preceptor for the teaching rotation and, as such, was well positioned to involve the resident in some relatively unique service activities.
Careful planning allowed for the rotation to be scheduled to allow the resident’s involvement in admission interviews with college of pharmacy applicants, attendance at a meeting of the University of Florida College of Pharmacy National Advisory Board, and participation in a series of one-on-one interviews with UF faculty and staff to gain insights into the varied demands of professional practice in academia.
In addition to those and other service duties, the resident was assigned a writing project to help mimic the scholarship activities required of faculty. The goal of this assignment was to expose the resident to the process of publication, including brainstorming topics, literature review, and manuscript submission. The short duration of the elective presented a challenge, but a rough draft of a manuscript was submitted before the completion of the rotation. Final edits were done via e-mail, and article submission occurred shortly after the end of the rotation.
Benefits and challenges
The purpose of a residency is to develop pharmacists to be competent clinical practitioners with enhanced leadership and professional skills; thus, every activity is planned for the mutual benefit of the resident and the institution. Here we discuss some of the benefits observed during the development and implementation of the academic teaching rotation.
Benefits for the resident
One of the biggest benefits of an academic teaching rotation is that it provides an in-depth training experience for residents already interested in a career in academia. The rotation experience expands on the basic principles often taught in teaching certificate programs, including lecture preparation, small-group facilitation, and assessment techniques. Allowing the resident to gain hands-on experience in these skill areas can reinforce other training methods while enabling the resident to develop and sharpen those skills through practice.
One benefit of participation in any pharmacy residency program is improved organizational and time management skills. The academic teaching rotation described here really tested those skills. Academia is a very independent area of pharmacy practice (rarely is there a supervisor hovering to ensure the completion of required duties) and also one in which it is common to have multiple projects in progress simultaneously. Therefore, faculty members need to be not only self-starters but also masters of organization to ensure that all projects are completed in a timely fashion. Giving residents a relatively independent training experience within a structured program such as the UF–LMH teaching rotation can help cultivate both initiative and organizational acumen.
One benefit of the teaching rotation that was not fully apparent at the outset was the reinforcement of clinical knowledge. The month-long rotation required the resident to facilitate group discussions or serve in the role of questioner in oral defense scenarios involving sometimes unfamiliar therapeutics topic areas. Fulfilling those roles successfully required that the resident be knowledgeable of a wide variety of topics; if the focus of teaching activities was an issue or topic rarely encountered in the hospital setting, a review by the resident was necessary.
The networking opportunities provided by an academic teaching rotation can be highly beneficial. The opportunity to meet and interact with a wide variety of faculty members and administrators can provide invaluable insights into the prerequisites for success in a career in academia. Often, pharmacy students are told to treat each fourth-year rotation as if it were a job interview; PGY1 residents might be advised to view an academic teaching rotation in the same way—a chance to network and build connections that may quickly lead to career opportunities.
Benefits for the college of pharmacy
The specific benefits that may accrue to a college of pharmacy hosting an academic teaching resident will vary with the institution and the skill level of the trainee, but some general benefits are almost assured. One of the most important benefits to be gained is the exposure of pharmacy students to “outside” views and perspectives. Especially at institutions where residents are not usually present, a visiting resident can help students learn more about the residency experience in general and gain new perspectives on the various career options available in pharmacy. Even if an institution already has a strong resident presence, bringing in a resident the students have not yet met can be beneficial in exposing them to fresh views and practice experiences.
One of the most obvious benefits to the college of pharmacy is the teaching assistance provided by the visiting resident. The resident is a licensed pharmacist who can help supervise students in a variety of activities, from classroom lectures and discussions to brown-bag medication reviews in the community. By allowing the resident—who is relatively unknown to the students at the beginning of the rotation—to engage in role-playing scenarios, faculty members may gain a better understanding of how the student might interact with an unknown patient in actual clinical practice. Another benefit is that because residents are typically recent pharmacy school graduates themselves, they may be able to bridge the gap between instructor and student perspectives and enhance the value of certain training activities.
A teaching rotation can also serve as a vehicle for better and more efficient hiring. The American Association of Colleges of Pharmacy recently reported a total of 374 vacant or “lost” faculty positions (i.e., positions discontinued or no longer funded) in 101 colleges and schools of pharmacy during the 2009–10 academic year; nearly 33% of the vacant positions were unfilled due to a lack of qualified candidates.8 Thus, at a time when it is increasingly difficult to find quality faculty members, pharmacy school administrators can use an academic teaching rotation as an extended job interview—an opportunity to evaluate how well the residents work with the current faculty and staff and assess their work under real-world circumstances. Even if the institution is not looking to hire new faculty members immediately, hosting a teaching rotation still provides a great opportunity for networking and future recruiting.
Challenges and lessons learned
As with any residency learning experience, there were challenges to overcome in structuring the UF–LMH teaching rotation and training the first visiting resident.
From the resident’s perspective, perhaps the biggest challenge was spending a whole month away from her usual practice site. In this case, the host teaching site was located a significant distance from the resident’s home institution. It was challenging to find a time window that would allow the resident to have the most beneficial experience at the college of pharmacy but minimize the impact of her absence from the primary practice site.
Other challenges relate to the scheduling of the teaching rotation. There are benefits to scheduling such a rotation early or late in the residency year. It may benefit the resident to participate in this type of learning experience early in the residency year to help develop skills that can be used while serving as a preceptor of students later in the academic year. On the other hand, it may be more beneficial for the college of pharmacy to offer the teaching rotation later in the academic year, as it will gain a more experienced—and presumably more effective—practitioner and instructor.
The wide variety of opportunities provided during the teaching rotation allowed the resident to experience and surmount the challenges associated with juggling multiple projects, something faculty members continually face.
One important lesson learned from our initial experience with the UF–LMH teaching rotation is the importance of a flexible and creative approach to program design. Often in pharmacy, there is no obvious solution to a particular problem or clinical situation; professional judgment must be used to reach the best conclusion. In the same manner, there is no right or wrong way to structure an academic teaching rotation. Every academic institution has unique strengths and weaknesses and unique opportunities to offer residents, and every trainee has different interests and strengths to bring to the residency program. By recognizing and capitalizing on each party’s unique qualities and assets, the rotation can be customized to meet the needs of both the institution and the resident.
A formal academic teaching rotation can provide a PGY1 pharmacy resident with experiences in teaching, service, and scholarly activities beyond those typically offered in residency programs.
The authors have declared no potential conflicts of interest.
- Copyright © 2012 by the American Society of Health-System Pharmacists, Inc. All rights reserved.