PGY1 Pharmacy Residency Preceptors
Preceptors and Rotations
Ambulatory Care
Ann-Marie Coroniti, PharmD, BCIDP, AAHIVP
Clinical Pharmacy Specialist, HIV/PrEP and Infectious Diseases
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: MCPHS University, Worcester, MA
- PGY1 Pharmacy Residency: UMass Memorial Medical Center, Worcester, MA
- PGY2 Ambulatory Care Residency: Beth Israel Deaconess Medical Center, Boston, MA
Primary Area of Practice: Ambulatory Care-HIV treatment and prevention
How do you give feedback and include resident self-evaluation?
I give feedback on-demand and try to give feedback daily as well. By giving on-demand feedback the resident can improve and develop in specific areas in real time instead of waiting for a scheduled evaluation. I also like to give feedback at the end of every week (AKA “feedback Fridays”) so we can recap the week and the resident can get a good sense of how they are progressing throughout the rotation. Scheduled evaluations consist of a midpoint and final evaluation and feedback will be verbal and documented in PharmAcademic. The resident will be expected to provide their own self-evaluation at this time as well. I try to give positive feedback in addition to constructive feedback as I think it is important for the resident to recognize what they are doing well in addition to what they can improve upon.
Caroline Letendre, PharmD
Clinical Pharmacy Specialist, Cardiometabolic Care
Beth Israel Deaconess Medical Center, Healthcare Associates, Boston, MA
Training:
- Pharmacy School: MCPHS University, Boston, MA
- PGY1 Pharmacy Residency: Tufts Medical Center, Boston, MA
- PGY2 Ambulatory Care Residency: Beth Israel Deaconess Medical Center, Boston, MA
Primary Area of Practice: Ambulatory Care, Primary Care
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
- Instructing: Residents will participate in many learning activities throughout the rotation. These learning activities include topic discussions, journal clubs, case presentations, and answering drug information questions. Residents are expected to prepare and lead these activities, and I will instruct by adding additional information as needed.
- Modeling: Clinical skills will be modeled for residents particularly at the beginning of the rotation. During the first week or two of the rotation, I utilize modeling as residents are learning the workflow of the clinic. Shadowing me allows the resident to observe how to work-up primary care patients, utilizing appropriate resources to develop patient-specific treatment plans, communicating with primary care providers and counseling patients on their medications.
- Coaching: Throughout rotation residents will perform various patient-care activities, such as medication reconciliation, medication counseling, therapeutic monitoring and clinic visits (in-person and telehealth) with primary care patients. As the resident performs these activities, coaching with feedback will help to fine-tune these skills.
- Facilitating: By the end of the rotation, residents will be able to independently perform clinic visits, medication counseling, and develop treatment and monitoring plans for primary care patients. Throughout the rotation, I help the resident facilitate an independent relationship with the primary care multidisciplinary team and encourage the resident to take the lead with communicating patient-care plans to the team.
How do you give feedback and include resident self-evaluation?
I provide timely, effective, and quality feedback on-demand and at scheduled intervals. On-demand feedback allows for development in specific areas in real time. I always provide positive feedback in addition to constructive feedback. Weekly scheduled feedback provides the resident time for self-evaluation and review of overall development on rotation from week to week. I will ask questions such as; “what do you think went well?” and “what would you like to improve on?”. This allows the resident to set a goal for the following week to improve on a skill during the course of the rotation experience.
Marissa McCann, PharmD
Clinical Pharmacy Specialist, Ambulatory Care
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: University of Pittsburgh, Pittsburgh, PA
- PGY1 Community Pharmacy Residency: Beth Israel Deaconess Medical Center, Boston, MA
Primary Area of Practice: Ambulatory Care-Chronic Pain, Palliative Care, Substance Use Disorder, Opioid Stewardship
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating)
As palliative/pain management may be a new area of pharmacy practice to most residents, the rotation will start with the first step, instruction. Prior to direct patient care, we will work through topic discussions with case questions to review opioid conversion, titration and philosophy of palliative/hospice care. Then, depending on the resident and preceptor's comfort level, the resident can shadow or independently work up assigned patients. The preceptor will coach to validate and/or correct their thought process. At the end of the rotation, the resident will be responsible for independent review, communication, and conducting interdisciplinary visits under the facilitating preceptor.
How often do you meet with the learner while they are on rotation:
We will meet daily in person and/or virtually in the morning to pre-round patients for the clinic. In the beginning of the rotation, we will be going to clinic together, but as the resident progresses and gains independence, I will slowly back away, and the resident will fully run the service. But that doesn't mean I will be invisible/unavailable. I will be available throughout the day in person, via telephone, and/or email to answer questions, discuss patients, and address any issues. I will also formally meet with the resident twice weekly for evaluation and feedback, in addition to our daily informal feedback. While I try to foster independence, I am never more than a text away if assistance is needed.
Katelyn Smith, PharmD, BCPS
Clinical Pharmacy Specialist, Ambulatory Care
Beth Israel Deaconess Medical Center, Boston, MA
Email Katelyn
Training:
- Pharmacy School: Northeastern University, Boston, MA
- PGY1 Pharmacy Residency: Northwestern Memorial Hospital, Chicago, IL
Primary Area of Practice: Ambulatory Care-General Cardiology
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
- Instructing: Throughout the rotation, residents will participate in many learning activities including topic discussions, journal clubs and drug information inquiries. While the resident is expected to prepare for each of these instructional sessions, as a preceptor I will help to facilitate the discussion and add additional thoughts and points of information as needed.
- Modeling: A large part of this ambulatory care rotation is patient counseling. During the first week or two of the rotation, I like to model what a typical counseling session looks like for the resident, and will have the resident observe the first few sessions. We then discuss how to properly counsel a patient and, once the resident feels comfortable, I allow them to do these counseling sessions independently.
- Coaching: Providing feedback is a very important facet of the resident/preceptor relationship. Throughout the rotation, there will be constant coaching both formally and informally. I always provide feedback during a formal midpoint and final meeting, and also provide daily to weekly informal feedback as necessary.
- Facilitating: Throughout the rotation, I like to help the resident facilitate an independent relationship with the multidisciplinary care team. I encourage residents to reach out to providers, either verbally or over email, on their own and also encourage residents to take the lead in discussions with nursing staff, other pharmacists, and any students (if applicable).
How often do you meet with the learner while they are on rotation:
During our ambulatory care rotation, I meet with the resident daily. We will typically touch base early in the morning to review our scheduled patients for the day. During this meeting, we discuss the patients' pertinent past medical histories, current medications, any pertinent laboratory values or recent testing, and our care plan for the day. We then touch base periodically throughout the day as needed, and always do a final check-in at the end of the day to discuss any outstanding questions or issues.
Cardiology
Sonia Kothari, PharmD, BCCP
Clinical Pharmacy Specialist, Cardiology/Advanced Heart Failure
Beth Israel Deaconess Medical Center, Boston, MA
Email Sonia
Training:
- Pharmacy School: Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ
- PGY1 Pharmacy Residency: Atlantic Health System, Morristown, NJ
- PGY2 Cardiology Residency: UMass Medical Center, Worcester, MA
Primary Area of Practice: Advanced Heart Failure
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
- Topic discussions will be utilized to provide direct instruction to residents throughout the rotation. These discussions will address various cardiology disease states, such as acute and chronic heart failure, acute coronary syndromes, hypertension, hyperlipidemia, arrhythmias, venous thromboembolism and anticoagulation.
- Clinical skills will be modeled for residents particularly at the beginning of the rotation. These skills include, but are not limited to collecting pertinent data about cardiac patients, utilizing appropriate resources to develop patient-specific treatment plans, communicating with advanced heart failure providers and educating patients about their cardiac medications.
- Residents will perform various patient-care activities, such as medication reconciliation, medication counseling, therapeutic monitoring and ambulatory clinic visits with heart failure patients while receiving coaching to allow for fine-tuning of these skills.
- By the end of the rotation, residents will be able to independently develop treatment and monitoring plans for heart failure patients in collaboration with physicians, nurse practitioners, and nurses, and communicate these plans effectively to patients and caregivers.
Approach to defining roles and expectations for the learner:
I will meet with the resident on the very first day of the rotation and discuss not only my goals for the rotation, but also the resident's goals and what they want to get out of the rotation. My position is a hybrid of inpatient and ambulatory cardiology, so I try to focus the majority of the rotation on what the resident's primary interests are. We will discuss the expectations related to required topic discussions, journal clubs/presentations, nursing in-services, as well as the responsibilities pertaining to patient care. We will also discuss the resident's preferred learning style so that I, as a preceptor, can make sure I am teaching in a way in which the resident is learning the most effectively.
Ryan Vesper, PharmD, BCCP
Clinical Pharmacy Specialist, Advanced Heart Failure and Transplant Cardiology
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: University of Missouri – Kansas City, Kansas City, MO
- PGY1 Pharmacy Residency: Medical University of South Carolina Health, Charleston, SC
- PGY2 Cardiology Residency University of North Carolina, Chapel Hill, NC
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
During the first week of rotation residents will be introduced to the Advanced Heart Failure and Transplant Cardiology team. I will be present daily on rounds during the first week to go over the workflow and foundations of taking care of patients with advanced heart failure. A small number of patients will be identified for the resident to follow on the first day of the rotation and this number will be expected to gradually increase as the rotation progresses. Prior to rounds we will discuss possible interventions for the patients on service and the resident will be expected to present those recommendations on rounds. Depending on the resident’s experience and progression during the first two weeks of rotation, I will allow the resident to independently cover the advanced heart failure service starting week 3 while making myself readily available for consultation. Following rounds each day we will evaluate and discuss the decisions made on rounds. In general, my approach to teaching is through the Socratic Method to encourage the development of critical thinking skills required to succeed long after the rotation is completed. This rotation will include core topic discussions that will serve to enhance the residents understanding of the following types of patients:
- Heart Failure with reduced and preserved ejection fraction (HFrEF and HFpEF)
- Advanced acute or chronic heart failure requiring evaluation for intravenous inotropic agents, placement of a left ventricular assist device (LVAD) or heart transplantation (OHT)
- Acute decompensated heart failure (ADHF)
- Patients with complications status-post LVAD
- Patients with complications status-post OHT
How do you give feedback and include resident self-evaluation?
I believe providing frequent, constructive feedback fosters personal and professional growth. My method of feedback incorporates both informal (in the moment feedback) and formalized feedback (Feedback Fridays). The goal of these feedback sessions will be to identify strengths, while also developing a specific plan to improve identified weaknesses. Residents will be asked to self-evaluate prior to each formalized feedback session and come with a list of two strengths, two weaknesses, and goals for the next week. These items will be presented prior to receiving feedback from myself. All formal feedback sessions will end with the resident providing input on the experience. It should also be noted that prior to the rotation residents will be expected to complete a SWOT analysis and provide 3 goals (2 professional and 1 personal) for the month. This information will be used to tailor the experience specifically to the resident and to track progression throughout the rotation.
Central Operations
Kelly Zhang, PharmD
Clinical Pharmacist, Central Operations
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: University of Connecticut, Storrs, CT
- PGY1 Community Pharmacy Residency: Beth Israel Medical Center, New York, NY
Primary Area of Practice: Pharmacy Operations, Sterile Products
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating)
I will give the residents a check list of all the areas that they will be trained in. There are many aspects of central operations, so the check list is helpful to the residents. Initially, I will be modeling so the residents can observe the various checking processes. As the rotation progresses, my goal is for the resident to be able to staff independently but also be available when needed. I will also periodically check in with the residents to see if there are areas that they would like more practice in.
Critical Care / Emergency Medicine
I. Mary Eche, PharmD, BCCCP, CACP, FCCM
Clinical Pharmacy Manager: Critical Care/ED
PGY2 Critical Care Residency Program Director
Email I. Mary
Education: Doctor of Pharmacy from Northeastern University (2004); PGY1 Pharmacy Practice Residency, Beth Israel Deaconess Medical Center (2005); PGY2 Critical Care Pharmacy Residency, The Johns Hopkins Hospital (2006)
Professional Membership: Society of Critical Care Medicine (SCCM), American Society of Health System Pharmacists (ASHP); American College of Clinical Pharmacy (ACCP); Massachusetts Society of Health System Pharmacists (MSHP)
Personal Interests: Running, traveling, photography
Rotation/s Offered: Medical ICU, Cardiac Surgery ICU, Pharmacy Management/Leadership
George Abdallah, PharmD, BCCP, BCCCP
Clinical Pharmacist
Beth Israel Deaconess Medical Center, Boston, MA
Email George
Training:
- Pharmacy School: Western New England University College of Pharmacy, Springfield, MA
- PGY1 Pharmacy Residency: Beth Israel Deaconess Medical Center Boston, MA
- PGY2 Critical Care Residency: Beth Israel Deaconess Medical Center Boston, MA
Primary Area of Practice: Cardiac Intensive Care, Cardiothoracic Intensive Care
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
- Instructing: Topic discussions are incorporated into the rotation to provide a disease state management foundation
- Modeling: Rounding with the resident during the first week of their rotation to model behavior and expectations
- Coaching: During patient work up and afternoon presentations, open ended questions and case-based scenarios are often used to guide the resident and to help foster critical-thinking skills
- Facilitating: During afternoon presentations, different hypothetical and patient care scenarios are used to help the resident refine the skill of developing alternative pharmacotherapy plans supported by evidence
How often do you meet with the learner while they are on rotation:
I meet with the resident multiple times a day while on rotation. I will usually meet with the resident 1 hour before interdisciplinary rounds to discuss patients, provide guidance and help the resident develop evidence-based medication and monitoring plans, if needed. In the afternoon, I meet with the resident to discuss the most critically ill patients, review their disease state management and ensure any actionable items are implemented and/or followed up on.
Gabrielle Cozzi, PharmD, BCCCP
Clinical Pharmacist
Beth Israel Deaconess Medical Center, Boston, MA
Email Gabrielle
Training:
- Pharmacy School: University of Buffalo School of Pharmacy and Pharmaceutical Science, Buffalo, NY
- PGY1 Pharmacy Residency: Hackensack University Medical School, Hackensack, NJ
- PGY2 Critical Care Residency: West Virginia University, Morgantown, WV
Primary Area of Practice: Medical Intensive Care
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
The first week of my rotation is typically where residents gain an insight into my role as a clinical pharmacist and how I interact with my multidisciplinary team of medical residents, nurses, respiratory therapists, etc. As the resident starts to feel more comfortable, I start to coach them to challenge their critical thinking skills and providing feedback for example. As the rotation progresses, I allow the resident to have more autonomy and facilitate their role.
Approach to providing feedback to your learners:
Feedback by self-reflection and discussion is an essential component of resident growth. Prior to rotation, I discuss with residents their goals and what steps they will take to achieve them. I incorporate "Feedback Fridays" into my rotation where I have the resident reflect on what they think they are doing well, what they think could improve on (and how), pros/cons about the rotation, as well as myself as a preceptor. Additionally, I like to give daily feedback on their performance, which may include delivery of recommendations during rounds and interactions with nursing.
Quynh N. Dang BS, PharmD, BCCP
Clinical Pharmacist
Beth Israel Deaconess Medical Center, Boston, MA
Email Quynh
Training:
- Pharmacy School: Massachusetts College of Pharmacy and Health Sciences, Boston, MA
Primary Area of Practice: Medical Intensive Care
Approach to giving feedback to learners:
I give feedback to the residents while on providing patient care and/or right after patient care rounds (ex. how to approach the team with interventions, when to bring up important intervention during round, which interventions can be addressed after rounds, etc.). Additionally, I schedule time to meet with the resident weekly (ex. Feedback Friday) to give additional feedback.
Pansy Elsamadisi, PharmD, BCPS, BCCCP
Clinical Pharmacist
Beth Israel Deaconess Medical Center, Boston, MA
Email Pansy
Training:
- Pharmacy School: Long Island University: Arnold and Marie Schwartz College of Pharmacy, Brooklyn, NY
- PGY1 Pharmacy Residency: The Brooklyn Hospital Center, Brooklyn, NY
- PGY2 Critical Care Residency: Beth Israel Deaconess Medical Center Boston, MA
Primary Area of Practice: Trauma and Surgical Intensive Care
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
I usually start with direct instruction and modeling for the resident. Once the resident demonstrates proficiency, I give them more autonomy and I take more of a coaching and eventually facilitating role. I believe that communication and continuous feedback are key when it comes to establishing an effective preceptor/resident dynamic.
Approach to setting expectations and delivering feedback to learners:
Prior to rotation, I set up a meeting with my resident to ensure we discuss my expectations of the resident as well as their expectations for the rotation. This allows me to tailor their rotation experience to their specific interests.
Anna Morien, PharmD, BCCCP
Clinical Pharmacist Specialist, Critical Care
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: University of Buffalo, Buffalo, NY
- PGY1 Pharmacy Residency: Baystate Medical Center, Springfield, MA
- PGY2 Emergency Medicine Residency: Baystate Medical Center, Springfield, MA
Primary Area of Practice: Neuroscience ICU
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
First, I establish what the resident's goals are and have the resident shadow on the first day of rotation so they can observe how I practice and see what the typical workflow of the unit looks like. Throughout the next few weeks of the rotation as the resident shows more progression and confidence, they will gain more independence while still receiving ample support and feedback on how they are doing and how they can improve. Once the resident is comfortable with handling the whole unit, I allow them to round on their own and be the pharmacy point person for the unit. Finally, the instructing aspect usually is in the form of topic discussions and responses to drug information questions throughout the rotation.
Approach to providing feedback to your learners:
I prefer giving in-person, in the moment feedback as much as I can. In doing so, I can reinforce good work and/or give constructive feedback in real-time. I also give formal feedback at the end of each week. I start the feedback session by having the resident reflect on what things went well and what areas they need to work on. We then formulate a plan for the coming weeks/rotations on how they will maintain good habits and improve on their weaknesses in order to meet their goals.
Mehrnaz Sadrolashrafi, PharmD, BCCCP
Clinical Pharmacist
Beth Israel Deaconess Medical Center, Boston, MA
Email Mehrnaz
Training:
- Pharmacy School: Massachusetts College of Pharmacy and Health Sciences, Boston, MA
- PGY1 Pharmacy Residency: Baystate Medical Center, Springfield, MA
- PGY2 Critical Care Residency: Baystate Medical Center, Springfield, MA
Primary Area of Practice: Medical Intensive Care
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
Depending on if I am precepting a 4 vs 5 weeks rotation block, the first two weeks of the rotation will be spent on intensive instructing and modeling to ensure my residents are familiarized with the fast moving environment in MICU. Week 3 will be spent on modeling and coaching and week 4/5 will be spent on coaching and facilitating my resident's learning experience.
How often do you meet with the learner while they are on rotation:
- Due to the complexity of patient care in MICU and depending on the resident's prior experience and previous rotations in training, I will be rounding with the residents in the first two weeks of the rotation to go over the workflow and foundations of taking care of critically-ill patients. The residents will gradually increase the number of patients they cover on a daily basis. By week 3 of the rotation, the residents are going to be fully responsible for taking care of the full unit.
- During weeks 3 and 4, the residents independently take on the role of being the primary clinical pharmacist for the team and I will be readily available on the unit if the residents need me for a second opinion.
- The residents will be the primary code blue responder while on rotation with me, which gives them the opportunity to learn and apply the critical care knowledge learned during rotation, to actual clinical scenarios.
Matthew Thaller, PharmD, BCCCP
Clinical Pharmacist, Critical Care
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: St. John's University
- PGY1 Pharmacy Residency: The Hospital of Central Connecticut, New Britain, CT
- PGY2 Critical Care Residency Residency: Beth Israel Deaconess Medical Center, Boston, MA
Primary Area of Practice: Critical Care and Emergency Medicine
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
Early in the learning experience, learners will be able to gain insight into my role as a clinical pharmacist and how I interact with my teams of residents, fellows, nurses, respiratory therapist, etc. and begin to develop their own critical thinking skills specific to the rotation. As the resident feels more comfortable in the practice area, I coach them to challenge their own critical thinking skills when approaching a clinical situation. As the rotation progresses, the resident gains more autonomy and I serve to facilitate their role on the team. Throughout the rotation, I encourage the learner to be present for all new situations (e.g. intubations, cardiac arrests, procedural sedations, etc.) and utilize the "see-one, do-one, teach-one" method to allow learners to advance their knowledge, gaining insight from both the initial teacher and subsequent learners.
How do you give feedback and how do you include resident self-evaluation?
I use a mix of formalized feedback as well as informal opportunities to highlight strengths and development opportunities. In-the-moment feedback allows the resident and preceptor to reflect on what has just happened with a concrete example. Feedback-Fridays allow a schedule time to summarize achievements made during the week and develop a plan for the next. No feedback session is complete without learner input on the experience and my function as a preceptor. I request that all learners self-evaluate and provide achievable goals prior to my rotation, as well as active reflection throughout the experience, to ensure that the rotation is tailored to each individual learner.
Adrian Wong, PharmD, MPH, FCCM, BCCCP
Assistant Professor of Pharmacy Practice
MCPHS University, Boston, MA
Email Adrian
Training:
- Pharmacy School: Northeastern University, Boston, MA
- Master of Public Health: Harvard T.H. Chan School of Public Health, Boston, MA
- PGY1 Pharmacy Residency: The Johns Hopkins Hospital, Baltimore, MD
- PGY2 Critical Care Residency: UPMC Presbyterian/University of Pittsburgh, Pittsburgh, PA
- Outcomes Research and Pharmacy Informatics Fellowship: Brigham and Women's Hospital/MCPHS University, Boston, MA
Primary Area of Practice: Medical Intensive Care, Academia
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
I tailor my preceptor role depending on the needs of the learner. For example, with the example of a research project, I would meet with the learner first to determine their experience and expectations and adjust my role to this. Some learners may need instructing or modeling if they have not completed the certain type of research project before. For those who have more experience, serving as a coach or mentor would be more helpful to develop their own knowledge, while also providing guidance as necessary.
Approach to setting expectations and delivering feedback to learners:
In my first meeting with a learner, I identify what they want to get out of a rotation and adapt the rotation to what they need to succeed. We also discuss the importance of self-reflection to begin the thought process of what feedback they anticipate but also to develop this critical life-long skill in medicine. Typically, I offer my learners at least daily feedback in a more informal setting but have scheduled #FeedbackFriday to reduce the potential anxiety from a learner asking for feedback. I also work with them on how to communicate feedback, including providing specific examples to support their feedback.
Hematology/Oncology
Emmeline C. Academia, PharmD, BCOP
Clinical Pharmacy Specialist, Hematology/Oncology
Beth Israel Deaconess Medical Center, Boston, MA
Email Emmeline
Training:
- Pharmacy School: University of California, San Francisco
- PGY1 Pharmacy Residency: University of Colorado Hospital, Aurora, CO
- PGY2 Hematology/Oncology Residency: University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Cancer Center, Aurora, CO
Primary Area of Practice: Ambulatory Care-Oncology (GI, Thoracic, Sarcoma)
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
Instructing and modeling are key in my practice setting, to understand: overall themes within oncology care, workflow within the ambulatory care setting, key internal and external members within oncology, and finally, how to practice closed-loop communication in a highly-matrixed environment. Coaching is used to guide the resident through clinical and coordinative roles in the clinic. My goal is to advance the resident quickly to become an integrated pharmacist within the team, providing patient education, follow-up, drug information, and treatment coordination for our complex patient population.
Approach to providing feedback to learners:
After a baseline discussion of learning styles and experiential goals, residents on this service will receive daily feedback during patient reviews/discussion (either before or after clinic based on resident preference) and may include any combination of clinical, communication, drug information, or organizational observations. Timely, self-reflective feedback is key to learning on this rotation, and my goal is to make sure our residents feel comfortable working in our clinic quickly. Depending on the format of the rotation, longer weekly discussions about the resident's adjustment to, experience, and goals on service will ensure that personal learning objectives are met. The resident's responsibilities will gradually increase as the resident progresses, with the overall goal of triaging all patients seen in one disease state clinic for potential ambulatory pharmacy needs.
Lily Jia, PharmD, BCOP
Clinical Pharmacy Specialist, Hematology/Oncology
Beth Israel Deaconess Medical Center, Boston, MA
Email Lily
Training:
- Pharmacy School: Virginia Commonwealth University, Richmond, VA
- PGY1 Pharmacy Residency: Massachusetts General Hospital, Boston, MA
- PGY2 Oncology Residency: Massachusetts General Hospital, Boston, MA
Primary Area of Practice: Ambulatory Care-Oncology (Breast, Gynecologic, and Head & Neck)
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
- Instructing: Before the learner does an activity (ex. round, talk to a patient), I talk the learner through what to expect and how to do the activity. This way, they have a general overview of what to expect, are prepared for the interaction, and are aware of what to look out for.
- Modeling: After talking the learner through the activity, I model for them what the pharmacist should do. For example, if we are rounding, I will have them shadow me on rounds and observe. In this way, they are able to see what the activity looks like and what they can expect when they are in the role.
- Coaching: After the learner has a chance to see a pharmacist in the role, the learners are expected to carry out the role on their own with back up or support from the preceptor. For example, at this point, the learner would take on the role as the pharmacist on rounds, but I would continue rounding with the learner to answer questions or jump in as needed.
- Facilitating: At this point, the learner is able to independently perform the duties of the role, and the preceptor is available for debriefing or feedback. For example, the learner would round alone without the preceptor. After rounds, the preceptor and learner can meet to discuss how rounds went, answer any questions, and debrief.
Approach to setting expectations with learners:
It is extremely important to discuss roles and expectations before any rotation, project, or assignment so that the preceptor and learner are on the same page and aware of any potential challenges or barriers. When discussing roles and expectations, I ask the learner what they wish to gain from their experience, what they believe their role in the experience is, and any challenges they anticipate. I also like to make clear my role in the rotation or project, hard and soft deadlines, and a general timeline of where I expect the project or rotation to be progressing. I believe that it is important to revisit this conversation on a regular basis in case things come up, deadlines change, or the learner has hit an unexpected roadblock.
Caroline M. Mejías-De Jesús, PharmD, BCOP
Clinical Pharmacy Specialist, Hematology/Oncology
Beth Israel Deaconess Medical Center, Boston, MA
Email Caroline
Training:
- Pharmacy School: University of Puerto Rico – Medical Sciences Campus, San Juan, PR
- PGY1 Pharmacy Residency: Massachusetts General Hospital, Boston, MA
- PGY2 Oncology Residency: Duke University Hospital, Durham, NC
Primary Area of Practice: Ambulatory Hematologic Malignancies/Bone Marrow Transplant
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
In my ambulatory hematology/oncology rotation, instructing and modeling are the first preceptor roles utilized for this experience. This allows the resident to acquire the knowledge and skills necessary for the medication management of hematology/oncology disease states. During the coaching role, I focus on strategies for patient education and how to navigate complex clinical cases. Finally, once the resident is ready to work independently, I am available for questions or for direction on more complex situations.
Approach to defining roles/expectations with your learners:
Before starting my rotation, I set up a meeting with the resident to determine areas of interest for topic discussions and projects. During this meeting we explore what skills the resident would like to work on (ex. patient education). On the first day of rotation, I share rotation expectations, provide an overview of the clinic and the medication access workflow, and describe how to communicate with healthcare providers and pharmacy staff. The rotation calendar is also discussed on the first day of the rotation. I meet with the resident every week to discuss their progress and determine which activities they can start to work on independently.
Lelas Shamaileh, PharmD, BCOP
Clinical Pharmacist
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: University of Illinois, Chicago, IL
- PGY1 Pharmacy Residency: St. Luke’s University Health Network, Bethlehem, PA
- PGY2 Oncology Residency: Karmanos Cancer Center, Detroit, MI
Primary Area of Practice: Inpatient Malignant hematology and cellular therapy
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
The start of my rotation is focused on modeling and instructing. My rotation is very heavy on topic discussions! Hematology is a very specialized field and can be overwhelming at first so it's important to me that we take the time to slowly go through basic concepts together. I usually lead the first few topic discussions to help my residents build a foundation of malignant heme and cellular therapy concepts. I also round with the Heme/BMT team every day, so residents will have a chance to see what my day looks like including chart review, interdisciplinary rounds, answering drug information questions, and patient education. As the resident progresses through the rotation, they are expected to lead topic discussions and are assigned patients to help them apply the knowledge they get from topics. I also have them look up drug information questions so they can build on their foundational knowledge. My goal for each resident is to have them assume full responsibility for their assigned patients and for me to have to intervene on their presentations/topics minimally.
How do you give feedback to the resident and include resident self-evaluation?
On the first day of the rotation, after going through introductions and expectations, I ask the resident their preferences for communication and feedback, and then we come up with a plan together. I ask what their goals for the rotation are and do periodic check-ins to make sure they feel like they are accomplishing their goals and getting what they want out of the experience. I think it's important to provide both positive and constructive feedback, and I take into consideration the time sensitivity of the subject when I'm deciding when I should provide feedback.
Julia S. Stevens, PharmD, BCOP
Clinical Pharmacy Specialist, Hematology/Oncology
Beth Israel Deaconess Medical Center, Boston, MA
Email Julia
Training:
- Pharmacy School: Purdue University, West Lafayette, IN
- PGY1 Pharmacy Residency: Indiana University Academic Medical Center, Indianapolis, IN
- PGY2 Oncology Pharmacy Residency: Froedtert & the Medical College of Wisconsin, Milwaukee, WI
Primary Area of Practice: Ambulatory Care-Oncology (Genitourinary and Immuno-Oncology clinics)
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
- Instructing: plays a limited role in my precepting style, although I occasionally will teach a resident about an unusual side effect, clinical scenario, or professional development topic.
- Modeling: I utilize modeling during the first few days as residents are learning the workflow of clinic and the basics of the disease state(s). Shadowing me provides valuable information to the resident about what kinds of interventions I make, how I interact with the team, and logistics of caring for my patient population.
- Coaching: I utilize this role most often throughout the rotation. I move residents to this style of precepting quickly so they can develop independence while also learning about the disease state.
- Facilitating: My goal for every resident is to move to the facilitator role by the end of the rotation within the core clinical skills/expectations of the rotation. I want residents to independently care for patients and grow through guided self-reflection.
Preceptor roles are fluid and change from one task to the next. While I might be instructing or modeling in one area, I will often be coaching or facilitating in other areas. I also seek to understand what strengths and weaknesses my resident brings into the rotation so that I can help them work towards the next step, whatever preceptor role that may require.
Approach to providing feedback to learners:
I am a firm believer in timely, genuine, and compassionate feedback paired with active self-reflection. I give residents an opportunity to reflect and receive feedback frequently throughout the day. For example, after I listen to a resident talk to a patient on oral chemotherapy, I might ask them "how do you think that went?" By hearing a resident's self-reflection first, I can help overconfident residents understand what they are missing and can help self-critical residents understand their strengths. I find that most residents underestimate their performance, so this provides a good opportunity to acknowledge the skills they are building and point out ways to continue to grow. I pair this daily self-reflection and feedback with weekly semi-formal feedback sessions so the resident has a venue to provide feedback to me and I can provide feedback on broader trends and performance to the resident.
Sarah Smalec, PharmD, BCPS, BCOP
Clinical Pharmacy Manager, Outpatient Oncology
Beth Israel Deaconess Medical Center, Boston, MA
Email Sarah
Training:
Pharmacy School: University of Connecticut
- PGY1 Pharmacy Residency: Beth Israel Deaconess Medical Center
Primary Area of Practice: Outpatient hematology/oncology infusion
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
- Instructing: I incorporate resident-led topic discussions and preceptor-led "chalk talks" throughout the rotation to reinforce rotation experiences by outlining the patient's journey through cancer care as well as current guidelines for treatment of specific malignancies and supportive care.
- Modeling: I start off the rotation by having the resident observe the pharmacist's role in the care team as they grow comfortable with the subject matter and practice setting. This provides the resident with the opportunity to learn and adopt communication strategies and intervention styles from me before beginning to operate independently.
- Coaching: Before and after residents make interventions or interact with providers and patients, we discuss their plan and how the interaction went so I can provide feedback to allow them to improve for next time.
- Facilitating: The goal for my rotation is to have the resident able to independently assess and triage clinical issues independently by the end of the rotation, utilizing the preceptor as a resource but functioning independently as a part of the care team.
How often do you meet with the resident/round with the resident?
On rotation, I rely on daily interactions with the resident to assess their progress and participate in teaching/topic discussions. For project work, I prefer to meet with the resident as often as they need to continue making progress and meeting milestones without interfering with their other responsibilities. I believe in tailoring the approach for both rotations and projects to allow residents to develop independence while still providing support and feedback as needed.
Infectious Diseases
Ryan Chapin, PharmD, BCIDP
Clinical Pharmacy Specialist, Antimicrobial Stewardship/Infectious Diseases
Beth Israel Deaconess Medical Center, Boston, MA
Email Ryan
Training:
- Pharmacy School: University of Connecticut, Mansfield, CT
- PGY1 Pharmacy Residency: Concord Hospital, Concord, NH
- PGY2 Infectious Diseases Residency: Beth Israel Deaconess Medical Center Boston, MA
Primary Area of Practice: Antimicrobial Stewardship, Infectious Diseases Consult Service
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
The first week of the ID rotation you are introduced to the ID Consult team! The focus is on forming and delivering recommendations with a smaller list of patients to start. We will discuss opportunities for making recommendations and getting involved on rounds. The preceptor will be present answering questions on the other consulted patients to set the example. The resident is responsible for delivering recommendations to the team for their 1-2 new patients they workup each day in addition to follow-up patients from prior days. Discussion of patients occurs with the preceptor each morning. The preceptor guides the resident as they work toward independent rounding and at least one in-service to the consult team by the end of the rotation.
How often do you meet with the learner while they are on rotation:
On the Infectious Diseases rotation, the pharmacy resident and I meet multiple times throughout the day and round daily at 1:30 pm with either the medical/surgical or immunocompromised consult service (working toward rounding independently from the preceptor). The resident will work up ID consult patients prior to discussion at 10:30am. Those with a flair for ID and antimicrobial stewardship will also review a restricted antimicrobial and participate in 'handshake' stewardship rounds (figuratively, don't worry, no physical handshakes necessary). The resident will also attend a wide variety of educational conferences throughout the week with their preceptor including but not limited to: ID case conference, ID journal club, Harvard-wide disease and research conference, and antimicrobial stewardship fellow conference.
Kendall Donohoe, PharmD, BCIDP
Clinical Pharmacy Specialist, Antimicrobial Stewardship/Infectious Diseases
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: Northeastern University, Boston, MA
- PGY1 Pharmacy Residency: Oregon Health & Science University Hospitals and Clinics, Portland, OR
- PGY2 Infectious Diseases Residency: University of Minnesota Medical Center (M Health Fairview), Minneapolis, MN
Primary Area of Practice: Inpatient Antimicrobial Stewardship and Infectious Diseases Consult
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
I start every rotation by meeting with the learner to assess their interest and level of previous experience in infectious diseases, and use this to help determine a starting point for which parts of the learning experience might require more direct instruction and which, if any, the learner might be able to progress more quickly to the modeling, coaching, and facilitating stages. This meeting is also a great opportunity to discuss the learning experience calendar, daily schedule, and expectations for the learner and for myself. We’ll create a plan for the first week of rotation, and then reassess at least weekly but potentially more often to make sure the learner is making progress toward the rotation objectives and their specific goals. My approach to different preceptor roles varies for each learner but usually consists of starting with instructing on expectations and modeling for the resident how I work up a patient, think through a question, speak with a team about a restricted antibiotic, and/or make an intervention on rounds. As the rotation progresses and the learner gains knowledge and confidence, I shift to a role in which I try to direct more responsibilities and communication from the ID team or other healthcare teams to the learner, while staying available for back-up and help as needed.
Approach to increasing independence of the learner on rotation:
The infectious diseases core rotation offers many different opportunities: pre-prescriptive antimicrobial approval, rounding with the infectious diseases general or immunocompromised consult service, drug information questions, participation in antimicrobial subcommittee meetings, attendance at educational conferences for the hospital’s ID Division, and even co-precepting or layered learning if there happens to be more than one learner on rotation at the same time. Depending on the interests and goals of an individual learner, the rotation can be customized to include some or all of these opportunities. I use the four preceptor roles mentioned above as a basic framework for any learner taking on a new skill or learning experience. In my mind, the learner is ready for more independence once I find that I have few adjustments to their assessments and plans, they communicate well with both pharmacy colleagues and other members of the team, and they demonstrate strong self-directed learning and drug information skills when encountering unfamiliar topics. In order to reach this point, it’s important to me to be able to observe the learner doing various rotation activities and be able to give frequent and timely feedback, plus take time once weekly to discuss how the learner’s rotation experience is going overall.
Christopher McCoy, PharmD, BCPS AQ-ID, BCIDP
PGY2 Infectious Diseases Residency Program Director
Clinical Pharmacy Manager, Antimicrobial Stewardship/Infectious Diseases
Beth Israel Deaconess Medical Center, Boston, MA
Email Christopher
Training:
- Pharmacy School:
- Bachelor of Science in Pharmacy: St. John's University, New York, NY
- Doctor of Pharmacy: Massachusetts College of Pharmacy and Health Sciences, Boston, MA
Primary Area of Practice: Antimicrobial Stewardship, Infectious Diseases Consult Service
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
I instruct using didactic sessions and handouts, model by demonstrating medical record review/excision of critical data, problem list and recommendations. I also take trainees to floors to provide active feedback on interacting with providers, encourage residents to take the driver's seat and present data to providers and afterwards we debrief on what went well, what can be improved. When facilitating a resident learning experience, I forward drug information questions from providers and supply the name of the resident as the primary contact for addressing guidelines or patient specific questions.
Approach to providing feedback to learners:
Feedback is critical to the stewardship role as providers require direction and appropriate reflection for the rationale for antibiotic changes, I provide real time feedback right after the interaction. I ask residents to self-reflect on each day's interventions and provider interactions.
Monica Mahoney, PharmD, BCPS, BCIDP, FCCP, FIDSA, FIDP
Clinical Pharmacy Specialist, Infectious Diseases
Beth Israel Deaconess Medical Center, Boston, MA
Email Monica
Training:
- Pharmacy School: Massachusetts College of Pharmacy and Health Sciences, Boston, MA
- PGY1 Pharmacy Residency: Tufts Medical Center, Boston, MA
- PGY2 Infectious Diseases Residency: Tufts Medical Center, Boston, MA
Primary Area of Practice: Outpatient Infectious Diseases Clinic and OPAT (Outpatient Parenteral Antimicrobial Therapy) Clinic
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
I try to incorporate the models from the beginning, and progress through the stages as the rotation continues and the resident shows growth and confidence. On day one, I sit down with the resident and select a patient or two that I have not previously looked at. I verbalize the process of where in the medical record I am looking, why I am looking there, what I am looking for. As I see notes or medications or laboratory results, I talk through my thought process so the resident can get a sense of how I approach an outpatient. Outpatient is usually a new experience for an acute care resident, so I want to make sure they get a good foundation. Residents will shadow me on the first few patient interactions, so I can model for them how I conduct a patient visit. Residents present all their patients to me before making recommendations to the clinicians or speaking to the patient, so I am able to coach them through their treatment regimen or monitoring plan. Lastly, I try to facilitate additional learning opportunities for the resident, be it shadowing a home infusion company teaching session or co peer-reviewing a manuscript.
Approach to providing feedback to your learners:
I give feedback on a daily basis! In particular, I try to be cognizant to give positive feedback in addition to constructive feedback. Any time the resident presents a patient, interacts with a patient, or completes an activity, I like to reflect on something that went well and something that can improve upon. I also try to stay humble and will comment on things that I think I could improve upon as well! Learning doesn't end upon graduating residency! Trainees sometimes don't see the daily interactions as feedback, so I make sure to also schedule time for a midpoint and final evaluation. These words are written and scheduled on the rotation calendar. For these and the "major" activities (journal club, case presentation) I like to ask the resident their thoughts first, and then provide my opinion.
Internal Medicine
Sarah Bor, PharmD, BCPS
Clinical Pharmacist II
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: Northeastern University, Boston, MA
- PGY1 Pharmacy Residency: AdventHealth Orlando, Orlando, FL
Primary Area of Practice: Internal Medicine, Surgery, Cardiovascular Medicine
How do you use the four preceptor roles in your precepting/mentoring (instructing, modeling, coaching, facilitating)?
As a preceptor, my goal is to tailor a learning experience to the resident in order to set them up for success. Initially, I will provide an overview of rotation expectations as well as targeted objectives. The resident will have the opportunity to add on any subjective goals and expectations based on personal interests and experience. In addition, I would like to make time to discuss learning styles and prior experiences. Within the first week, I will model the role of a pharmacist to the resident: rounding with a multidisciplinary team, order verification, answering drug information questions, communicating with nursing through pages and calls and collaborating with central pharmacy to optimize operations ensuring medication delivery and administration. Once the resident is comfortable, they will be encouraged to slowly transition into a pharmacist role within the multidisciplinary team and serve as a primary resource for the remainder of the rotation. Throughout the rotation, I will coach the resident and provide necessary support in order to ensure comfortability and confidence. Lastly, I will facilitate further learning opportunities and desired experience for the learner: organize in-services with the team, determine ideal patients for case presentations or journal clubs, provide topic discussions, assist in patient workups, provide feedback regularly, coordinate shadowing opportunities, etc.
How do you give feedback to the resident (how often, what types) and how do you include resident self-evaluation?
Feedback is an integral part to learning and growing in residency. From prior experience as a resident and as a trainer, I have various approaches I plan to utilize. Each week, the resident will receive feedback during 'Feedback Fridays.' During this time, I expect the resident to self-reflect on their experience as well as reflect on my precepting. Together, we will go over our strengths and weaknesses from the week as this will allow us to develop an action plan for the week to come and enhance the learning experience. The resident will also receive formal feedback through a Midpoint and a Final Evaluation through PharmAcademic. Lastly, I will cater any additional feedback techniques to each resident as it is a unique to each learner.
Alexa Carlson, PharmD, MEd, BCPS
Associate Clinical Faculty
Northeastern University, Boston, MA
Email Alexa
Training:
- Pharmacy School: Butler University, Indianapolis, IN
- Master's Degree in Education: Northeastern University, Boston, MA
- PGY1 Pharmacy Residency: Temple University Hospital, Philadelphia, PA
- PGY2 Internal Medicine Residency: Virginia Commonwealth University, Richmond, VA
Primary Area of Practice: Adult Internal Medicine
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
- My main interaction with residents is through my role as a medicine preceptor. I like to orient my residents the week before the start so we can discuss their background in medicine, what they have done in previous rotations, and role expectations for my APPE students, the resident and me as a preceptor. Usually with residents, we will focus on modeling and coaching up front. We will start with me rounding in a layered learning model with the students and resident, and I will have the resident attend some of my student "pharm rounds" so they can see my roles as a clinical pharmacist with the medical team, and as a preceptor with APPE students. I also use modeling/coaching in separate resident "pharm rounds" where we will discuss patient care before and/or after internal medicine rounds in the morning and I can hear their thought process and share mine as appropriate.
- As we touch base throughout the rotation experience, and the resident demonstrates appropriate growth, they will begin to round independently with my students as we move into facilitation where the resident will serve as the primary pharmacist for our medical team and I am the backup available to help respond to additional questions. Direct instruction comes through the required topic discussions for medicine residents with the preceptors, or more pointed instructions prior to a task the resident has not completed previously including updating a patients home medication list, or using an interpreter.
Approach to advancing a learner's independence/workload on rotation:
For regular tasks, I would like to see the resident complete at least one successfully and then I am happy to allow them to perform them independently. If there is area for growth identified in the task, like completing a medication reconciliation, I will provide feedback and watch them complete the task until such time as they demonstrate the ability to perform independently. We will talk about goals at our weekly feedback meetings. My residents normally start by following four medical patients, and ask they get used to the expectations of a medicine pharmacist, we can increase the number of patients they are following, and move to them rounding independently with me available to assist nearby, to me as a resource in my office. Similarly, I don't expect my resident to serve as the direct preceptor of my APPE students, but as their level of independence and clinical skills increases, I am happy to allow my residents to have more interaction and oversight with the students as appropriate.
Joshua Etheridge, PharmD, BCPS
Clinical Pharmacist
Beth Israel Deaconess Medical Center, Boston, MA
Email Joshua
Training:
- Pharmacy School: Northeastern University, Boston MA
- PGY1 Pharmacy Residency: Beth Israel Deaconess Medical Center, Boston, MA
Primary Area of Practice: Adult Internal Medicine
How do you use the four preceptor roles in your precepting/mentoring (instructing, modeling, coaching, facilitating)?
- Instructing: Throughout the rotation, instruction will be provided through various learning activities including patient presentations, drug information questions topic discussions, and journal clubs.
- Modeling: Being a visual learner myself, a large part of my precepting style involves modeling up front to showcase to a learner how I would go about interacting with the members of the team, working up patients, and managing different clinical scenarios.
- Coaching: My coaching style builds upon the way that I model as a preceptor. When working with a resident and discussing clinical scenarios or various topics I tend to ask open-ended questions in order help residents verbalize their thought process and develop plans. Not only does this help the learner by reinforcing their knowledge and acknowledging current deficits/areas for growth, it aids me by signaling areas where I may help to supplement learning and focus on in order to improve our learning experience.
- Facilitating: Being an earlier rotation in what I think is a great environment for facilitation, I generally try to encourage residents to develop their own relationship with the multidisciplinary care team on Internal Medicine and become for themselves a face for pharmacy. I think this helps immerse the learner in an environment where the opportunities for learning are endless, confidence can flourish, and the learner can really develop themselves and their clinical practice.
How do you give feedback to the resident and how often do you include resident self-evaluation?
My main forms of resident feedback are more verbal, on-the-spot feedback and positive reinforcement. I also supplement in weekly reflections as well as Pharmacademic documentation which I find helpful for residents to use when retrospectively reviewing their performance and reflecting on their own progress and learning throughout residency.
Ilona Grigoryan, PharmD, BCPS
Clinical Pharmacist
Beth Israel Deaconess Medical Center, Boston, MA
Email Ilona
Training:
- Pharmacy School: Northeastern University, Boston MA
- PGY1 Pharmacy Residency: The University of Chicago Medicine
Primary Area of Practice: Adult Internal Medicine
How do you use the four preceptor roles in your precepting/mentoring (instructing, modeling, coaching, facilitating)?
I like to start the rotation by modeling so that the resident can observe my thought process when solving a problem or developing a drug regimen. During this time, I am able to gauge the resident’s background knowledge. I quickly transition into coaching so that the resident can build upon their skills, instructing when appropriate. As the rotation progresses, my ultimate goal is to have the resident work independently while remaining available when needed and for debriefing. I like to incorporate aspects of transitions of care to ensure the resident is able to perform a thorough medication history as well develop counseling skills.
How do you give deliver feedback to the resident?
I like to set expectations at the beginning of rotation. I provide feedback on a regular basis, informally throughout the day and at the end of each week to review the resident’s progress and address any concerns. This is in addition to a standard midpoint and final evaluation. I believe regular feedback lessens ambiguity and allows the resident to reflect on their own progress.
Nick Palisano, PharmD, BCIDP
Clinical Pharmacist Specialist, Internal Medicine, ID
Beth Israel Deaconess Medical Center, Boston, MA
Email Nick
Training:
- Pharmacy School: University of Buffalo, Buffalo, NY
- PGY1 Pharmacy Residency: Beth Israel Deaconess Medical Center, Boston, MA
- PGY2 Infectious Diseases Residency: Beth Israel Deaconess Medical Center, Boston, MA
Primary Area of Practice: Internal Medicine
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
- Instructing: During the internal medicine rotation, we hold formal and informal topic discussions along with article reviews and didactic teachings with pharmacy co-residents and the medical teams (attendings, residents, interns, and students). These instructional topics cover general medicine topics such as atrial fibrillation, VTE treatment and prophylaxis, and pneumonia.
- Modeling: During the first few weeks of the rotation, I round with the resident to model the general roles of the pharmacist on an internal medicine team. This includes reading medications, making recommendations, and performing transitions of care (i.e. med recs, working with outpatient pharmacies on drug coverage, and signing out to outpatient and ICU pharmacists).
- Coaching: Residents are encouraged to be more independent on rounds and during patient interactions. I will be present during most interactions but take a step back to give more autonomy to further enhance the learning process. We will identify resident strengths and areas for improvement to focus on during the rest of the rotation and future learning experiences.
- Facilitating: The residents will serve as the primary pharmacist for the service by the end of the rotation. I will observe and provide feedback on the resident's interactions and recommendations with minimal intervention during rounds. We will focus on developing critical thinking skills and dive deeper into patient cases to have a more wholistic understanding of the patients.
How do you define roles/expectations with your resident?
My preceptor philosophy incorporates creating a comfortable learning environment that focuses on mutual respect and dedication. Roles and expectations of any learning experience, whether it be clinical rotations or a resident project, will be discussed before the experience begins. I believe in frequent check-ins with the resident throughout the experience to identify areas that are going well and things that could be improved. I will work with residents to develop a realistic timeline/schedule that fits our busy workloads.
Medication Safety
Elona Djeriki, PharmD, MBA
Clinical Pharmacist
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: MCPHS University, Boston, MA
- Graduate School: MBA – MCPHS University, Boston, MA
- Fellowship: Medication Safety, Quality and Informatics Fellowship, Saint Vincent Hospital, Worcester, MA
Primary Area of Practice: Medication Safety and Quality
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
I instruct essential principles, guidelines, protocol and policies related to medication safety and quality. I serve as a model for effective communication with healthcare teams and stakeholders regarding medication-related concerns. I provide regular feedback on the resident's performance and set achievable learning objectives tailored to their level of competence and understanding. Lastly, I help the resident facilitate and lead discussions around medication safety topics and quality initiatives with various stakeholders.
How often do you meet with the learner while they are on rotation?
My role within the administration rotation is to serve as a preceptor for the resident's M&M presentation. I meet with the resident regularly to evaluate their progress and address any needs/lingering concerns or questions the resident may have. I am available almost daily to meet with the resident as their schedule permits and encourage the resident to reach out if they are in any need of assistance.
Leana N. Mahmoud, MAS, PharmD
Pharmacy Quality Improvement Program Manager
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: Jordan University of Science and Technology
- Graduate School: Master of Applied Science in Patient Safety and HealthCare Quality - Johns Hopkins Bloomberg School of Public Health
Primary Area of Practice: Pharmacy Management and Leadership
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
The residents are able to collaborate with different stakeholders, often performing independently by taking the lead at meetings and in projects. During the rotation, the preceptors meet regularly with the residents to provide feedback aimed at refining the leaners skills and enhancing their learning experience. Additionally, topic discussions are held to emphasize the concepts learned throughout the rotation.
NICU
Nilam K. Patel, PharmD, BCPPS
Clinical Pharmacist
Beth Israel Deaconess Medical Center, Boston, MA
Email Nilam
Training:
- Pharmacy School: Massachusetts College of Pharmacy and Health Sciences, Boston, MA
- PGY1 Pharmacy Residency: Elliot Health System, Manchester, NH
- PGY2 Pediatric Pharmacy Residency: Elliot Health System, Manchester, NH
Primary Area of Practice: Neonatal Intensive Care
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
- As a preceptor, my goal is to have the resident increase their knowledge base and become independent as the rotation progresses. In the beginning, I sit down with residents and go over the syllabus, expectations, and potential projects. I will also go over workflows specific to the NICU practice site. As part of the multi-disciplinary team, pharmacist participates in patient-care rounds on the NICU. In the beginning, I will pre-round with residents and attend rounds with residents. As the resident feels more comfortable, I will slowly start backing away.
- Topic discussions are a major part of the NICU rotation. There are core topics that we will discuss but if residents find any specific topics that are interesting, I will try to include them into the syllabus.
Approach to providing feedback to your learners:
I meet with residents to provide feedback weekly and ask the resident to do a self-reflection for the week. We will discuss what things went well during that particular week, things that can be improved upon, and progress with any projects that are being worked on. At this time, we will also set specific goals for the upcoming week.
Solid Organ Transplant
Dominique Dairion, PharmD
Clinical Pharmacy Specialist, Abdominal Solid Organ Transplant
Beth Israel Deaconess Medical Center, Boston, MA
Training:
- Pharmacy School: University of Mississippi
- PGY1 Pharmacy Residency: Baptist Memorial Hospital, Memphis, TN
- PGY2 Organ Transplant Residency: Beth Israel Deaconess Medical Center, Boston, MA
Primary Area of Practice: Abdominal solid organ transplant
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
As a preceptor, I want to create an environment that sets learners up for success. At the beginning of the rotation, I define expectations and help learners create their goals. Patient education is a major responsibility of transplant pharmacists. I spend the first few days of rotation having learners observe transplant pharmacy patient education and medication discharge sessions. When comfortable, learners are expected to take the lead during these sessions with my support. When working with the transplant team there are a variety of providers that we interact with. Throughout the rotation, I teach learners how to best communicate their recommendations/ questions to different providers. At the end of this rotation, I hope learners have the knowledge needed to care for the transplant patient population, feel comfortable providing medication education, and are confident interacting with various providers.
How do you give feedback to the resident and include resident self-evaluation?
I prefer to give feedback in the moment along with once weekly formal feedback sessions. At the end of every day, I also ask if there are any concepts that the learner would like to review or any questions regarding information we discussed. During feedback Fridays, we review some of the more complicated situations/ patients and how we could have improved our patient care. I also like to ask the learner if they have any feedback for me. I think it’s important to meet learners where they are and to implement teaching methods that are individualized for their needs.
Kaitlyn Zheng, PharmD, BCTXP
Clinical Pharmacy Specialist, Solid Organ Transplant
Beth Israel Deaconess Medical Center, Boston, MA
Email Kaitlyn
Training:
- Pharmacy School: Northeastern University, Boston, MA
- PGY1 Pharmacy Residency: Hahnemann University Hospital, Philadelphia, PA
- PGY2 Transplant Residency: University of Cincinnati Medical Center, Cincinnati, OH
Primary Area of Practice: Solid Organ Transplant
Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):
During the first few days of the transplant rotation, you will spend time meeting many of the friendly personalities across our transplant team. During this time, we spend time learning the transplant surgery and consult service structures and day-to-day work flow/responsibilities. With regards to clinical care during the initial days, we spend time structuring effective ways to work up transplant patients and identify opportunities to make valuable recommendations to optimize care. We pre-round on patient lists daily and practice presenting patients, so the learner feels comfortable and confident delivering recommendations to the clinical team on rounds.
Approach to increasing independence of the learner on rotation:
During the beginning of the rotation, I gather a baseline assessment of the learner's prior experiences and interests in transplant pharmacy. At the beginning of the rotation, I will observe the learner's confidence when interacting with providers. I also assess the learner's ability to formulate rational recommendations, and provide supporting literature and guidelines. As the resident becomes more comfortable with the team and familiarizes themselves with transplant literature and guidelines, I will encourage the learner to communicate recommendations to the team independently. We spend time practicing different methods for teaching transplant medication information to patients of varying health literacy, so the resident feels prepared when encountering tough discharge medication teaching scenarios. Depending on the resident's interest in transplant, we might further explore opportunities to work on QI/QA projects.