The myth of a tough preceptor

[Dred Pirate]

This isn't a brand new article, but I felt it is good to share. To many of the preceptors I have met over the year try so hard to be "the tough ones". I have never felt that was necessary - I teach practical knowledge, I do hold people to high standards (attendance, deadlines, etc) - but never chastise them for getting the wrong answer. I feel pharmacy is very bad at what is talked about here.

thoughts?

The Myth of the Tough Preceptor — The Overrun

I had a reputation as a tough preceptor. I was the one that people either sought out because they wanted the challenge; or the one that they avoided. I thought I held students to a high standard, thought I was tough but fair, and thought that any student of mine who passed through my finishing schoo

www.overrunproductions.com

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[owlegrad]

Yeah, I agree. Grilling people is just so much less interesting to me (and less helpful) than having conversations and filling in gaps as you identify them.

I do admit when a student forgets something we have already been over I do want to grill them a little

 

[Dred Pirate]

Yeah, I agree. Grilling people is just so much less interesting to me (and less helpful) than having conversations and filling in gaps as you identify them.

I do admit when a student forgets something we have already been over I do want to grill them a little

grilling them on something you have already taught them is completely different - I have a handfull of things I require they commit to memory (think code dosing, TPA, mag, and amio vs non-code dosing)

 

[lord999]

I hate pimping, though I believe in scutwork (cart fills, luer lock 200 bags, etc., manually go through these records). I agree that questioning them on rote stuff that you brought up is good or prewarned them for practice. I also believe in reading where if I ask a couple of questions on a topic and it's clear that they don't know it (clinical or technical), I assign a reading and tell them to "teach" me it in the morning. But unlike counseling (who the hell actually does the IHS questions in a real context?), I think open ended questions work the best to start a learning discussion (what do you think about this situation? What are the actual problems here?). The most significant coaching I tend to do is to get them to form a situationally appropriate problem statement which we can then tackle at the level of complexity. In this age where the answers are a screen away, problem formation and prioritization remains one of the few arts that ought to be taught at an experiential level.

 

[radio frequency]

I actually think I succeeded in spite of my “tough” preceptor, rather than because of him. It was a rotation I never wanted or asked for, in an area not covered meaningfully in school. First day was a grilling on what all the various drugs used were and minutae about how they differed….which was never covered in class, and definitely not to the extent he expected me to know on Day 1 (I was not forewarned to know these, either). He basically told me he was completely disappointed in me the first day, and it went from there. The entire rotation was adversarial from the start, through no fault of my own. This was right after an inpatient rotation that had encouraged me with regular teachings and readings, and had actually given me a lot of praise for my medication knowledge and ability to work with the medical team. I came away from this later rotation knowing my preceptor wasn‘t really there to teach, but to stroke his own ego about his personal clinical skills. Don’t be that preceptor.

This was years ago, and now I actually work at the same facility as this particular preceptor, and occasionally have to deal with him professionally. I have put his grillings behind me, but I know I would never want to work directly with him again. It is frustrating to think I could have learned more and had a much more pleasant rotation with a preceptor who put learning first and foremost, and didn‘t bring along the baggage of a fragile ego.

 

[Sparda29]

I would rather get pimped, given scutwork than get chastised for being late or not dressing professionally.

One thing I hated the most in rotations was being assigned a research topic in something that had very little research in it to begin with and then having to attach my preceptor's name to the report being written. Almost like the research was being assigned to me to boost the preceptor's own portfolio.

My favorite rotations were internal med (was allowed to work on a team with the medical residents and then me and the medical residents had to answer to the attending physician and clinical pharmacist during rounds) and retail (actually at CVS, but I was allowed to sit in the corner all day and take care of all the problem Rx and doctor calls instead of counting pills or dealing with customers).

Least favorite rotation would have to be the public health rotation (that I actually flunked because of being late), where I was expected one week to walk around Harlem and offer free condoms and free HIV tests to random people and another week, go to drug dens to deliver safe injection kits and bring back used sharps containers.

 

[letsquitpharm]

I really hated one of my "tough" hospital preceptors til this day. She talked to me in such a condescending way that made me feel quite uneasy and undeserving for my physical presence there. She was a recent resident-turned hire and therefore a relatively new preceptor, but she was very obvious from early start that she wanted to be the gatekeeper kind. By the end of the rotation, she literally tried to fail me despite I wasn't taught most of the stuff in school but still showed tremendous growth. And I had to do whatever I could to reverse that, including a lengthy talk with the APPE coordinator and threatening to report some of the crazy drama and mistreatment I experienced to the highest level of my school.

I understand people have egos, and completing a residency or accumulating X years of exp at a reputable facility may seem like a big accomplishment to many, but my suggestions to all clinical preceptors: please talk to the students beforehand and get to know them personally. Every student is different, and some of them may never want to pursue a career in hospital. It would be a waste of time to maintain the same academic expectation for students going into retail vs hospital vs industry. Please be nice to the younger generations of students, because you never know if one of them would become your hiring manger or direct report one day

 

[Dred Pirate]

I actually think I succeeded in spite of my “tough” preceptor, rather than because of him. It was a rotation I never wanted or asked for, in an area not covered meaningfully in school. First day was a grilling on what all the various drugs used were and minutae about how they differed….which was never covered in class, and definitely not to the extent he expected me to know on Day 1 (I was not forewarned to know these, either). He basically told me he was completely disappointed in me the first day, and it went from there. The entire rotation was adversarial from the start, through no fault of my own. This was right after an inpatient rotation that had encouraged me with regular teachings and readings, and had actually given me a lot of praise for my medication knowledge and ability to work with the medical team. I came away from this later rotation knowing my preceptor wasn‘t really there to teach, but to stroke his own ego about his personal clinical skills. Don’t be that preceptor.

This was years ago, and now I actually work at the same facility as this particular preceptor, and occasionally have to deal with him professionally. I have put his grillings behind me, but I know I would never want to work directly with him again. It is frustrating to think I could have learned more and had a much more pleasant rotation with a preceptor who put learning first and foremost, and didn‘t bring along the baggage of a fragile ego.

honestly - that is a total dick move - and I know somebody who fits that model - it is sad because they think they are better than everyone. I a usually a fairly humble person, but I do get a tad passive aggressive and go out of my way to make comments/bring up situations where I am fairly certain they don't know the answer to (which is perfectly fine as we work in different areas) but I make it a point to let them know they don't know everything.

Like @lord999 said - scutwork is fine, a lot of job falls into that category - like was brought up in the guy who made the pyxis error - routine work can have significant impact - and they got to know that,

 

[Dred Pirate]

I would rather get pimped, given scutwork than get chastised for being late or not dressing professionally.

true story - I always let my students/residents wear scrubs - I work in the ED. One day our clinical coordinator chastized my student for wearing scrubs and not wearing a shirt and tie. Was really unprofessional about it. I responded by telling the clin cord that not a single ED doc wears a tie, they all wear scrubs, and then printed an article from the UK NIH banning ties because of the big infection risk they pose (nobody washes their tie). I told her that if she has an issue with the dress of the student to come to me as it was massively unprofessional of her to go to the student on something I told him was OK.

I was so pissed.....

 

[BenJammin]

My P4 year I had a preceptor who made us do a project about explaining medical concepts to a 5 year old. The preceptor acted like the 5 year old and we were tasked with trying to explain something to her. All she did was interrupt us constantly with "what's that?". She legitimately thought it was a positive learning experience until I told her a few years ago when I saw her at a conference that she was one of the worst preceptors I ever had as a student.

 

[CetiAlphaFive]

How do you guys handle it when a resident is so exhausted that they can barely keep their eyes open? Tbh i feel conflicted. I'm like, extremely empathetic and can understand. But then I'm like, bro coffee exists.
I would never like formally ding or chastise someone for it, but i feel torn

 

[Dred Pirate]

How do you guys handle it when a resident is so exhausted that they can barely keep their eyes open? Tbh i feel conflicted. I'm like, extremely empathetic and can understand. But then I'm like, bro coffee exists.
I would never like formally ding or chastise someone for it, but i feel torn

that is a little complicated - I think first thing is to find out why they are so tired? Is it because of excessive workload, poor time management, or something outside of work (either their "fault" or outside of their control) Once you know this, you can get a better idea how to address it.

 

[Sparda29]

that is a little complicated - I think first thing is to find out why they are so tired? Is it because of excessive workload, poor time management, or something outside of work (either their "fault" or outside of their control) Once you know this, you can get a better idea how to address it.

For me it was because I was expected to be there early in the morning like 7-8AM, and I didn't go to sleep till 2AM-3AM because me and my friends are nocturnal and like hanging out in the evening and at night. So, I was usually just getting 3-4 hours of sleep on weekdays. Was not willing to sacrifice the social life for rotations.

I always used to start off the rotation by asking if I could work 11AM-7PM or 3PM-11PM.

 

[lord999]

For me it was because I was expected to be there early in the morning like 7-8AM, and I didn't go to sleep till 2AM-3AM because me and my friends are nocturnal and like hanging out in the evening and at night. So, I was usually just getting 3-4 hours of sleep on weekdays. Was not willing to sacrifice the social life for rotations.

I always used to start off the rotation by asking if I could work 11AM-7PM or 3PM-11PM.

"Was not willing to sacrifice the social life for rotations."

I wish I had that sort of courage to act on that wisdom.

 

[CetiAlphaFive]

"Was not willing to sacrifice the social life for rotations."

I wish I had that sort of courage to act on that wisdom.

I think in his case it isn't courage as much as a blank space where there should be a diagnosis. Lol

 

[confettiflyer]

true story - I always let my students/residents wear scrubs - I work in the ED. One day our clinical coordinator chastized my student for wearing scrubs and not wearing a shirt and tie. Was really unprofessional about it. I responded by telling the clin cord that not a single ED doc wears a tie, they all wear scrubs, and then printed an article from the UK NIH banning ties because of the big infection risk they pose (nobody washes their tie). I told her that if she has an issue with the dress of the student to come to me as it was massively unprofessional of her to go to the student on something I told him was OK.

I was so pissed.....

Ugh. My student, my rotation, not your student…I hated when people did that (not my current site). Like, if you have issues, and if it’s not imminent patient or staff safety related, you go through the primary preceptor. That’s just professional courtesy from one colleague to another.

 

[Dred Pirate]

For me it was because I was expected to be there early in the morning like 7-8AM, and I didn't go to sleep till 2AM-3AM because me and my friends are nocturnal and like hanging out in the evening and at night. So, I was usually just getting 3-4 hours of sleep on weekdays. Was not willing to sacrifice the social life for rotations.

I always used to start off the rotation by asking if I could work 11AM-7PM or 3PM-11PM.

I do question how you graduated and seem to be able to change jobs at will. Not gonna lie, there is a tad bit jealousy involved to be able to speak so freely.

That being said, if that happened with a student of mine I would have had a sit down where we set expectations. My students actually generally did 11a-7p since my goal was to get the busy time of the ED - but I also make them work nights as well. I had one tell me they couldn't work nights because of their dog. I told them they had two weeks to come up with a plan. The did.

 

[Sparda29]

I do question how you graduated and seem to be able to change jobs at will. Not gonna lie, there is a tad bit jealousy involved to be able to speak so freely.

That being said, if that happened with a student of mine I would have had a sit down where we set expectations. My students actually generally did 11a-7p since my goal was to get the busy time of the ED - but I also make them work nights as well. I had one tell me they couldn't work nights because of their dog. I told them they had two weeks to come up with a plan. The did.

Nights would have been cool with me too. I just hate waking up any earlier than 9-11AM and having to deal with rush hour traffic heading to the place and then rush hour traffic heading home.

 

[RxPreceptor]

Nights would have been cool with me too. I just hate waking up any earlier than 9-11AM and having to deal with rush hour traffic heading to the place and then rush hour traffic heading home.

Yeah, I had a similar experience when doing drug info rotation. Come in "late", leave "late", avoid rush hour traffic both ways & overall have more time to commit to rotation. Not so much about sacrificing other things but having a good sense of time management and prioritization...starting early for the sake of being first does not translate into being high priority/high level of commitment

Good preceptors can allow students to adapt to get the most out of a rotation

 

[confettiflyer]

I do question how you graduated and seem to be able to change jobs at will. Not gonna lie, there is a tad bit jealousy involved to be able to speak so freely.

That being said, if that happened with a student of mine I would have had a sit down where we set expectations. My students actually generally did 11a-7p since my goal was to get the busy time of the ED - but I also make them work nights as well. I had one tell me they couldn't work nights because of their dog. I told them they had two weeks to come up with a plan. The did.

Tangent here. I love dogs, I’ve been known to get sidetracked for hours finding/returning lost dogs in my area, but people need to stop with the “dogs are children” crap. Like, no, they’re not…not even close.

Stop trying to equate the two and gain sympathy/scheduling benefits that are reserved for actual parents of humans.

 

[radio frequency]

Tangent here. I love dogs, I’ve been known to get sidetracked for hours finding/returning lost dogs in my area, but people need to stop with the “dogs are children” crap. Like, no, they’re not…not even close.

Stop trying to equate the two and gain sympathy/scheduling benefits that are reserved for actual parents of humans.

I think you can believe dogs are not children, and still know your dog will poop on your floor or eat your curtains if you leave them alone for a certain length of time. So making a plan is a good idea there. But I also agree that animals are very clearly not children and you do have a bit more leeway with leaving animals unattended vs children. Except in situations where your pet is sick. You probably don’t want to leave a vomiting animal alone in your house if you can help it. In some climates they could be outside, but this isn’t true everywhere.

 

[owlegrad]

Tangent here. I love dogs, I’ve been known to get sidetracked for hours finding/returning lost dogs in my area, but people need to stop with the “dogs are children” crap. Like, no, they’re not…not even close.

Stop trying to equate the two and gain sympathy/scheduling benefits that are reserved for actual parents of humans.

Agreed. I’ve been fortunate in that I’ve never worked with someone who legitimately puts forth or pets as being equivalent to children so it’s difficult for me to imagine someone being that out of touch. It just sounds crazy to me tbh.

 

[Dred Pirate]

Tangent here. I love dogs, I’ve been known to get sidetracked for hours finding/returning lost dogs in my area, but people need to stop with the “dogs are children” crap. Like, no, they’re not…not even close.

Stop trying to equate the two and gain sympathy/scheduling benefits that are reserved for actual parents of humans.

I **** you not- I work with this one rph who actually asked during the staff interview for a new director (I paraphrase)
For some people their pets are their children. Is it acceptable to take days off to provide care or take funeral leave if they pass.
She even emailed HR asking for pets to be included in the same light as children when it comes to various leaves.

 

[owlegrad]

I mean is taking a day off for a pet's death unreasonable? I don't think so. Obviously, it is not on the same level as losing a child but I think one day off for a funeral isn't unreasonable.

Heck, I wouldn't even ask the question to be honest. If I need a day off, I am going to take it. Are they going to fire me for a single day off? Doubtful.

 

[Dred Pirate]

I mean is taking a day off for a pet's death unreasonable? I don't think so. Obviously, it is not on the same level as losing a child but I think one day off for a funeral isn't unreasonable.

Heck, I wouldn't even ask the question to be honest. If I need a day off, I am going to take it. Are they going to fire me for a single day off? Doubtful.

taking a day off (and using PDO) for death of a pet = OK
wanting to use 4 days of company paid funeral leave for a dead dog = unreasonable

 

[CetiAlphaFive]

I do question how you graduated and seem to be able to change jobs at will. Not gonna lie, there is a tad bit jealousy involved to be able to speak so freely.

That being said, if that happened with a student of mine I would have had a sit down where we set expectations. My students actually generally did 11a-7p since my goal was to get the busy time of the ED - but I also make them work nights as well. I had one tell me they couldn't work nights because of their dog. I told them they had two weeks to come up with a plan. The did.

I have a classmate who i would've guessed Sparda was, if not for knowing that they live in separate states.
How the dude thrived/s in school and now as a professional was always so baffling. His current hobby is going to open mic standup events and telling other people's jokes 😂

 

[Sparda29]

I have a classmate who i would've guessed Sparda was, if not for knowing that they live in separate states.
How the dude thrived/s in school and now as a professional was always so baffling. His current hobby is going to open mic standup events and telling other people's jokes 😂

There's people on here who went to school with me.

 

[Sparda29]

I do question how you graduated and seem to be able to change jobs at will. Not gonna lie, there is a tad bit jealousy involved to be able to speak so freely.

That being said, if that happened with a student of mine I would have had a sit down where we set expectations. My students actually generally did 11a-7p since my goal was to get the busy time of the ED - but I also make them work nights as well. I had one tell me they couldn't work nights because of their dog. I told them they had two weeks to come up with a plan. The did.

I have a classmate who i would've guessed Sparda was, if not for knowing that they live in separate states.
How the dude thrived/s in school and now as a professional was always so baffling. His current hobby is going to open mic standup events and telling other people's jokes 😂

I know who to kiss ass to and who I can manipulate.

 

[DagS132]

I know who to kiss ass to and who I can manipulate.

Street smart

 

[CetiAlphaFive]

Street smart

I think that's a very generous way of putting it

 

[confettiflyer]

I mean is taking a day off for a pet's death unreasonable? I don't think so. Obviously, it is not on the same level as losing a child but I think one day off for a funeral isn't unreasonable.

Heck, I wouldn't even ask the question to be honest. If I need a day off, I am going to take it. Are they going to fire me for a single day off? Doubtful.

I had a student call out a day because her dog died, or something like that. Sounded like crap and would have probably produced crap work, so a win-win keeping them at home.

Our students are pretty involved with patient care, so if you’re not 100%, I really don’t want that extra liability.

That said… 1 day is fine, but Irish wake for a dog, that’s gonna elicit an unintended eye roll from me.

But I suppose it’s a thin line between a pet dying and mental health concerns, the latter being a valid reason for calling out multiple days (if needed).

 

[naseuy]

This isn't a brand new article, but I felt it is good to share. To many of the preceptors I have met over the year try so hard to be "the tough ones". I have never felt that was necessary - I teach practical knowledge, I do hold people to high standards (attendance, deadlines, etc) - but never chastise them for getting the wrong answer. I feel pharmacy is very bad at what is talked about here.

thoughts?

The Myth of the Tough Preceptor — The Overrun

I had a reputation as a tough preceptor. I was the one that people either sought out because they wanted the challenge; or the one that they avoided. I thought I held students to a high standard, thought I was tough but fair, and thought that any student of mine who passed through my finishing schoo

www.overrunproductions.com

I never chastise students for getting the wrong answer. I do ask them to look things up if they're not sure, or if they can't come up with the right answer. On the first day of their rotation with me I tell my students that "I will get back to you" is a valid answer. I will not remind them of follow up questions they have on purpose, and it is up to them to get back to me.