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Experiential learning principles: 5 & 6

Professionalism is as important to student growth as clinical competence
Our next learning principle is professionalism is as important to student growth as clinical competence. A picture that the brain lifting weights. Anyone lifting weights if they are lifting a fairly significant weight, knows how important it is to have the weight equally balanced. This is similar to the clinical competence side and the professionalism side of training students. There they’re both elements they’re critically important and need to be equally weighted in our design of the training experience. When you’re talking about clinical competence, we provide this training to students by giving them practice at what it is we want them to develop their skill and knowledge in.
And that’s going to be very unique to the rotation depends on the nature of the rotation and the opportunities that are available at the practice site. But the key here is that the learning comes from actual involvement from from practicing what it is we want them to learn through action. It’s very different to training students to develop their professionalism, to develop professional behavior and professional demeanor. We help students develop a sense of professionalism, not by giving them things to do or things to practice, but by immersing them in a culture that exhibit the professional behavior that we want them to develop. Now this is where it really helps to be consistent across rotation sites within a program.
For example, if as a preceptor, it’s very important to me that students develop a commitment to academic honesty. If they write a paper and they submit something, a newsletter article for example, they submit that to me. I should be able to accept the fact that they’re honest that they’ve actually done the work. And we know that I have had cases in which some students of plagiarizing material. It’s so easy now on the internet, cut and paste information. So in my rotations, I tell the students up front from the very beginning. If you commit blatant plagiarism, fraudulent plagiarism of a written assignment, you will fail the rotation.
That may seem very harsh, but communicates to the students, how important that is as a professional behavior. For professions like pharmacy that is so dependent on honesty and integrity. Now if a student in the same program would go to another rotation, with the different preceptor. And that preceptor doesn’t really care about whether they plagiarize. And they will
plagiarize, and the preceptor says: “hey! If you plagiarize, I’ll tell you not to do it again. But I’m not going to fail you on the rotation. I’m not going to sign any specific consequences to you.” That sends mixed messages to the students. They’re not being immersed in a consistent culture. So one of the things that is very important is from rotation to rotation. In terms of executing the professional development of a student, is to see to it that there’s as much consistency as possible across rotations and across training sites. Taking this a step further, I developed a design of a taxonomy of professionalism. This is based on three dimensions. I published this back in 2009.
This is based largely on my observations as pharmacy director. Evaluating the performance of hundreds of pharmacists who I worked with over the years. And what I observed was that at the most basic level, the pharmacist needed to have fundamental competence, a professional capability, a knowledge of pharmacy that was was sufficient for them to perform competently as a pharmacist. And that is critically important. But I think many of you worked in pharmacy would would agree with me. That’s not enough. A truly exceptional pharmacist, the kind of pharmacist that you want to work with have more than competence to offer. Competence alone is not going to make someone extraordinary pharmacist. What I observed was the second level.
The higher level of of professionalism that would enable a pharmacist take competence to a higher level is connection. Being able to connect with people. To communicate effectively with people. I call these people skills. It involves interpersonal compatibility. The pharmacist who can get along with people, who works well with coworkers, who relate well to patients and to nurses and physicians, is far more effective than the pharmacist who simply has good competence but lacks people skills. In the highest level, the highest dimension of professionalism is character, personal reliability, ethical skills, being trustworthy. The type of person that people can rely on. Who demonstrates honesty integrity kind of relates to the plagiarism example that I provided earlier.
So what we’re trying to develop in our students is this three-step approach that we not only provide them with the competence in pharmacy that they need. We afford them an opportunity to develop their people skills, strengthen those skills and also emphasized the importance of character in their professional behaviours. Our last experiential learning principles that competence requires action. Now it’s pretty clear if we go back to our basketball analogy. It’s pretty clear that if you can’t shoot the ball into the basket. That’s incompetent when it comes to a basketball player. What I would argue is that the basketball player who is capable of shooting the ball through the basket.
But when they have an open shot, chooses not to take it is just as incompetent as the basketball player who can’t shoot. In other words, if you have the capacity, if you have the ability to shoot the ball through the basket, but you don’t. You still don’t score points and your team is still going to lose. So pharmacy is a lot more than just having the ability. It also involves the motivation and inspiration to become involved in patient care and utilize your knowledge in practical ways to help patients and to provide services through the pharmacy department. Wayne Gretzky, who wasn’t a basketball player. He was a hockey player but one of the greatest of all time.
As a great quote about taking the shot, he
said: “You missed one hundred percent of the shots you never take.” how true that is. You can’t score if you don’t shoot the ball. You can’t provide good patient care if you don’t actually get involved in patient care. So let’s review what we’ve covered in these videos. The experiential learning principles we’ve covered five. First, good precepting starts with defining good learning outcomes. Those learning outcomes function as the target. They define what we want students to achieve during the rotation. Everything needs to be focused on those learning outcome. Second is what learning is a product of thinking. That we have to engage students in critical thinking.
These kind of thinking that causes them to analyze information, evaluate information form their own conclusions. It’s that deep level process was higher levels of cognition that will enable them to develop the deep learning that they can use in the future in a variety of ways. And they will retain long-term into the future. Third principle is that students must progress from cognitive knowledge to performance ability. It’s not just about getting them to learn what we want them to learn, but getting them to do what we want them to do. That just to be able to do it but to actually do it when the opportunity arises. This gets to the next principle and that is professionalism.
It is as important student growth as clinical competence. Students need to develop their communication skills and they need to be immersed in a culture that manifest the type of character that we want them to develop as a true health professional. And lastly competence requires action. We don’t actively get involved as a health professional. You are not going to be able to provide much assistance to your patient population. We also covered four guaranteed preceptor techniques. The first one is to Master the Fundamentals. Identify that twenty percent that’s most critical for eighty percent of the outcome. And make sure that students have ample opportunity to thoroughly developed their skills and developed their knowledge in relation to those fundamental aspects of learning.
Second principle of the second technique is “Ask, Don’t Tell.” In other words, don’t lecture to students on an advanced practice experience rotation, but ask them questions brought it out from them. Get them to think critically and make decisions and answer questions. “Tell Me Why” is the third technique and this involves asking them probing questions. Continually asking them why, why do you think that? how does this work? Explain the mechanism to me. What if something changed? What would you do then? Constantly get them to dig deeper into their thought processing. And then lastly, importance of automatic recall, that there are some facts that students should be able to recall effortless.
If they have to struggle, recording those facts that’s going to make it much more difficult for them in the future. The remaining sessions that we’ve got coming up. Session 2 about assessment evaluating student performance. Session 3 and designing a structured well-organized learning experience. Session 4 I·m bringing out the best in every student. And our last session will be on the traits of great preceptors and the qualities of great rotations. This concludes session 1. I hope you will continue on and and participate in session 2. (Week 2)

In this video, Prof. Brown talks about the Principle 5 & 6 of the experiential learning.

  • Principle 5. Professionalism is as important to student growth as clinical competence.

  • Principle 6. Competence requires action.

There will be more to talk about in the next few weeks. But now we have to assess how much you have learned this week. Please go to the next activity and take the weekly quiz. If you have any thoughts, you are welcome to do that in the comments.

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