Tag Archives: stages of learning

Transcript:
Hello, my name is Dr. Tablet but you can just call me Tab. In this video, we’ll be following Wanda on her first few days of hospital practicum and I’ll be sharing seven helpful tips along the way. Let’s get started.Today is Wanda’s first day, she refers to the email from her practice educator to confirm her start time
and dress code. Before leaving, she checks that she has her notebook, pens and orientation documents in her bag.Wanda arrives at the designated meeting place 15 minutes early, wearing her lab coat and UBC nametag. She meets Justin, her practice educator, and introduces herself. Excited to begin, Wanda asks if now is a good time for Justin to go over the orientation documents with her. Justin suggests reviewing them later, since rounds are starting soon and he’d like her to participate and observe.To kick off team rounds, everyone is given the opportunity to introduce themselves to the rest of the team. This brings me to my first tip. Introduce yourself as a student pharmacist to the people around you. This may include health care professionals, medical staff, other team members or patients. Fostering a good rapport can help you
create a positive learning space. It can also help you get to know the roles of other workers at the site and help them understand yours. While Wanda had a chance to meet most of the health care team right at the start of her practicum, your experience may be different. It’s important that you introduce yourself with your name, program and year level whenever you meet someone new.During team rounds, Wanda takes initiative in her learning by being attentive, asking questions and taking notes to refer back to later. This brings me to my next tip. Be adaptable and seize learning opportunities. Practicums are a chance for students to immerse themselves in the practice setting and observe their practice educators and other team members. Asking questions and being open to new experiences can help you get the most out of your practicum. Wanda shadows her practice educator for most of the day as he provides care to his patients. Before each interaction, she introduces herself as a pharmacy student and follows the pharmacist’s lead as he speaks with the patient. She takes notes, asks questions, and debriefs with her practice educator between the interactions. After lunch, Justin gives Wanda an unofficial tour of the practice site and sits down with her to discuss the practicum schedule.Guided by the orientation documents, they discuss a tentative timeline for the practicum and review expectations. Setting expectations should be a discussion between you and your practice educator at the start of your practicum. Each practice educator may approach things a little bit differently in terms of their style of teaching or even
their feedback approach. It’s important to discuss expectations for patient care activities and how to integrate yourself into the site’s workflow. It’s also a good idea to determine how and when you’ll be touching base for feedback. Wanda returns home after a busy first day. Now that she’s had some time to observe the workflow, she has a better understanding of the learning opportunities available and can start to think about her personal goals. This brings me to my next tip. When identifying your goals and working on your learning contract, consider site-specific factors such as the patient population, available resources and unique needs.The next day, Wanda and Justin review the learning contract together. Wanda notices that her practice site offers many opportunities to practice medication reconciliation, also known as Med Rec. She asks Justin if that would be something she could focus on during her practicum. Justin asks her about her comfort level and previous experience with the process. Wanda has never completed one before with a real patient and admits
to feeling a bit nervous. Justin suggests that she shadow him first as he performs the tasks and work toward taking more of a lead role as she becomes more comfortable.Later that day, Justin models how to complete a Med Rec. Wanda was looking forward to having him observe and provide feedback as she completed the activity. But before she has a chance to do so, they find out that help is
needed in the dispensary. Wanda is reluctant to go as she feels she has plenty of experience dispensing medications and figures she has more to learn on the ward. Let’s pause for a moment and explore Wanda’s feelings.

Although Wanda is excited to spend time on the patient ward, it’s important that she learns about
all aspects of pharmacy practice. Pharmacists are responsible for both patient care and drug distribution tasks. Student pharmacists are expected to build a solid understanding of medication distribution processes in a variety of practice settings. Students can be expected to become more familiar with medications,
learning their shape, color and branding. Learn how to use various pharmacy distribution technologies. Learn how to identify, manage and prevent distribution errors, and understand the procedures and workflow of a pharmacy practice. My advice for students is to embrace all aspects of pharmacy workflow. Wanda considers the importance of learning the medication distribution process and its impact on patient care and safety. After reflecting on her feelings, she goes forward with a growth mindset and follows Justin to the dispensary.

Justin meets with Wanda at the end of the day to provide some feedback. In reflecting on her patient interaction earlier that day, Justin commends her for being thorough in her information gathering, but suggest she use fewer technical terms. Wanda is surprised she thought the interaction went really well. My advice to students is to be
open to receiving feedback. Feedback is an important step in the learning process and can help
you improve your knowledge and skills. We can’t improve if we don’t know what we need to work on. I would encourage you to be curious and ask for examples to understand your practice educator’s perspective. Practice educators take the time to provide feedback because they care and are invested in their students learning. Wanda thanks Justin for his feedback. Although she recognizes that she is still learning, she can’t help
but feel a bit frustrated. She feels like she’s always struggling and checking her notes while all her peers seem to be doing so well. It’s common for students to feel this way. My advice for you is to remember that learning is a process and it all starts with day one.

When working to develop a new skill, feelings of frustration and other emotional responses are normal. To understand Wanda’s situation, we need to recognize that learning is a process and there are four stages students must transition through when learning a new skill. In the unconscious incompetence stage. Students don’t know what they don’t know. They are inept, unaware of it, and may not recognize the value
of a new skill or the need to learn it. For example, before providing a Med Rec for a patient, Wanda didn’t
know what she needed to work on. When students become aware of what they
don’t know, what they can’t do or how much they need to learn, they have entered
the conscious, incompetent stage. During this stage, it’s normal for students to feel hesitant and uncomfortable. They may have low confidence or feel like they’re making a lot of errors. Students will transition in and out of this stage frequently throughout the course of their program. While it can be difficult to acknowledge
your learning gaps, this stage is key as this is where learning starts. With time and work, students will enter the conscious competence stage.

Here, students understand or know how to do something, but need to think
and work hard to do it. They still need to refer to their notes or checklists and go through each process step by step in order to complete the task. The skill doesn’t come naturally yet. The fourth and final stage
is unconscious competence. This is when the task can be done easily and is almost second nature. Wanda’s practice educator, Justin, is at this stage and is able to complete a Med Rec easily without having to consciously think about each individual step in the process. While on practicum, continue to observe, reflect, and ask questions. What you gain from your practicum depends on how much effort you put into it. In Wanda’s case, she embraced the spirit of experiential learning, was open-minded to new learning opportunities, and demonstrated adaptability to the dynamic practice environment. She made the most of the rest of her practicum by being actively engaged in her own learning. When her practicum finally came to an end, she left with invaluable
experience, new skills and knowledge and a better understanding of what it means to be a pharmacist.

I hope you found this video helpful. Thanks for watching. I’m Dr. Tablet and I hope you have a fanTABulous practicum.

Acknowledgements:
We would like to thank Alyssa Low (Undergraduate Student) for helping to create this video and Garrett Tang (Undergraduate Student) for designing original images (e.g. Dr. Tablet).