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Preceptor Training: Staying Current

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Preceptor Training: Staying Current Staying Current and Relevant! Mitchell Pelter, Pharm.D., FCSHP, FASHP, ASH-CHC Disclosure I have no potential conflicts of interest Learning Objectives • Apply the suggested guide as a start for lifelong learning strategies to keep current • Identify quick online newsletters from reputable sources, as a means to efficiently keep up • Employ learners as change agents to improve our colleagues’ techniques to continuously improve their evidence-based medical knowledge This is NOT intended to be a drug literature search/retrieval presentation! This is NOT an exhaustive list of resources – only a sampling Your Professional Obligation • Keep your professional knowledge and skills up-to-date. • Are your patients receiving the benefit of state-of-the art treatments? • Regularly take part in activities that maintain and develop your competence and performance. • Be familiar with guidelines and developments that affect your work. • Keep up-to-date with, and follow, the law, medical guidance and regulations relevant to your work. • Take steps to monitor and improve the quality of your work. • Keeping your knowledge current is not passive, you must work continuously and lifelong! • ASHP PGY 1 Standard 4: Requirements of the Residency Program Director and Preceptors This is not about Translation “Translation is the process of turning observations in the laboratory, clinic and community into interventions that improve the health of individuals and the public — from diagnostics and therapeutics to medical procedures and behavioral changes.” Why CE does not = keeping up! • State Boards establish minimums not high bar! • Where you obtain education may matter • Drug company sponsored can be highly tainted/subtle drug promotion • “Free” might be a red flag for commercial • How much CME do you retain? • Patients depend on you, the medical team depends on you, students/residents depend on you, the mother of the person next to you depends on you! • We are providers/prescribers: Patient responsibility include best evidence-based tx! • Medline citations indexed in 2020: 953,000 • FDA approved novel drugs in 2020: 53 • And you think your education/training from 20xx will get you through a career? Staying Current The first step, develop a system: What kind of learner are you? Browser, emails, info in small bites, a pile of info once a month, live presentations, online, or combination Check your institutions library for free online access at home or mobile app • Passive feeds • Evidence reviews • NEJM Journal Watch • Cochrane Reviews • Podcasts (AAFP, BMJ, NEJM, ACC) • UpToDate • Pubmed alerts on saved searches • Wiki Journal Club app • Electronic delivery of journal TOC (AJHP) • NEJM Resident 360 • ACP Journal Club • Clinical Libraries • EvidenceAlerts • Clinics of North America • ProMED • Mayo Clinic Proceedings • JAMA Network • Scientific American Medicine • Read by QxMD • Professional association newsletters • Not everything online/PubMed is good science! • And…beware of predatory journals Staying Current (cont) • Live • Medical librarian • Residents’ Journal Club • Medical Grand Rounds • Discussion/socialize new articles with colleagues (i.e., informal JCs) • Teaching students/residents • APhA Advanced Preceptor Training certificate • Choose challenging environment (practice what you learn!) • Free Clinic opportunities to improve primary care skills • Medical center committee participation • CSHP APh Chronic Disease State Management Certificate program • BPS Board certification review courses (ACCP, APhA) • Test of knowledge • Board certification and review materials NEJM Journal Watch • Online version free, arrives weekly/monthly • Email alerts, RSS Feed • Surveys > 250 medical/scientific journals • General Medicine (Physician’s First Watch) • Specialty: Cardiology, Emergency Medicine, Gastroenterology, Hospital med, neuorology, ID, Onc/hem, HIV/AIDS, General med (twice/week) • Topics: Geriatrics, DM, respiratory infections, allergy/asthma, HTN, STDs, arthritis/rheumatic dx, lipids, stroke, breast CA, nutrition/obesity Suggested for: Am care, acute care, select specialties • IMPORTANT NOTE: Nejm.org • Wealth of information: Mobile, Journal, research and reviews, study protocols, case studies, audio, PowerPoints, CME, multimedia – most for free https://www.jwatch.org/ PubMed Alerts • Free • Email alerts • Maintained by NLM/NIH • 28million citations • Alerts search for new articles on topics of interest • Many articles might be free via institution Suggested for: All areas of pharmacy practice https://www.ncbi.nlm.nih.gov/guide/howto/receive-search-results/ ACP Journal Club (Ann Int Med) • Free • RSS feed • Wide range of IM and its subspecialties • Reviews/summarizes best new evidence from 120 journals monthly • Part of Ann Int Med • Editorials, easy to read abstracts, page of notable articles Suggested for: Adult practice; Am care, acute care, specialties https://www.acponline.org/clinical-information/journals-publications/acp-journal-club EvidenceAlerts • Free • Email alerting system • DynaMed Plus and McMaster University Health Information Research Unit collaboration • Current best evidence from research tailored to your interest • 110 journals (including Cochrane library), rated for quality Suggested for: Am care, acute care, specialties https://plus.mcmaster.ca/evidencealerts/ ProMED • Free • Daily email bulletins • Monitors emerging ID, global, affecting humans, animals, plants • Worldwide ID reporting system • Sources include media, official reports, online summaries, local observers. All reports are screened by experts in human, plant and animal diseases • Official program of ISID Suggested for: Am care ID, travel medicine, lesser extent acute care ID https://www.promedmail.org/ JAMA Network Open • Free • Daily email TOC • Open access, reputable organization • Restricted to JAMA Network • General medicine journal customizable to interest (including pharmacy) Suggested for: General medicine, specialties https://jamanetwork.com/journals/jamanetworkopen/ Read by QxMD • Free app • Single place to keep up with new literature, reviews and search PubMed • Simple interface for seamless access to medical literature by reformatting into personalized digital journal • Follow your favorite: Journals, specialties, collections, keywords Suggested for: Am care, acute care, specialties https://qxmd.com/read-by-qxmd Cochrane Library • No email or RSS • Might be free through your elibrary • Very thorough, systematic reviews/meta- analysis • Topics are limited Suggested for: All areas of pharmacy practice http://www.cochranelibrary.com/ UpToDate • Pricey ($53/month, $1,229/3 years) • Might be available for free via your organization • Very popular mobile app esp among students/residents • Free CME (via HC version)? Suggested for: Am care, acute care, specialties Journal Club: Medicine app • $6.99 Suggested for: Am care, acute • Collaborate website care, specialties • Concise summaries of landmark clinical trials • Articles: Allergy, cards, critical care, derm, ER, endo, GI, OB/GYN, hem/onc, ID, neph, neuro, oph, pain, palliative, peds, PM, prevent, psych, pulm, radiol, rheum, surgery, urology https://www.wikijournalclub.org/wiki/Main_Page NEJM Resident 360 • Free • Designed for medical students/residents to build foundation knowledge for rotations • Landmark trials, reviews, guidelines, core reading, testing of knowledge Suggested for: Am care, acute care, specialties https://resident360.nejm.org/resource_collections Institutional Clinical library Topic Reviews • The Clinics • Content alerts, full access might be free in your institution • Separate journals for: Am care, Cardiology, ER/Critical Care, GI/Liver, IM, Ortho, Pathology, Psych, Radiology, Surgery, ID and lots more! • Medical Clinics of North America very popular • Reviews entire disease topic • Mayo Clinic Proceedings • Content alerts, full access, might be free in your institution • Symposium publications can cover an entire topic • Scientific American Medicine • Pricey, $280/year but might be free in your institution • Frequently updated, book-like, illustrated Suggested for: Am care, acute care, specialties Professional Associations American Heart Association American College of Cardiology APh Chronic Disease State Management Certificate Program https://www.cshp.org/general/custom.asp?page=CP_APP_Touro Board Certifications • Boards test knowledge already acquired • Some have prep course, live/home study guides for CE • BPS Specialties • Ambulatory care, cardiology, critical care, compounded sterile preparations, critical care, geriatrics, infectious disease, nuclear, nutrition support, oncology, pediatrics, pharmacotherapy, psychiatry, solid organ transplantation • Others • Pain Educator (CPE), Diabetes Educator (CDE), Asthma (AE-C), Hypertension (ASH-CHC), HIV (AAHIVE), Anticoagulation (CACP) BPS Recertification Options Example BCACP Develop an article file/recall system • Paper or electronic • File system ideas: AHFS, Cecil’s Textbook of Medicine, Washington Manual, etc… Pearls • Have an established day/time in your calendar for literature review • Engage/challenge colleagues • Informal JCs • “Study of the week” • Involve MD colleagues • Become the information specialist in your area of specialty • Maintain an inquisitive mind in your practice • Keep small notebook of questions-answers, literature searches • Use CME to meet your CE needs • Typically more sophisticated than pharmacist-based CE • Travel to exotic locales (might not be tax deductible?) • No additional costs using CME towards
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