Preceptor-Specific Criteria of Excellence
2017-2018 American Association of Colleges of Pharmacy (AACP)
Master Preceptor Recognition Program (MPRP)
Experiential Education Assessment/Evaluation for Master Preceptor Nominee
Master Preceptor Nominee: ______
Evaluator Name: ______
Evaluator Title: ______
Evaluator School/College of Pharmacy and Work Address: ______
______
Evaluator Telephone Number: ______
Evaluator Email Address: ______
Evaluator Telephone Number: ______
Please submit the following documentation with this evaluation form:
(1) The dates and type(s) of experiential education experiences completed by the master preceptor nominee for the period of time of precepting for your institution
(2) Overall summary of student evaluations of pharmacy practice experiential experiences completed by the master preceptor nominee for the period of time of precepting for your institution
Evaluator Signature: ______Date: ______
The purpose of the American Association of Colleges of Pharmacy (AACP) Master Preceptor Recognition Program (MPRP) is to nationally recognize preceptors who are not full-time employees of a school/college of pharmacy for their sustained commitment to excellence in experiential education and professional practice. Master Preceptor Nominees must have a minimum of ten (10) years as a preceptor for a school/college of pharmacy. Master Preceptor Nominees will be evaluated based upon their demonstration of and contributions to Experiential Education, Pharmacy Practice, Community Service, and Awards/Recognition. The MPRP is funded in part by the American Pharmacists Association (APhA), the American Society of Health-System Pharmacists (ASHP), the National Association of Boards of Pharmacy (NABP) Foundation, and the National Association of Chain Drug Stores (NACDS) Foundation.
This instrument is being used to evaluate preceptor-specific criteria of excellence in the education of PharmD students. To complete the assessment, please select the response that best corresponds with your level of agreement with each statement. All data will remain confidential. This assessment, along with the additional documentation regarding experiential education experiences completed within the past ten (10) years, should be saved as a PDF document and submitted electronically with the other application information and assessments for the master preceptor nominee. Note that the response “Not Applicable” should be selected only if you have insufficient information on which to base your evaluation of a particular item. In addition, the narrative portion of this evaluation must be completed in order for this evaluation to be complete.
Please use the following scale for the questions below:
1=strongly disagree; 2=disagree; 3=neutral; 4=agree; 5=strongly agree;
N/A=insufficient information to evaluate
As a practitioner/preceptor, the master preceptor nominee….
Disagree Agree
1. Possess Leadership/Management skills by…
a. Demonstrating effective managerial and leadership 1 2 3 4 5 N/A
relationships with pharmacist colleagues and staff
b. Demonstrating aspects of humility related to 1 2 3 4 5 N/A
his/her own limitations
c. Monitoring quality of professional practice and 1 2 3 4 5 N/A
teaching activities
d. Demonstrating nondiscriminatory behavior and practice 1 2 3 4 5 N/A
e. Being active in professional organizations (e.g., ACA , 1 2 3 4 5 N/A
ACCP, AMCP, APhA, ASCP, ASHP, NCPA etc.)
2. Embodies his/her practice philosophy by…
a. Demonstrating personal motivation and by inspiring 1 2 3 4 5 N/A
pharmacists to develop pharmaceutical care practice
b. Having a mission or vision statement of pharmacy 1 2 3 4 5 N/A
c. Patterning his/her practice after standard guidelines 1 2 3 4 5 N/A
or other model practices
d. Insisting that ownership or administration supports 1 2 3 4 5 N/A
pharmaceutical care services
3. Is a role model practitioner in…
a. Providing patient-centered pharmaceutical care 1 2 3 4 5 N/A
b. Ethical decision making 1 2 3 4 5 N/A
c. Patient care problem solving 1 2 3 4 5 N/A
d. Providing medication, diseases and health 1 2 3 4 5 N/A
education to patients
e. Professional patient care behavior 1 2 3 4 5 N/A
Please use the following scale for the questions below:
1=strongly disagree; 2=disagree; 3=neutral; 4=agree; 5=strongly agree;
N/A=insufficient information to evaluate
As a practitioner/preceptor, the master preceptor nominee….
Disagree Agree
4. Is an effective, organized, and enthusiastic teacher by...
a. Teaching by example 1 2 3 4 5 N/A
b. Demonstrating patient assessment skills 1 2 3 4 5 N/A
c. Demonstrating and discussing my own clinical 1 2 3 4 5 N/A
reasoning process
d. Demonstrating ethical behavior and high personal 1 2 3 4 5 N/A
character
e. Having a strong command of drug therapy knowledge 1 2 3 4 5 N/A
f. Demonstrating a caring attitude towards students and 1 2 3 4 5 N/A
patients
g. Teaching patient-provider communication skills 1 2 3 4 5 N/A
including empathic listening skills
5. Encourages self directed learning of the student with constructive
feedback by...
a. Identifying and responding to each student’s specific 1 2 3 4 5 N/A
learning needs
b. Challenging the learning process of each student 1 2 3 4 5 N/A
pharmacist
c. Coaching student pharmacist behavior through 1 2 3 4 5 N/A
effective, constructive and timely feedback
d. Making student pharmacist teaching an important focus 1 2 3 4 5 N/A
of the practice site
e. Treating students as colleagues-in-training 1 2 3 4 5 N/A
6. Has well developed interpersonal/communication skills 1 2 3 4 5 N/A
Please use the space below to describe how the Master Preceptor nominee had demonstrated continuous commitment and contribution to experiential education and pharmacy practice. This description may also include expanding on the ratings provided above regarding the nominees’ leadership/management skills, pharmacy practice philosophy, ability as an effective and enthusiastic teacher and/or encouraging the self-directed learning of students. This narrative portion of this evaluation must be completed in order for this evaluation to be considered complete.
2017-2018 AACP Master Preceptor Recognition Program Assessment/Evaluation Form for
the Nominating Experiential Education Department