Pharmacy Residency Preceptors and Rotations

Emmeline C. Academia, PharmD

Clinical Pharmacy Specialist, Ambulatory Care
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: University of California, San Francisco
• PGY1 Pharmacy Residency: University of Colorado Hospital, Aurora, CO
• PGY2 Hematology/Oncology Residency: University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Cancer Center, Aurora, CO

Primary Area of Practice: Ambulatory Care-Oncology (GI, Thoracic, Sarcoma)

Approach to providing feedback to learners:

After a baseline discussion of learning styles and experiential goals, residents on this service will receive daily feedback during patient reviews/discussion (either before or after clinic based on resident preference) and may include any combination of clinical, communication, drug information, or organizational observations. Depending on the format of the rotation, longer periodic discussions (e.g. weekly) about the resident's adjustment to, experience, and goals on service will ensure that personal learning objectives are met. The resident's responsibilities will gradually increase as the resident progresses, with the overall goal of triaging all patients seen in one disease state clinic for potential ambulatory pharmacy needs.

Melanie Berry, PharmD, BCACP

Clinical Pharmacy Specialist, Ambulatory Care
Beth Israel Deaconess Medical Center
Boston, MA

Training

• Pharmacy School: University of Missouri-Kansas City, Kansas City, MO
• PGY1 Community Pharmacy Residency: Cleveland Clinic, Cleveland, OH
• PGY2 Ambulatory Care Residency: Boston Medical Center, Boston, MA

Primary Area of Practice: Ambulatory Care-HIV and HIV prevention

Approach to providing feedback to learners:

I give feedback on-demand and scheduled intervals. On-demand feedback allows for development in specific areas in real time in order to develop skills in a specific area. Weekly scheduled feedback provides the resident a time for further self-evaluation and review of overall skills to develop week to week. I feel like this combination is essential to produce an independent resident during the rotation.

Sulgi Chae, PharmD

Clinical Pharmacy Specialist, Ambulatory Care
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: Northeastern University, Boston, MA
• PGY1 Pharmacy Residency: Providence Health, Olympia, QA
• PGY2 Pain/Palliative Care Residency: University of Maryland, Baltimore, MD

Primary Area of Practice: Ambulatory Care-Chronic Pain, Palliative Care, Opioid Stewardship

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

As palliative/pain management may be a new area of pharmacy practice to most residents, the rotation will start with the first step, instruction. Prior to direct patient care, we will work through topic discussions with case questions to review opioid conversion, titration and philosophy of palliative/hospice care. Then, depending on the resident and preceptor's comfort level, the resident can shadow or independently work up assigned patients. The preceptor will coach to validate and/or correct their thought process. At the end of the rotation, the resident will be responsible for independent review, communication, conducting interdisciplinary visits under the facilitating preceptor.

How often do you meet with the learner while they are on rotation:

I meet with the resident daily meet in person and/or virtually in the morning to pre-round on patients for the clinic. I am additionally available throughout the day in person, via telephone, and emails to answer questions, discuss patients, and address any issues. I will also meet with the residency biweekly for evaluation and feedback. The resident and preceptor will schedule an independent time throughout the week for topic discussions and mentorship.

Vivian Cheng, PharmD, BCPS

Clinical Pharmacy Specialist, Ambulatory Care
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC
• PGY1 Pharmacy Residency: VA Eastern Colorado Healthcare System, Aurora, CO
• PGY2 Ambulatory Care Residency: University of Colorado Skaggs School of Pharmacy, Aurora, CO

Primary Area of Practice: Ambulatory Care-Primary Care

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

• Instructing: I believe it is useful to have topic discussions led by the learner so I may better determine their baseline knowledge and then instruct by filling in missing pieces. For students or new PGY1 residents, I may create a pre-rotation packet/quiz that will assess their baseline knowledge of pertinent disease states for this rotation, and will review the answers with them with some case-based discussion. I think instructing is important throughout the duration of the entire rotation, not just necessarily at the beginning.
• Modeling: I strongly believe in demonstrating skills/processes for learners, especially early in the rotation. For example, during the first several days of rotation I will ask the learner to shadow me as I see patients, communicate with providers, look up answers to questions, and document notes. With clinical scenarios, I may over-explain my thought-process to demonstrate all the pieces of information I considered, or explain exactly how I performed a literature search. I may write longer assessments in my notes, also to model my clinical thinking process. I adjust the duration of shadowing to the learner's learning style and comfort level, knowing that some learners are more hands-on and prefer to jump in early whereas others may prefer a longer time shadowing. However, I think it is important to challenge the learner to jump in even if they may not feel 100% ready; it teaches them the important skill of learning in the moment and adapting to a situation.
• Coaching: This is the foundation of my precepting style. Coaching allows the preceptor to fine-tune the learners' skills and help them gain confidence. I generally try to move quickly from modeling to coaching so that more time can be spent observing the learner performing skills and providing timely feedback. I let the resident write their own notes to completion, then review with them and provide constructive feedback. I also challenge the learner with more case-based discussions during the coaching phase, encouraging them to "think out loud" and challenging them with more "what if" scenarios to help coach them through higher-level critical thinking and thinking-on-the-spot. I place a heavy emphasis on creating safe learning environments, and this is especially important with coaching since the learner is moving towards independence but still needs guidance.
• Facilitating: Towards the end of a rotation, I expect learners towards the end of their training year, to be able to perform certain tasks independently and I remain available as needed for debriefing. This includes conducting patient encounters without me being present, answering provider consults independently, and creating teaching materials. I adjust the learners' degree of independence based on their individual performance and their goals for the experience. I may push a resident planning to pursue a career in ambulatory care to be more independent with more clinic responsibilities than a resident less interested in ambulatory care or who may not be performing at as high of a level.

Approach to setting expectations and delivering feedback to learners:

I send an email before their rotation instructing them to come prepared for the first day with 2-3 goals for the rotation. Knowing their goals helps me reframe my expectations for them and better customize their learning experience. Additionally, I set aside time on day one of rotation to discuss roles and expectations. It is important to discuss expectations for both the resident and the preceptor. We review the residents' learning style to better adjust my teaching style to maximize their rotation experience. I also ask learners how often they like to receive feedback.

Lily Jia, PharmD

Clinical Pharmacy Specialist
Beth Israel Deaconess Medical Center
Boston, MA
Email Lily

Training

• Pharmacy School: Virginia Commonwealth University, Richmond, VA
• PGY1 Pharmacy Residency: Massachusetts General Hospital, Boston, MA
• PGY2 Oncology Residency: Massachusetts General Hospital, Boston, MA

Primary Area of Practice: Ambulatory Care-Oncology (Breast, Gynecologic, and Head & Neck)

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

• Instructing: Before the learner does an activity (ex. round, talk to a patient), I talk the learner through what to expect and how to do the activity. This way, they have a general overview of what to expect, are prepared for the interaction, and are aware of what to look out for.
• Modeling: After talking the learner through the activity, I model for them what the pharmacist should do. For example, if we are rounding, I will have them shadow me on rounds and observe. In this way, they are able to see what the activity looks like and what they can expect when they are in the role.
• Coaching: After the learner has a chance to see a pharmacist in the role, the learners are expected to carry out the role on their own with back up or support from the preceptor. For example, at this point, the learner would take on the role as the pharmacist on rounds, but I would continue rounding with the learner to answer questions or jump in as needed.
• Facilitating: At this point, the learner is able to independently perform the duties of the role, and the preceptor is available for debriefing or feedback. For example, the learner would round alone without the preceptor. After rounds, the preceptor and learner can meet to discuss how rounds went, answer any questions, and debrief.

Approach to setting expectations with learners:

It is extremely important to discuss roles and expectations before any rotation, project, or assignment so that the preceptor and learner are on the same page and aware of any potential challenges or barriers. When discussing roles and expectations, I ask the learner what they wish to gain from their experience, what they believe their role in the experience is, and any challenges they anticipate. I also like to make clear my role in the rotation or project, hard and soft deadlines, and a general timeline of where I expect the project or rotation to be progressing. I believe that it is important to revisit this conversation on a regular basis in case things come up, deadlines change, or the learner has hit an unexpected roadblock.

Katelyn Smith, PharmD, BCPS

Clinical Pharmacy Specialist, Ambulatory Care
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: Northeastern University, Boston, MA
• PGY1 Pharmacy Residency: Northwestern Memorial Hospital, Chicago, IL

Primary Area of Practice: Ambulatory Care-General Cardiology

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

• Instructing: Throughout the rotation, residents will participate in many learning activities including topic discussions, journal clubs and drug information inquiries. While the resident is expected to prepare for each of these instructional sessions, as a preceptor I will help to facilitate the discussion and add additional thoughts and points of information as needed.
• Modeling: A large part of this ambulatory care rotation is patient counseling. During the first week or two of the rotation, I like to model what a typical counseling session looks like for the resident, and will have the resident observe the first few sessions. We then discuss how to properly counsel a patient and, once the resident feels comfortable, I allow them to do these counseling sessions independently.
• Coaching: Providing feedback is a very important facet of the resident/preceptor relationship. Throughout the rotation, there will be constant coaching both formally and informally. I always provide feedback during a formal midpoint and final meeting, and also provide daily to weekly informal feedback as necessary.
• Facilitating: Throughout the rotation, I like to help the resident facilitate an independent relationship with the multidisciplinary care team. I encourage residents to reach out to providers, either verbally or over email, on their own and also encourage residents to take the lead in discussions with nursing staff, other pharmacists, and any students (if applicable).

How often do you meet with the learner while they are on rotation:

During our ambulatory care rotation, I meet with the resident daily. We will typically touch base early in the morning to review our scheduled patients for the day. During this meeting, we discuss the patients' pertinent past medical histories, current medications, any pertinent laboratory values or recent testing, and our care plan for the day. We then touch base periodically throughout the day as needed, and always do a final check-in at the end of the day to discuss any outstanding questions or issues.

Julia S. Stevens, PharmD

Clinical Pharmacy Specialist, Ambulatory Care
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: Purdue University, West Lafayette, IN
• PGY1 Pharmacy Residency: Indiana University Academic Medical Center, Indianapolis, IN
• PGY2 Oncology Pharmacy Residency: Froedtert & the Medical College of Wisconsin, Milwaukee, WI

Primary Area of Practice: Ambulatory Care-Oncology (Genitourinary and Immuno-Oncology clinics)

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

• Instructing: plays a limited role in my precepting style, although I occasionally will teach a resident about an unusual side effect, clinical scenario, or professional development topic.
• Modeling: I utilize modeling during the first few days as residents are learning the workflow of clinic and the basics of the disease state(s). Shadowing me provides valuable information to the resident about what kinds of interventions I make, how I interact with the team, and logistics of caring for my patient population.
• Coaching: I utilize this role most often throughout the rotation. I move residents to this style of precepting quickly so they can develop independence while also learning about the disease state.
• Facilitating: My goal for every resident is to move to the facilitator role by the end of the rotation within the core clinical skills/expectations of the rotation. I want residents to independently care for patients and grow through guided self-reflection.
  
  Preceptor roles are fluid and change from one task to the next. While I might be instructing or modeling in one area, I will often be coaching or facilitating in other areas. I also seek to understand what strengths and weaknesses my resident brings into the rotation so that I can help them work towards the next step, whatever preceptor role that may require.

Approach to providing feedback to learners:

I am a firm believer in timely, genuine, and compassionate feedback paired with active self-reflection. I give residents an opportunity to reflect and receive feedback frequently throughout the day. For example, after I listen to a resident talk to a patient on oral chemotherapy, I might ask them "how do you think that went?" By hearing a resident's self-reflection first, I can help overconfident residents understand what they are missing and can help self-critical residents understand their strengths. I find that most residents underestimate their performance, so this provides a good opportunity to acknowledge the skills they are building and point out ways to continue to grow. I pair this daily self-reflection and feedback with weekly semi-formal feedback sessions so the resident has a venue to provide feedback to me and I can provide feedback on broader trends and performance to the resident.

Jennifer Bui, PharmD, BCPS

Clinical Pharmacist II: Cardiology Medicine
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Education: Doctor of Pharmacy from Northeastern University (2015); PGY1 Pharmacy Practice Residency, Boston Medical Center (2016)

Current Professional Memberships, Service & Leadership: American College of Cardiology (ACC); Massachusetts Society of Health System Pharmacists (MSHP)

Rotation/s Offered: Cardiology Medicine

Personal Interest: Traveling, avid foodie, visiting art museums, attending concerts

Sonia Kothari, PharmD, BCCP

Clinical Pharmacy Specialist, Cardiology/Advanced Heart Failure
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ
• PGY1 Pharmacy Residency: Atlantic Health System, Morristown, NJ
• PGY2 Cardiology Residency: UMass Medical Center, Worcester, MA

Primary Area of Practice: Advanced Heart Failure

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

• Topic discussions will be utilized to provide direct instruction to residents throughout the rotation. These discussions will address various cardiology disease states, such as acute and chronic heart failure, acute coronary syndromes, hypertension, hyperlipidemia, arrhythmias, venous thromboembolism and anticoagulation.
• Clinical skills will be modeled for residents particularly at the beginning of the rotation. These skills include, but are not limited to collecting pertinent data about cardiac patients, utilizing appropriate resources to develop patient-specific treatment plans, communicating with advanced heart failure providers and educating patients about their cardiac medications.
• Residents will perform various patient-care activities, such as medication reconciliation, medication counseling, therapeutic monitoring and ambulatory clinic visits with heart failure patients while receiving coaching to allow for fine-tuning of these skills.
• By the end of the rotation, residents will be able to independently develop treatment and monitoring plans for heart failure patients in collaboration with physicians, nurse practitioners, and nurses, and communicate these plans effectively to patients and caregivers.

Approach to defining roles and expectations for the learner:

I will meet with the resident on the very first day of the rotation and discuss not only my goals for the rotation, but also the resident's goals and what they want to get out of the rotation. My position is a hybrid of inpatient and ambulatory cardiology, so I try to focus the majority of the rotation on what the resident's primary interests are. We will discuss the expectations related to required topic discussions, journal clubs/presentations, nursing in-services, as well as the responsibilities pertaining to patient care. We will also discuss the resident's preferred learning style so that I, as a preceptor, can make sure I am teaching in a way in which the resident is learning the most effectively.

Kelly Nguyen, PharmD, BCPS

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
Email Kelly

Training

• Pharmacy School: Massachusetts College of Pharmacy and Health Sciences, Boston, MA
• PGY1 Pharmacy Residency: Baystate Medical Center, Springfield, MA
• PGY2 Cardiology Residency Tufts Medical Center, Boston, MA

Primary Area of Practice: General Cardiology, Heart Failure

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

• Instructing: Each learner has a different level of knowledge, skill, experience, and goals. Depending on the level of the learner, we may have specific discussions and required readings to help gain a baseline foundation in the practice area of general cardiology and advanced heart failure.
• Modeling: When I model, I like to "think aloud" to show the learner how I approach clinical scenarios. I also prefer to teach topics based on cases and patients that come in real-time so that the learner has topic that relates to someone they are caring for.
• Coaching: Furthermore, when we counsel patients, I give the learner the opportunity to watch me (and/or partner up with me) to counsel the post-MI or new HF patients at the start of their rotation, depending on their comfort level. Once this is done and they develop their own routine, I would act in the coaching role and have the learner counsel a future patient and then provide feedback and direction that allows the learner to refine their knowledge and skill.
• Facilitation: I would incorporate facilitating by including continual self-assessment opportunities, formally on Pharmacademic as well as in-person feedback sessions, to help learners develop a habit of critically examining their own behaviors and clinical decisions.

Approach to setting expectations and delivering feedback to learners:

Currently, I am a preceptor in training. Based off my experiences as a student and resident, I am a firm believer in defining roles and expectations prior to starting the rotation. As a PGY1 resident, it was my responsibility to set up a meeting (i.e. email, calendar invites) with my preceptor at least a week prior to starting rotation. I quickly discovered that it was helpful to have a one-on-one with the preceptor about any questions I had about the upcoming experience and syllabus, set up expectations, discuss what my goals were for the rotation and the year, and how my preceptor would support me in reaching those goals. This way, we are more likely to be on the same page when Day 1 of rotation starts. This was also a good "ice-breaker" if I never had the opportunity to get to know the preceptor prior to rotation. I carried this forth to my PGY2 residency where this was not a common practice and I found much success in doing so!

I. Mary Eche, PharmD, BCPS, BCCCP, CACP

Clinical Pharmacy Manager: Critical Care/ED
PGY2 Critical Care Residency Program Director
Email I. Mary

Education: Doctor of Pharmacy from Northeastern University (2004); PGY1 Pharmacy Practice Residency, Beth Israel Deaconess Medical Center (2005); PGY2 Critical Care Pharmacy Residency, The Johns Hopkins Hospital (2006)

Professional Membership: Society of Critical Care Medicine (SCCM), American Society of Health System Pharmacists (ASHP); American College of Clinical Pharmacy (ACCP); Massachusetts Society of Health System Pharmacists (MSHP)

Personal Interests: Running, traveling, photography

Rotation/s Offered: Medical ICU, Cardiac Surgery ICU, Pharmacy Management/Leadership

George T. Abdallah, PharmD, BCCCP

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: Western New England University College of Pharmacy, Springfield, MA
• PGY1 Pharmacy Residency: Beth Israel Deaconess Medical Center Boston, MA
• PGY2 Critical Care Residency: Beth Israel Deaconess Medical Center Boston, MA

Primary Area of Practice: Cardiac Intensive Care, Cardiothoracic Intensive Care

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

• Instructing: Topic discussions are incorporated into the rotation to provide a disease state management foundation
• Modeling: Rounding with the resident during the first week of their rotation to model behavior and expectations
• Coaching: During patient work up and afternoon presentations, open ended questions and case-based scenarios are often used to guide the resident and to help foster critical-thinking skills
• Facilitating: During afternoon presentations, different hypothetical and patient care scenarios are used to help the resident refine the skill of developing alternative pharmacotherapy plans supported by evidence

How often do you meet with the learner while they are on rotation:

I meet with the resident multiple times a day while on rotation. I will usually meet with the resident 1 hour before interdisciplinary rounds to discuss patients, provide guidance and help the resident develop evidence-based medication and monitoring plans, if needed. In the afternoon, I meet with the resident to discuss the most critically ill patients, review their disease state management and ensure any actionable items are implemented and/or followed up on.

Gabrielle Cozzi, PharmD, BCCCP

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: University of Buffalo School of Pharmacy and Pharmaceutical Science, Buffalo, NY
• PGY1 Pharmacy Residency: Hackensack University Medical School, Hackensack, NJ
• PGY2 Critical Care Residency: West Virginia University, Morgantown, WV

Primary Area of Practice: Medical Intensive Care

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

The first week of my rotation is typically where residents gain an insight into my role as a clinical pharmacist and how I interact with my multidisciplinary team of medical residents, nurses, respiratory therapists, etc. As the resident starts to feel more comfortable, I start to coach them to challenge their critical thinking skills and providing feedback for example. As the rotation progresses, I allow the resident to have more autonomy and facilitate their role.

Approach to providing feedback to your learners:

Feedback by self-reflection and discussion is an essential component of resident growth. Prior to rotation, I discuss with residents their goals and what steps they will take to achieve them. I incorporate "Feedback Fridays" into my rotation where I have the resident reflect on what they think they are doing well, what they think could improve on (and how), pros/cons about the rotation, as well as myself as a preceptor. Additionally, I like to give daily feedback on their performance, which may include delivery of recommendations during rounds and interactions with nursing.

Quynh N. Dang BS, PharmD, BCCP

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: Massachusetts College of Pharmacy and Health Sciences, Boston, MA

Primary Area of Practice: Medical Intensive Care

Approach to giving feedback to learners:

I give feedback to the residents while on providing patient care and/or right after patient care rounds (ex. how to approach the team with interventions, when to bring up important intervention during round, which interventions can be addressed after rounds, etc.). Additionally, I schedule time to meet with the resident weekly (ex. Feedback Friday) to give additional feedback.

Pansy Elsamadisi, PharmD, BCPS, BCCCP

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: Long Island University: Arnold and Marie Schwartz College of Pharmacy, Brooklyn, NY
• PGY1 Pharmacy Residency: The Brooklyn Hospital Center, Brooklyn, NY
• PGY2 Critical Care Residency: Beth Israel Deaconess Medical Center Boston, MA

Primary Area of Practice: Trauma and Surgical Intensive Care

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

I usually start with direct instruction and modeling for the resident. Once the resident demonstrates proficiency, I give them more autonomy and I take more of a coaching and eventually facilitating role. I believe that communication and continuous feedback are key when it comes to establishing an effective preceptor/resident dynamic.

Approach to setting expectations and delivering feedback to learners:

Prior to rotation, I set up a meeting with my resident to ensure we discuss my expectations of the resident as well as their expectations for the rotation. This allows me to tailor their rotation experience to their specific interests.

Eli Philips, PharmD

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: Massachusetts College of Pharmacy and Health Sciences, Boston, MA
• PGY1 Pharmacy Residency: Maine Medical Center, Portland, ME
• PGY2 Emergency Medicine Residency: University of Vermont Medical Center, Burlington, VT

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

My philosophy of teaching is to encourage critical thinking via Socratic questioning; facilitate progression through the "see-one, do-one, teach-one" for procedural experiences; and provide meaningful constructive feedback. I believe early development of critical thinking skills allows for impactful, time-effective teaching that persist long after the experience is complete. The "see-one, do-one, teach-one" allows for learners to progress through the cycle of knowledge, gaining insight from both the initial teacher and subsequent learners.

Approach to providing feedback to your learners:

My feedback method mixes frequent informal with formalized ("Feedback-Fridays") feedback with the goal to highlight strengths and develop specific steps for improvement. I request learners self-evaluate and provide goals prior to my experience, during, and at the completion to ensure that each experience is tailored specifically to the learner. No feedback session is complete without learner input on the experience and my function as a preceptor.

Holly Reed, PharmD

Clinical Pharmacist: Critical Care
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Education: Doctor of Pharmacy from the University of Michigan (2017); PGY1 Pharmacy Practice Residency, Nebraska Medicine (2018); PGY2 Emergency Medicine Residency, Nebraska Medicine (2017)

Professional Membership: American Society of Health System Pharmacists (ASHP); Society of Critical Care Medicine (SCCM)

Personal Interests: Cats

Rotations Offered: Surgical ICU, Medical ICU

Sandra Rumyantsev, PharmD, BCCCP

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
Email Sandra

Training

• Pharmacy School: Massachusetts College of Pharmacy and Health Sciences, Boston, MA
• PGY1 Pharmacy Residency: Tower Health, Reading, PA
• PGY2 Critical Care Residency Residency: Roanoke Memorial Hospital, Roanoke, PA

Primary Area of Practice: Trauma and Surgical Intensive Care

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

When I precept a resident on my 4 week rotation, I initially like to give them instruction on my expectations. I also use the first week to model how I participate on rounds and my expectations as a critical care pharmacist. The next few weeks are dedicated to coaching the resident on how they can improve on rounds and patient care. During the last week, I step back and help facilitate but give my resident autonomy.

Approach to providing feedback to your learners:

During my rotation, I like establishing every Friday as feedback day, AKA "feedback Friday", so the resident knows and anticipates when feedback is coming. I also believe that if necessary, immediate feedback is also important. I give verbal feedback and document our conversations in PharmAcademic so the resident always has something to refer to in writing.

Mehrnaz Sadrolashrafi, PharmD, BCCCP

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
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Training

• Pharmacy School: Massachusetts College of Pharmacy and Health Sciences, Boston, MA
• PGY1 Pharmacy Residency: Baystate Medical Center, Springfield, MA
• PGY2 Critical Care Residency: Baystate Medical Center, Springfield, MA

Primary Area of Practice: Medical Intensive Care

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

Depending on if I am precepting a 4 vs 5 weeks rotation block, the first two weeks of the rotation will be spent on intensive instructing and modeling to ensure my residents are familiarized with the fast moving environment in MICU. Week 3 will be spent on modeling and coaching and week 4/5 will be spent on coaching and facilitating my resident's learning experience.

How often do you meet with the learner while they are on rotation:

• Due to the complexity of patient care in MICU and depending on the resident's prior experience and previous rotations in training, I will be rounding with the residents in the first two weeks of the rotation to go over the workflow and foundations of taking care of critically-ill patients. The residents will gradually increase the number of patients they cover on a daily basis. By week 3 of the rotation, the residents are going to be fully responsible for taking care of the full unit.
• During weeks 3 and 4, the residents independently take on the role of being the primary clinical pharmacist for the team and I will be readily available on the unit if the residents need me for a second opinion.
• The residents will be the primary code blue responder while on rotation with me, which gives them the opportunity to learn and apply the critical care knowledge learned during rotation, to actual clinical scenarios.

Rachael Scott, PharmD

Clinical Pharmacist: Critical Care

Education: Doctor of Pharmacy from the University at Buffalo (2017), PGY1 Pharmacy Practice Residency at Buffalo General Medical Center (2018), PGY2 Critical Care Residency at Mayo Clinic (2019)

Professional Membership: Neurocritical Care Society (NCS), Society of Critical Care Medicine (SCCM), American College of Clinical Pharmacy (ACCP)

Personal interests: hockey, running, traveling, hiking, reading almost anything

Adrian Wong, PharmD, MPH, BCPS, BCCCP

Assistant Professor of Pharmacy Practice
MCPHS University
Boston, MA
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Training

• Pharmacy School: Northeastern University, Boston, MA
• Master of Public Health: Harvard T.H. Chan School of Public Health, Boston, MA
• PGY1 Pharmacy Residency: The Johns Hopkins Hospital, Baltimore, MD
• PGY2 Critical Care Residency: UPMC Presbyterian/University of Pittsburgh, Pittsburgh, PA
• Outcomes Research and Pharmacy Informatics Fellowship: Brigham and Women's Hospital/MCPHS University, Boston, MA

Primary Area of Practice: Medical Intensive Care, Academia

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

I tailor my preceptor role depending on the needs of the learner. For example, with the example of a research project, I would meet with the learner first to determine their experience and expectations and adjust my role to this. Some learners may need instructing or modeling if they have not completed the certain type of research project before. For those who have more experience, serving as a coach or mentor would be more helpful to develop their own knowledge, while also providing guidance as necessary.

Approach to setting expectations and delivering feedback to learners:

In my first meeting with a learner, I identify what they want to get out of a rotation and adapt the rotation to what they need to succeed. We also discuss the importance of self-reflection to begin the thought process of what feedback they anticipate but also to develop this critical life-long skill in medicine. Typically, I offer my learners at least daily feedback in a more informal setting but have scheduled #FeedbackFriday to reduce the potential anxiety from a learner asking for feedback. I also work with them on how to communicate feedback, including providing specific examples to support their feedback.

Katelyn Richards, PharmD, BCPS

PGY2 Solid Organ Transplant Residency Program Director
Clinical Pharmacy Specialist, Solid Organ Transplant
Beth Israel Deaconess Medical Center
Boston, MA
Email Katelyn

Training

• Pharmacy School: Northeastern University, Boston, MA
• PGY1 Pharmacy Residency: University of Chicago Medical Center, Chicago, IL
• PGY2 Solid Organ Transplant Residency: University of Wisconsin, Madison, WI

Primary Area of Practice: Solid Organ Transplant

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

I incorporate all roles into my precepting style. Transplant is a highly specialized area that is often times not fully presented in pharmacy school. As a result, I focus primarily on instructing, modeling and coaching for PGY1s with some facilitating depending on the level of independence demonstrated by the resident.

Approach to providing feedback to your learners:

Feedback during the rotation is both informal and formal. I am in constant contact with residents on a transplant rotation. If we are having a conversation about patient care, I am giving you informal feedback. I also try to do a "Feedback Friday" along with a standard midpoint and final evaluation.

Kaitlyn Zheng, PharmD

Clinical Pharmacy Specialist, Solid Organ Transplant
Beth Israel Deaconess Medical Center
Boston, MA
Email Kaitlyn

Training

• Pharmacy School: Northeastern University, Boston, MA
• PGY1 Pharmacy Residency: Hahnemann University Hospital, Philadelphia, PA
• PGY2 Transplant Residency: University of Cincinnati Medical Center, Cincinnati, OH

Primary Area of Practice: Solid Organ Transplant

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

During the first few days of the transplant rotation, you will spend time meeting many of the friendly personalities across our transplant team. During this time, we spend time learning the transplant surgery and consult service structures and day-to-day work flow/responsibilities. With regards to clinical care during the initial days, we spend time structuring effective ways to work up transplant patients and identify opportunities to make valuable recommendations to optimize care. We pre-round on patient lists daily and practice presenting patients, so the learner feels comfortable and confident delivering recommendations to the clinical team on rounds.

Approach to increasing independence of the learner on rotation:

During the beginning of the rotation, I gather a baseline assessment of the learner's prior experiences and interests in transplant pharmacy. At the beginning of the rotation, I will observe the learner's confidence when interacting with providers. I also assess the learner's ability to formulate rational recommendations, and provide supporting literature and guidelines. As the resident becomes more comfortable with the team and familiarizes themselves with transplant literature and guidelines, I will encourage the learner to communicate recommendations to the team independently. We spend time practicing different methods for teaching transplant medication information to patients of varying health literacy, so the resident feels prepared when encountering tough discharge medication teaching scenarios. Depending on the resident's interest in transplant, we might further explore opportunities to work on QI/QA projects.

Ryan Chapin, PharmD, BCIDP

Clinical Pharmacy Specialist, Antimicrobial Stewardship/Infectious Diseases
Beth Israel Deaconess Medical Center
Boston, MA
Email Ryan

Training

• Pharmacy School: University of Connecticut, Mansfield, CT
• PGY1 Pharmacy Residency: Concord Hospital, Concord, NH
• PGY2 Infectious Diseases Residency: Beth Israel Deaconess Medical Center Boston, MA

Primary Area of Practice: Antimicrobial Stewardship, Infectious Diseases Consult Service

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

The first week of the ID rotation you are introduced to the ID Consult team! The focus is on forming and delivering recommendations with a smaller list of patients to start. We will discuss opportunities for making recommendations and getting involved on rounds. The preceptor will be present answering questions on the other consulted patients to set the example. The resident is responsible for delivering recommendations to the team for their 1-2 new patients they workup each day in addition to follow-up patients from prior days. Discussion of patients occurs with the preceptor each morning. The preceptor guides the resident as they work toward independent rounding and at least one in-service to the consult team by the end of the rotation.

How often do you meet with the learner while they are on rotation:

On the Infectious Diseases rotation, the pharmacy resident and I meet multiple times throughout the day and round daily at 1:30 pm with either the medical/surgical or immunocompromised consult service (working toward rounding independently from the preceptor). The resident will work up ID consult patients prior to discussion at 10:30am. Those with a flair for ID and antimicrobial stewardship will also review a restricted antimicrobial and participate in 'handshake' stewardship rounds (figuratively, don't worry, no physical handshakes necessary). The resident will also attend a wide variety of educational conferences throughout the week with their preceptor including but not limited to: ID case conference, ID journal club, Harvard-wide disease and research conference, and antimicrobial stewardship fellow conference.

Christopher McCoy, PharmD, BCPS AQ-ID, BCIDP

PGY2 Infectious Diseases Residency Program Director
Clinical Pharmacy Manager, Antimicrobial Stewardship/Infectious Diseases
Beth Israel Deaconess Medical Center
Boston, MA
Email Christopher

Training

• Pharmacy School:
  • Bachelor of Science in Pharmacy: St. John's University, New York, NY
  • Doctor of Pharmacy: Massachusetts College of Pharmacy and Health Sciences, Boston, MA

Primary Area of Practice: Antimicrobial Stewardship, Infectious Diseases Consult Service

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

I instruct using didactic sessions and handouts, model by demonstrating medical record review/excision of critical data, problem list and recommendations. I also take trainees to floors to provide active feedback on interacting with providers, encourage residents to take the driver's seat and present data to providers and afterwards we debrief on what went well, what can be improved. When facilitating a resident learning experience, I forward drug information questions from providers and supply the name of the resident as the primary contact for addressing guidelines or patient specific questions.

Approach to providing feedback to learners:

Feedback is critical to the stewardship role as providers require direction and appropriate reflection for the rationale for antibiotic changes, I provide real time feedback right after the interaction. I ask residents to self-reflect on each day's interventions and provider interactions.

Nick Mercuro, PharmD, BCIDP

Infectious Diseases Specialist
Email Nick

Education: Doctor of Pharmacy, University of Rhode Island (2015); PGY1 Pharmacy Practice, Henry Ford Hospital (2016); PGY2 Infectious Diseases Pharmacotherapy, Maine Medical Center (2017); Infectious Diseases & Antimicrobial Stewardship Outcomes Fellowship, Wayne State University (2019)

Professional Memberships: Society of Infectious Diseases Pharmacists (SIDP); Making a Difference in Infectious Diseases (MAD-ID); Infectious Diseases Society of America (IDSA); American College of Clinical Pharmacy (ACCP)

Rotations offered: Infectious Diseases Consult (general & immunocompromised services), Antimicrobial Stewardship

Personal Interests: Music, cooking, short hikes, snowboarding, New England sports, enjoying time with friends & family

Nick Edmonds, PharmD

Clinical Pharmacy Manager, Medicine/Surgery Team
Beth Israel Deaconess Medical Center
Boston, MA
Email Nick

Training

• Pharmacy School: Ohio Northern University Raabe College of Pharmacy, Ada, OH
• PGY1 Pharmacy Residency: Mercy Health – St. Rita's Medical Center, Lima, OH
• PGY2 Ambulatory Care Residency: Mercy Health – St. Rita's Medical Center, Lima, OH

Primary Area of Practice: Adult Internal Medicine

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

Preceptor roles will be tailored to the specific resident's experiences and strengths, time of the learning year, and the activity being taught. In general, I like to start with the "modeling" role, gauge the resident's performance, and assess the need for differing preceptor roles based on their performance. I believe strongly that modeling is necessary so that they resident can understand what the preceptor's expectations are and, to some extent, how they will be evaluated on that task. I spend a lot of time talking through what I am doing, what my thought process and critical thinking process is, and encourage questions from the resident. Based on performance and comfort/confidence of the resident I look to move into the coaching and facilitating role to allow the resident to practice independently with me as a backup available for questions, complex cases.

Approach to providing feedback to your learners:

Feedback is an ongoing and continuous process and I employ several strategies to ensure that I am doing my job in helping the resident to keep growing and improving. I do my best to deliver feedback at the time I notice either an opportunity to reinforce positive actions or when I observe a potential for improvement (provided the environment is suitable for delivering feedback). At a minimum I provide daily feedback, asking the resident to reflect on what they felt went well and what they can improve upon. Additionally, I employ a weekly feedback session at the end of the week. I make sure to document in depth verbal feedback and weekly feedback sessions so the resident may refer to a written version of the feedback later. When it comes to formal midpoint and final evaluations, I ensure that these are scheduled and on our calendars on day one of the rotation so we both know when and where it will take place.

Kanizeh Hernandez, PharmD, BCPS

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
Email Kanizeh

Training

• Bachelors of Science, Biochemistry: Moravian College, Bethlehem, PA
• Pharmacy School: University of California, San Francisco, CA
• PGY1 Pharmacy Residency: Massachusetts General Hospital, Boston, MA

Primary Area of Practice: Adult Internal Medicine

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

The initial part of the rotation is focused on direct instruction with the goal of setting a baseline upon which the residents can continue to build on. This includes providing the necessary resources (e.g. primary literature, guidelines, review articles, etc.) early on to assist the residents to work both efficiently and effectively. Concurrent with direct instruction, I teach by ‘modeling' and reviewing my thought process at each step. I provide residents with evidence based rationales for clinical decisions and encourage them to utilize this method in their rotations. Residents are also prepared to anticipate clinical questions when responding to providers so they are able to provide thorough and well-rounded recommendations. At the midpoint of the rotation, residents are coached to function independently and put into practice the knowledge they have gained so far. This takes place in an observed and guided setting allowing the resident to build confidence and rely on the preceptor in case of challenging issues or questions. Towards the end of the rotation, depending on the resident's level of experience and confidence, I facilitate the transition to where the resident is responsible for all patients and serves as the sole pharmacist for the team.

Approach to increasing independence of the learner on rotation:

I find it beneficial to provide real time feedback to the residents so that they have the opportunity to resolve issues as they occur. In addition to real time feedback, I also set up brief end of the day summaries and more in-depth weekly discussions to highlight positive learning experiences and opportunities for growth/improvement. From the start, I create an approachable environment so residents are comfortable reaching out in-person or via email/phone with questions or concerns. I encourage residents to provide feedback (both positive and constructive) on how the rotation, learning experiences and/or teaching styles can be modified to meet their expectations. I incorporate resident self-evaluations to create, add to or alter certain experiences so that the rotation is more individualized to each resident's learning style and knowledge base. Residents' well-being is vital to their success and we work closely together to find a healthy work/life balance.

Kristen Knoph, PharmD, BCPS

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
Email Kristen

Training

• Pharmacy School: University of Rhode Island, Kingston, RI
• PGY1 Pharmacy Residency: UPMC Presbyterian/University of Pittsburgh, Pittsburgh, PA
• PGY2 Pharmacotherapy Residency: Mayo Clinic Hospital, Rochester, MN

Primary Area of Practice: Adult Internal Medicine

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

The Internal Medicine rotation is a great opportunity for the resident to integrate themselves into the medical team and become independent. I incorporate the four precepting roles by starting out with modeling the pharmacist role on Internal Medicine team rounds. Depending on the resident's progress, my goal is to quickly transition to a coaching role in which the resident is the primary pharmacist on rounds but I am available to provide guidance and feedback. By the end of the rotation, I move into a facilitating role and the resident is independently responsible for covering the full service. I incorporate the instructing role by including core and elective topic discussions as well as drug information questions from patient cases.

Approach to setting expectations and delivering feedback to learners:

Before every new rotation, I meet with the resident to discuss their previous experience and specific goals for the rotation. Throughout the rotation, I provide continuous in-person feedback and guidance. At least once weekly, I also meet with the resident for more formal feedback to review the resident's self-evaluation about their performance and progress. During these meetings, I share my feedback on the resident's strengths as well as areas for improvement and together we can develop a plan for areas to focus on for the remainder of the rotation to meet their individualized goals.

Marissa McCann, PharmD

Clinical Pharmacist II: Med/Surg
Email Marissa

Education: Doctor of Pharmacy, University of Pittsburgh School of Pharmacy (2005); PGY1 Pharmacy Practice Residency, Beth Israel Deaconess Medical Center (2006) Professional Membership: Massachusetts Society of Health System Pharmacists (MSHP)

Rotation/s Offered: Internal Medicine - Hospitalist Service

Personal Interests: Traveling, live music, craft beer, exercise, volunteering

May Adra, PharmD, BCPS

Assistant Pharmacy Director, Safety, Quality & Regulatory Affairs
Email May

Education: B.S. in Pharmacy (1992), PharmD (2000), MCPHS

Board Certification: BCPS

Post-Graduate Work Experience: Medication Safety Coordinator, Tufts Medical Center, Boston, MA (2005-09), BIDMC (2009-present)

Current Professional Memberships: ASHP, MSHP

Rotations Offered: Medication Safety

Nilam K. Patel, PharmD, BCPPS

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
Email Nilam

Training

• Pharmacy School: Massachusetts College of Pharmacy and Health Sciences, Boston, MA
• PGY1 Pharmacy Residency: Elliot Health System, Manchester, NH
• PGY2 Pediatric Pharmacy Residency: Elliot Health System, Manchester, NH

Primary Area of Practice: Neonatal Intensive Care

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

• As a preceptor, my goal is to have the resident increase their knowledge base and become independent as the rotation progresses. In the beginning, I sit down with residents and go over the syllabus, expectations, and potential projects. I will also go over workflows specific to the NICU practice site. As part of the multi-disciplinary team, pharmacist participates in patient-care rounds on the NICU. In the beginning, I will pre-round with residents and attend rounds with residents. As the resident feels more comfortable, I will slowly start backing away.
• Topic discussions are a major part of the NICU rotation. There are core topics that we will discuss but if residents find any specific topics that are interesting, I will try to include them into the syllabus.

Approach to providing feedback to your learners:

I meet with residents to provide feedback weekly and ask the resident to do a self-reflection for the week. We will discuss what things went well during that particular week, things that can be improved upon, and progress with any projects that are being worked on. At this time, we will also set specific goals for the upcoming week.

Stefanie Clark, PharmD, BCOP

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
Email Stefanie

Training

• Pharmacy School: University of Oklahoma College of Pharmacy, Oklahoma City, OK
• PGY1 Pharmacy Residency: Baystate Medical Center, Springfield, MA
• PGY2 Oncology Residency: University of New Mexico Hospitals, Albuquerque, NM

Primary Area of Practice: Inpatient Hematology/Bone Marrow Transplant, Inpatient Medical Oncology

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

• Instructing: I provide cancer-specific guidelines/readings and assign topic discussions involving disease states and therapies so the resident can build and enhance their knowledge.
• Modeling: The resident attends rounds with me and learns the role of the pharmacist on the hematology/BMT and medical oncology teams. I review the information I am looking for in patient workups/presentations and rounds with the resident.
• Coaching: The resident starts to pick up more patients to work up and round on throughout the rotation, and I coach the resident on how to develop their skills, become more confident, and assess when they are ready to round on their own.
• Facilitating: The resident rounds on their own once confident to do so. I am available as needed and we review discussions from rounds afterwards.

Approach to increasing independence of the learner on rotation:

I increase the residents' independence and workload throughout the rotation as the resident is able to demonstrate that they can manage their responsibilities effectively, retain/recall knowledge and new information, and clinically and confidently apply this knowledge and information without becoming overwhelmed.

Caroline M. Mejías-De Jesús, PharmD, BCOP

Clinical Pharmacist
Beth Israel Deaconess Medical Center
Boston, MA
Email Caroline

Training

• Pharmacy School: University of Puerto Rico – Medical Sciences Campus, San Juan, PR
• PGY1 Pharmacy Residency: Massachusetts General Hospital, Boston, MA
• PGY2 Oncology Residency: Duke University Hospital, Durham, NC

Primary Area of Practice: Ambulatory Hematologic Malignancies/Bone Marrow Transplant

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

In my ambulatory hematology/oncology rotation, instructing and modeling are the first preceptor roles utilized for this experience. This allows the resident to acquire the knowledge and skills necessary for the medication management of hematology/oncology disease states. During the coaching role, I focus on strategies for patient education and how to navigate complex clinical cases. Finally, once the resident is ready to work independently, I am available for questions or for direction on more complex situations.

Approach to defining roles/expectations with your learners:

Before starting my rotation, I set up a meeting with the resident to determine areas of interest for topic discussions and projects. During this meeting we explore what skills the resident would like to work on (ex. patient education). On the first day of rotation, I share rotation expectations, provide an overview of the clinic and the medication access workflow, and describe how to communicate with healthcare providers and pharmacy staff. The rotation calendar is also discussed on the first day of the rotation. I meet with the resident every week to discuss their progress and determine which activities they can start to work on independently.

Katelyn Richards, PharmD, BCPS

PGY2 Solid Organ Transplant Residency Program Director
Clinical Pharmacy Specialist, Solid Organ Transplant
Beth Israel Deaconess Medical Center
Boston, MA
Email Katelyn

Training

• Pharmacy School: Northeastern University, Boston, MA
• PGY1 Pharmacy Residency: University of Chicago Medical Center, Chicago, IL
• PGY2 Solid Organ Transplant Residency: University of Wisconsin, Madison, WI

Primary Area of Practice: Solid Organ Transplant

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

I incorporate all roles into my precepting style. Transplant is a highly specialized area that is often times not fully presented in pharmacy school. As a result, I focus primarily on instructing, modeling and coaching for PGY1s with some facilitating depending on the level of independence demonstrated by the resident.

Approach to providing feedback to your learners:

Feedback during the rotation is both informal and formal. I am in constant contact with residents on a transplant rotation. If we are having a conversation about patient care, I am giving you informal feedback. I also try to do a "Feedback Friday" along with a standard midpoint and final evaluation.

Kaitlyn Zheng, PharmD

Clinical Pharmacy Specialist, Solid Organ Transplant
Beth Israel Deaconess Medical Center
Boston, MA
Email Kaitlyn

Training

• Pharmacy School: Northeastern University, Boston, MA
• PGY1 Pharmacy Residency: Hahnemann University Hospital, Philadelphia, PA
• PGY2 Transplant Residency: University of Cincinnati Medical Center, Cincinnati, OH

Primary Area of Practice: Solid Organ Transplant

Approach to utilizing ASHP Preceptor Roles (instructing, modeling, coaching, facilitating):

During the first few days of the transplant rotation, you will spend time meeting many of the friendly personalities across our transplant team. During this time, we spend time learning the transplant surgery and consult service structures and day-to-day work flow/responsibilities. With regards to clinical care during the initial days, we spend time structuring effective ways to work up transplant patients and identify opportunities to make valuable recommendations to optimize care. We pre-round on patient lists daily and practice presenting patients, so the learner feels comfortable and confident delivering recommendations to the clinical team on rounds.

Approach to increasing independence of the learner on rotation:

During the beginning of the rotation, I gather a baseline assessment of the learner's prior experiences and interests in transplant pharmacy. At the beginning of the rotation, I will observe the learner's confidence when interacting with providers. I also assess the learner's ability to formulate rational recommendations, and provide supporting literature and guidelines. As the resident becomes more comfortable with the team and familiarizes themselves with transplant literature and guidelines, I will encourage the learner to communicate recommendations to the team independently. We spend time practicing different methods for teaching transplant medication information to patients of varying health literacy, so the resident feels prepared when encountering tough discharge medication teaching scenarios. Depending on the resident's interest in transplant, we might further explore opportunities to work on QI/QA projects.