CEimpact Podcast

Entrustable Professional Activities: The 101 for Pharmacy Preceptors

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In this episode, we dive into the evolving use of Entrustable Professional Activities (EPAs) as a tool for assessing and supporting learner development in pharmacy experiential education. Dr. Abigail Elmes, Research Assistant Professor at the University of Illinois Chicago College of Pharmacy, shares her insights on implementing EPA-based assessments in Advanced Pharmacy Practice Experiences (APPEs). Whether you're new to EPAs or navigating their integration into your practice site, this episode offers practical strategies to promote student growth, improve feedback conversations, and overcome common barriers in EPA-based assessment.
 
Host
Kathy Schott, PhD
Vice President, Education & Operations
CEimpact

Guest
Abigail Elmes
Research Assistant Professor
University of Illinois Chicago College of Pharmacy

Get CE: CLICK HERE TO CPE CREDIT FOR THE COURSE!

CPE Information
 
Learning Objectives
At the end of this course, preceptors will be able to:
1. Explain the purpose and structure of Entrustable Professional Activities (EPAs) in pharmacy education
2. Identify strategies to provide effective learner feedback using entrustment-supervision scales

0.05 CEU/0.5 Hr
UAN: 0107-0000-25-147-H99-P
Initial release date: 3/26/2025
Expiration date: 3/26/2028
Additional CPE details can be found here.

The speakers have no relevant financial relationships with ineligible companies to disclose.

This program has been:
Approved by the Minnesota Board of Pharmacy as education for Minnesota pharmacy preceptors.

Reviewed by the Texas Consortium on Experiential Programs and has been designated as preceptor education and training for Texas preceptors.

Want more education on this or other topics?
Check out this article authored by our guest, Dr. Abigail Elmes, and colleagues – Preceptor Perspectives Using Entrustable Professional Activity-Based Assessments During Advanced Pharmacy Practice Experiences.


And here are links to a few great resources:

  • ten Cate O. Nuts and bolts of entrustable professional activities. J Grad Med Educ. 2013;5(1):157-158. doi:10.4300/JGME-D-12-00380.1
  • ten Cate O, Jarrett JB. Would I trust or will I trust? The gap between entrustment determinations and entrustment decisions for trainees in pharmacy and other health professions. Pharmacy. 2023;11(3):107. doi:10.3390/pharmacy11030107
  • ten Cate O, Schwartz A, Chen HC. Assessing trainees and making entrustment decisions: on the nature and use of entrustment-supervision scales. Academic Medicine. 2020;Publish Ahead of Print. doi:10.1097/ACM.0000000000003427
  • Persky AM, Fuller KA, Cate O ten. True entrustment decisions regarding entrustable professional activities happen in the workplace, not in the classroom setting. Am J Pharm Educ. 2021;85(5):8536. doi:10.5688/ajpe8536


Check out the full library of Preceptor By DesignTM courses available for preceptors on the CEimpact website. Ask your experiential program director or residency program director if you are a member so that you can access it a

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Speaker 1:

Welcome back to Preceptor Practice, where we dive into the latest ideas shaping pharmacy precepting. I'm your host, kathy Schott. Entrustable professional activities, or EPAs, have been gaining traction as an assessment strategy in pharmacy education for years and are becoming the norm. As we look to the newest ACPE standards revisions effective July 1 of this year. As we look to the newest ACPE standards revisions effective July 1 of this year, in this episode of Preceptor Practice, we dive into the evolving use of EPAs as a tool for assessing and supporting learner development in pharmacy experiential education.

Speaker 1:

Dr Abigail Elms is a research assistant professor at the University of Illinois Chicago College of Pharmacy, where their faculty and preceptors have been using EPAs for several years now. Dr Elms joined me to share her insights on implementing EPA-based assessments into their program's advanced pharmacy practice experiences. Whether you're new to EPAs or navigating their integration into your practice site, this episode offers practical strategies to promote student growth, improve feedback conversations and overcome barriers in EPA-based assessment. Let's listen in and I'm super excited to tap into your expertise and try to help our listeners, primarily preceptors, navigate what's coming at them sooner or later. If they haven't seen EPAs yet, they're certainly going to, so let's just start with a quick introduction from you. If you wouldn't mind, tell me a little bit about yourself and how you got involved with the whole concept of EPAs.

Speaker 2:

Sure, so I'm Abigail Elms. I'm a research assistant professor here at the University of Illinois, chicago College of Pharmacy, and trustable professional activities were kind of being introduced. When I was in pharmacy school I went to the University of Pittsburgh and so I very briefly experienced them as a student, kind of just before I was heading into Appy's. Then I never really heard about them again, ever really heard about them again. I went to Northeastern University for my PGY1 residency and then I came here to UIC for an academic fellowship. I did a fellowship to focus more so on research and scholarship of teaching and learning, and I was able to also complete a Master of Health Professions education during my fellowship, and so that's when I really learned about entrustable professional activities. My fellowship director was working on some research related to EPAs and UIC was implementing them within the experiential curriculum during my fellowship as well. So it was a really good time to come to UIC, learn about EPAs, kind of, as they were being implemented.

Speaker 1:

Yeah yeah, yeah, it's all about timing. Yes, well, let's jump in. Can you just take a minute to briefly explain what entrustable professional activities, or what we commonly refer to EPAs, are, and why are they taking hold in pharmacy education?

Speaker 2:

Yeah, I think EPAs are very aptly named. They just kind of outline specific tasks that any professional is entrusted to do in the real world. So in the context of pharmacists, what are pharmacists entrusted to do by the public, by other health care professionals et ceteraable? And in the context of pharmacists, it's specifically entrusted to pharmacists versus nurses, versus doctors, etc. The EPAs in general are being used in competency-based education models to assess learners them well. They assess a learner's performance of that activity using a balance of entrustment and supervision. So they trust the learner to complete that task with varying levels of supervision across the curriculum. And we document that kind of balance of entrustment and supervision utilizing entrustment supervision scales. So generally the scales are five levels. There are different scales in the literature so it kind of depends on what the institution uses would receive a level on the entrustment supervision scale versus a score or a letter grade that you would typically see in other kind of academic courses or what some preceptors might be used to. So it's important.

Speaker 2:

Pharmacy education you alluded to it being included in accreditation standards. That's more for faculty. But we're also using EPAs to assess how our graduates, or if our graduates can do the actual tasks that they're going to be asked to do when they enter practice. So the EPAs really help bridge between what they're learning in the classroom, what they're learning in experiential settings, with what they're being asked to do in the workplace. So we're making sure this kind of buzzword but we're making sure they're practice ready by assessing them on what they're actually going to be doing in practice.

Speaker 1:

Right, right, really making it more practical, more of a practical assessment really. And the continuum, the supervision continuum is from almost demonstration. I mean doing it with complete supervision all the way up to doing it with, is it no supervision?

Speaker 2:

It depends on the scale, but the lowest I've seen is observe only. They don't even get to do it yet. They can only observe someone doing it Right All the way through direct supervision. I'm, as the preceptor, standing directly next to the student as they're doing it. You can have indirect supervision where the student is counseling someone. If it's a community pharmacy I'm going to verify prescriptions over here and they're counseling someone or picking out an OTC product, something like that Then you can go towards complete independence and then eventually you get towards teaching others how to do it.

Speaker 1:

Oh right, yeah, so it's kind of the full spectrum of what that looks like. Okay, okay, yeah, now that does all kind of. That rings a bell from my days at DRIP, yeah, so, as we were talking about these before I moved on, so that makes sense, yeah, and so and you really touched on this I mean the primary difference from traditional competency-based assessments is, you know, we're not, we're not assigning letter grades. It's it's a much more I don't know relatable way to assess a specific task, and I'm sure we'll get into you know some of the benefits of that, but I can see how assessing on an EPA just sets you up for better feedback, for you know all of the things that are part of the precepting role.

Speaker 2:

Definitely, I think, one. I say this a lot to different people who are kind of confused on like the difference between competency versus an EPA. I think the real difference is that the competency is describing the person doing the work, like the learner, whereas the EPA is describing the work. So it's a little we'll get into subjectivity, but it's a little bit easier to talk about the work being done versus the attributes of the learner.

Speaker 1:

Yeah, yeah makes sense. How have you at UIC, have you integrated EPAs into your? Maybe you've integrated them into IPPEs too, but into your APPE experiences?

Speaker 2:

Yeah, so it was back in I want to say 2021, that we fully integrated them into the APPE assessments. We have integrated them into IPPEs and some direct patient care skills labs as well, and some direct patient care skills labs as well. We did it in phases, so we kind of chose faculty and non-faculty preceptors to kind of pilot it out with, adjust the assessment accordingly, try to get some preceptor education available before we told everybody that's what we're doing and they, I think, were very helpful in kind of championing the project, kind of being the experts for their other preceptors to go to.

Speaker 1:

So I thought that was pretty useful yeah yeah, so talk a little bit about the strategies that you use when assessing students with EPAs and you know, thinking about our listeners as preceptors. You know what are some of the you know strategies that you've found have been helpful in either completing assessments yourself or you know teaching others how to do it.

Speaker 2:

Yeah, I think I use them really to drive the feedback conversation with the learner. That's been, I think, the biggest help. It's kind of like motivational interviewing where you ask a patient, you know if they're trying a level two on the entrustment supervision scale. These are the specific things that I think that if you were to do we could get you up to a level three, or I would entrust you to go do that without me standing directly beside you. So I think that's helpful for students to really have actionable things to work on. I also think it's useful for students to well.

Speaker 2:

It's useful for us as preceptors so that I know you know I'm graduating this student who's ready to enter practice. But I think students get a little bit more meaning out of the assessment if they know that you know this is what I'm actually going to be doing when I graduate Also kind of takes the scariness out of graduating because you already can do it. Your preceptor has entrusted you to be able to do that independently. So I think that is a useful thing to talk about with learners too. Really, giving them the full scope of this isn't just paperwork that I have to do for your pharmacy school. This is real world what you'll have to do. So these are the things that you can work on to be better at your future job.

Speaker 1:

Yeah, right, right, right. And to build confidence right. I mean not just, not just confidence. You know, it might be helpful if we backed up just a couple of steps. Could you give me a couple of examples of an actual EPA and and and, you know? And then let's just talk about what that trust continuum looks like relative to a specific example.

Speaker 2:

Sure, there's many versions. So AACP released some EPAs in 2016, 2017, and then they just released I want to say 2022, the co-EPAs. I'm not as familiar with the co-EPAs, or they call them COPA, mainly because we implemented the EPAs before they were released. So those are the ones that we use. But one is fulfill a medication order.

Speaker 2:

That's very hard to do independently as an unlicensed pharmacist. So they if I'm, if I have a IPI student let's say on their this is their first time in a community pharmacy they're probably going to observe and maybe do some direct supervision, like I. They're going to be able to verify everything with me directly beside them, checking them. Maybe an APPE student would be able to hit a level three where it's indirect, but really never at a level four because they're unlicensed. So that's kind of what that spectrum is and AACP has said you know, level three or indirect supervision is kind of where we want them to be at graduation. So we're really never expecting them to be at a level four until you hit residency and that's the point where you can be independent.

Speaker 1:

Right, yeah, Put it which you're actually licensed and can legally practice, Right, OK, Well, I think that's helpful and it'll give us an example to maybe refer back to as we continue our conversation. Do you have any you know any positive stories from students? You know I? This is a change for them too, right? So I wondered if you had maybe a specific example of how an EPA assessment helped shape a student's development, something that you know is a real and true situation.

Speaker 2:

I don't know if I have super specific example like a super specific EPA, I can say so. My clinical practice site is on a mobile unit that goes out onto the west side of Chicago and does opioid use disorder care. It's a very niche role for a pharmacist about buprenorphine and more about the kind of counseling techniques because that's the role of the pharmacist on this mobile unit. So I think I have seen, through directed feedback with the EPA's specific recommendations, I guess communication skills based on that feedback over time you can definitely tell I'm sure most preceptors can relate from week one to week four or five or six that growth I think EPAs help to facilitate and kind of speed up that growth if that makes sense. So definitely revisiting those EPA, those assessments throughout in a more like formative way, like hey, this is based on today, this is where I would put you at. You don't have to document that, you can just say this is where I would put you at, so that they kind of either get positive or negative feedback based on what you observed that day.

Speaker 1:

But either way, because of the trust and trustment scale, they know what they're shooting for right. So there's clarity about what they need to achieve to get to that next level of indirect supervision or whatever the next level of, you know, indirect supervision or you know whatever the next level is.

Speaker 2:

Definitely yeah.

Speaker 1:

Yeah, so you're saying you can definitely see the impact that it's having when you're communicating with students about their various performance areas.

Speaker 2:

And it really is. I know it's the same EPAs over, kind of over and over again for every module or what have you, but every student is going to perform differently and so it kind of helps to break up the monotony of like, hey, this student really needs to work on EPA five or whatever.

Speaker 1:

And yeah, that way it spices things up a little bit too pharmacy environment versus something completely unique like what you're doing, you know, demonstrating those. That's a whole different ballgame from a. You know, communication skills, standpoint or counseling skills and all that kind of stuff. So, yeah, yeah, so definitely transferable, but yeah, that makes a lot of sense. So talk a little bit about common challenges preceptors face when using EPAs. You know, and you had the benefit, I think, of you know, having some of those focus groups early on that I'm sure were pretty enlightening. But A we're talking about change right from the same old evaluation that you filled out about these students for the last 15 years to a whole new way of evaluating student performance. So obviously that's a challenge. But beyond that, you know what are some of the challenges that you're seeing preceptors experience?

Speaker 2:

Yeah, I think the publication that we just had was those focus groups across the country. So they kind of focused on EPAs within Appies as a whole, not really looking at specific like the specific entrustment scales that the institution uses or the specific even EPAs that the institution uses. So I thought that was pretty helpful. They talked a lot about subjectivity of the of entrustment can be kind of. Epas are meant to make competency-based education more concrete, but entrustability in itself is pretty abstract, right. So that was pretty commonly reported. You can't? I mean, I think everybody can relate that some preceptors are more trusting of their learners or maybe even like very not so much trusting of their learners than others. So there's subjectivity in that too.

Speaker 1:

Mm-hmm.

Speaker 2:

I would say it is is a. Obviously it's a change between the different types of assessments, but the pharmacy students especially love to get five out of five. They love to get a hundred percent. But we just talked about how a level three is perfectly adequate for an APPE level student upon graduation. That's where we want them to be at. So kind of communicating that to preceptors and students is difficult.

Speaker 2:

I would also say some institutions, like my institution, will link some of the entrustment supervision levels to specific letter grades and so if let's say on an APPE they earn a level two, that would equate to a B, but then the preceptor comes back and say they're not a B student, they're an A student. I don't agree with that. So that kind of disconnect can be kind of difficult. Yeah, yeah, yeah, I would say they can be pretty lengthy too. The assessments themselves, the co-EPAs, are. There's 13 statements and so if we're assessing using this scale for 13 assessments at least twice, like midpoint and final evaluation. Multiply that by, you likely have more than one student at a time. It's a lengthy process. So that was a challenge that came up as well.

Speaker 1:

Yeah, yeah, I can imagine. Okay, so that all makes sense. Abigail, can you talk a little bit about are there certain kinds of EPAs that are harder to assess, you know, and maybe harder to assess in certain practice settings? I just remember from our you know previous assessments that I worked with. You know there's the foundational knowledge section and then there's the professionalism section, and then there's the professionalism section and then there's the patient care you know section. So from an EPA perspective, does that kind of translate similarly? Or you know what's been your experience?

Speaker 2:

I would say it's not necessarily specific skills like you're talking about. Specific skills, like you're talking about EPAs in general, can only capture so much.

Speaker 2:

So, things like professionalism would be integrated into whatever activity but it's not necessarily being assessed by one EPA. I think that was a challenge that came up in the focus groups, that not all EPAs apply to every practice site. The EPAs were really developed for entry-level practice but the role of the pharmacist is expanding, it's evolving over time, so we know that not all of these tasks are going to be pertinent to every preceptor's site. So that's especially evident in indirect patient care settings, usually elective type of settings like managed care, academia, industry. So unless there's a not applicable or NA kind of option, that can be difficult for preceptors. For the patient care APIs, for the patient care EPAs. So with the pharmacist patient care process in the new co-EPAs the first eight align with the pharmacist patient care process. So those are especially useful in the patient care settings because we're going through that every day.

Speaker 1:

Yeah, yeah, well, and that kind of, I think, answers. Another question I was going to have is, to your point, the role of pharmacist is evolving and some of these tasks are going to become obsolete, you know, over time. So how does the model build in the opportunity you know that flex, the opportunity, you know for the EPAs to still be applicable as a role changes, evolves, grows, expands, whatever, but with a set of those established around the pharmacist patient care model that sort of covers those bases largely, right, yeah, okay, that makes sense. That's yeah, that model's there for a reason. Yeah, so talk a little bit about.

Speaker 1:

You touched on this sort of the subjectivity in entrustment, supervision, ratings, and you know that's like that's nothing new. We've we've always struggled with, we've always struggled with. You know how do you manage, we've always struggled with. You know how do you manage subjectivity and you know, and you said too I mean this becomes a little bit about us as preceptors. Are we the kind of person that you know hands out trust willingly and easily, or are we a person who keeps things super tight and, you know, is afraid to let go? And certainly that's going to impact our how we assess learners. But talk a little bit about what steps preceptors can take to ensure consistency, you know, as they're beginning to be as they begin to interact with these new EPA assessments. So what are some practical things preceptors can do to you know? Try to address that concern and be consistent in how they work with students.

Speaker 2:

Yeah, I would say a lot of preceptors, team precept.

Speaker 2:

So definitely aligning with the other preceptors at your practice site is number one and then on the kind of, the next step would be to be on the same page as the institution. So a lot of institutions will have everybody will have an experiential education department that will have resources that preceptors can watch to kind of understand what kind of student performance looks like at a level two versus a level three and so on, and we have it kind of in different practice settings as well so that preceptors can watch and kind of understand what those expectations look like Right On an even like zoomed out perspective. Some regions in the country are, if you know, many preceptors take students from different pharmacy institutions in the area. There's at least four pharmacy schools in the Chicago area, so many of them will utilize the same assessment across all of their students. If you can kind of create a, if they can all collaborate and work together on what that looks like, so that can help with consistency and understanding. What are other institutions, preceptors, expecting of their students? To try to minimize that subjectivity.

Speaker 1:

Right, right, yeah, no, that makes sense. And you I'm assuming you did, you know a pretty big education push when you all rolled these out, you know to your preceptors. Yeah, yeah, to get everybody on board. Are there other resources or training that you know you found to be helpful, or did UIC really have to create the wheel on their own?

Speaker 2:

of EPAs. He created EPAs and in the last few decades has published lots of kind of bite-sized papers on what EPAs are, how they're being used, how they shouldn't be used. So I think they're not all 10 pages long. I can think of a few that are just one pagers on what to do. So that has been helpful. That's. Yeah, that's kind of the biggest thing of trying to understand what the actual theory is behind EPAs can kind of be helpful to translating it in this, although it's not always a clear translation.

Speaker 1:

Yeah, yeah yeah, well, it sounds like primarily. You know preceptors need to lean on their institutions, you know to provide that education and guidance.

Speaker 1:

Make sure there's alignment with you, know what the institution is hoping you know to see and you know how they're hoping to have them used. Well, let's talk a little bit more deeply about feedback. I know we've touched on it a little bit, but talk a little bit more, maybe get a little bit more in the weeds on how preceptors can kind of capitalize on the EPA framework to create that. So first day you're orienting them to the practice site and what your role is on the team.

Speaker 2:

The EPAs that they'll be performing at your site are what they're going to be assessed on, what they're likely going to be performing in their first week, and still think the preceptor should do it when the first day that they visit that site and often throughout.

Speaker 2:

So I know we always, we give feedback all the time, every day, for students. They don't necessarily understand that it's feedback being given to them. So I think being super explicit of I'm going to assess you on the EPA now yeah, this is what you would be, what I would entrust you to do, based on your performance today. It's being super specific and explicit in what you're telling them is is helpful. Like I said, revisit throughout the week. Revisit it. You don't have to just do it for the midpoint and the final I know it's a lengthy assessment Do the ones that they want to work on. So really, really just focusing in on what that student wants to do in the future and what they want to work on within this specific experience with you, future and what they want to work on within this specific experience with you.

Speaker 2:

Yeah, I mean, it sounds to me like you could even go as far as put those EPAs into your syllabus or into your you know?

Speaker 1:

yeah, I mean, these are the things that we're going to make sure we assess while you're with me over the next three, four, five weeks, whatever the length of the experience is, and if we get to these other ones, great. But these will be the ones that we're focusing on and this is where we'll be working together to get you to Definitely yeah, yeah, yeah, yeah Super intentional approach to assessment, which is great. So talk a little bit about where you see these assessments going in the future of the profession. You know we talked a little bit about the fact that this, you know everything's changing. I mean, in Iowa, we just adopted standard of care and you know that is a wave that's going to continue across other states, which changes how pharmacists are practicing. So how, where do you see EPAs going in all of that change?

Speaker 2:

Yeah, I think EPAs, even just a few years ago, were this big new thing that was going to change the way pharmacy education works. I don't necessarily think that's true. By their nature, I think I mentioned EPAs can't assess everything. They're not going to assess the specific attributes of a learner, so things like communication skills, professionalism, those aren't going to be captured by an EPA. So I think there'll still be a tool within our kind of toolkit of assessment, but I think there'll be a small part of that, that larger toolkit, as we kind of understand what they can tell us. They can tell us lots of things, but there's also some things that they're not telling us that we should still be assessing, like those other professionalism, communication things.

Speaker 1:

Yeah, yeah, Can you share a little bit about how UIC is managing that?

Speaker 2:

Yeah we have a couple After the entrustment supervision scale with the EPA kind of assessment. We have a couple more questions that were similar to our previous assessment that kind of capture those types of non-cognitive attributes.

Speaker 1:

Yeah, yeah, got you. Yeah, like, yeah, that makes sense. So a little bit of a hybrid, yeah.

Speaker 2:

Yeah, yeah, mm-hmm.

Speaker 1:

Yeah, hybrid, yeah, yeah, yeah. I remember we had a question on one assessment that was simply yes or no, and it was related to legal and ethical practice, and we had debates about whether or not that should be assessed on a scale or if it was just either did it or you didn't, and you know so, yeah, that's a good call out that not everything is covered in this new approach, and that we still have to be mindful.

Speaker 1:

You know that we're looking at the whole professional. Definitely yeah, as we wrap up here, you know what advice would you give to new preceptors who are just starting to use EPAs in their rotation? Any particular you know tips or how just to start the journey?

Speaker 2:

Yeah, I would say talk to the preceptors, either at the institution or who precept for that institution. What are they doing? How are they managing subjectivity? How are they managing pushback from students who don't get a five out of five? Just understanding the perspective of the people who are actually implementing it is very helpful. I think I mentioned this again and again. But your institutional resources, your experiential education department, will have lots of support.

Speaker 2:

If I had to do a plug, I would say you had mentioned we did some preceptor education right before we implemented our EPAs, and I think most pharmacy institutions would. I'd advocate for consistent, repetitive preceptor education. Preceptor turnover is real, pharmacist turnover is real and I'm pretty comfortable with EPAs. But every session I go to I learn something new. So I think it's just useful to continuously introduce it, just like we're continuously introducing it for the students. Preceptors need some support in that way too. So even for the new preceptor, even asking the institution if you're not seeing it right away, like what education did you give the preceptors when you were first rolling this out? Right To kind of get oriented to that?

Speaker 1:

Yeah, that's a good call out because, yeah, because certainly turnover is a real thing and if you're only doing, if you're only having access to education once a year, but you've got students today, you've got to figure it out right.

Speaker 1:

Yeah, and I appreciate you calling out to just the leading on colleagues, and you know others who have had more experience with this concept. So well, Abigail, this was super helpful. You know, I know that many schools have implemented EPAs, but many are still, you know, in the process of, you know, getting there, and so this change is coming for folks, for preceptors and for learners. You know, I think it's an approach that makes a lot of sense and, you know, eventually is going to be second nature for all of us, but certainly that's not the case today. So I appreciate you being willing to share your time and your expertise. If you wouldn't mind sharing a couple of links on those written resources that you mentioned, I'd add those to the show notes for listeners. They could pull those down and have a look at them. Maybe not any of the 10 pagers, but make a couple of short ones.

Speaker 2:

Okay, okay, for sure.

Speaker 1:

All right, all right, well, thank you so much. This was a great conversation. I'm really grateful to be able to draw on your expertise. Awesome, thank you. Thank you for listening. Using EPAs and experiential education really shifts the focus from abstract evaluation to practical, observable skills that align with real-world pharmacy practice. By incorporating entrustment supervision skills into feedback, preceptors can more effectively guide learners toward becoming confident, competent and practice-ready pharmacists. As promised, I've added some of the resources referenced in this episode to the show notes, and remember to check out previous episodes of Preceptor Practice and visit the full library of Preceptor by Design courses available for preceptors on the CE Impact website. Be sure to ask your experiential program director or residency program director if you're a member so that you can access it all for free, and if you're a member, don't forget to claim your CE. Thanks again for listening and I'll see you next time on Preceptor Practice.