CEimpact Podcast

Building Clinical Reasoning Skills in Student Pharmacists and Residents

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In this episode, Kathy Schott sits down with Dr. Kate Smith, clinical faculty and pharmacy education expert, to explore one of the most critical and challenging aspects of training student pharmacists and residents: developing clinical reasoning skills. Drawing from over a decade of experience in both clinical practice and education, Dr. Smith discusses nuanced differences between clinical reasoning, critical thinking, and problem-solving and offers preceptors practical, classroom-tested strategies to support learners. From using patient cases and SOAP notes to applying the "One Minute Preceptor" model, this episode is a must-listen for any pharmacy educator or preceptor aiming to foster confident, capable, and patient-centered practitioners.

Host
Kathy Schott, PhD
Vice President, Education & Operations
CEimpact

Guest
Kathryn (Kate) Smith, PharmD, BCACP
Associate Professor of Instruction
University of Iowa 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. Differentiate clinical reasoning from critical thinking and problem-solving
2. Identify practical strategies to teach and assess clinical reasoning skills in student pharmacists and residents in experiential settings.

0.05 CEU/0.5 Hr
UAN: 0107-0000-25-215-H99-P
Initial release date: 6/18/2025
Expiration date: 6/18/2028
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.

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Speaker 1:

Welcome to the Preceptor Practice Podcast. I'm your host, Kathy Schott, and today we're diving into a powerful and often misunderstood concept in pharmacy education clinical reasoning. What exactly is it? How is it different from critical thinking or problem solving and, most importantly, how can preceptors help students and residents develop this essential skill? Joining me today is Dr Kate Smith, a faculty member at the University of Iowa College of Pharmacy, who brings over a decade of experience in teaching and mentoring future pharmacists. Kate is passionate about helping learners transition from knowing facts to making sound clinical decisions in real-world settings. So, whether you're a seasoned preceptor or new to experiential education, today's conversation is full of practical takeaways that you can start using immediately.

Speaker 1:

Let's get started. Well, welcome Kate. Thanks so much for being here with me today. I had the pleasure of hearing you speak at our Standard of Care Institute here in Iowa a few weeks back Institute here in Iowa a few weeks back and then I found a paper that you had published on clinical reasoning, and it aligned perfectly with the topic that I'm hoping we can chat about today, which is developing clinical reasoning skills in our student pharmacists and residents. So I'd love to start by having you just do a quick introduction of yourself. I know you were newer to Iowa recently and so share a little bit about you and what you're passionate about in this topic.

Speaker 2:

Yeah, thank you for having me. So I'm Kate Smith and I have been a faculty member at several different institutions for colleges of pharmacy. I graduated from the University of Minnesota with my PharmD and since then I've just really been curious about how pharmacy students learn to be pharmacists. I know it doesn't just happen overnight, right. There's a whole process behind it. So how can we make it more efficient? How can we make it richer, right? How can we make sure, when we graduate pharmacy students and send them out into practice, that they know what we need them to know and they're ready to solve the problems that they're going to face? So throughout my 11 years as pharmacy faculty, I've been kind of exploring those problems in different areas. So I've taught everything from the skills like the practical lab part of class taught a lot of diabetes content, some leadership content. So I've been at the University of Iowa about a year and a half now.

Speaker 1:

Okay, time flies and already we've had you speak at one of our state conferences yeah, perfect. Well, today the goal is really to provide preceptors specifically with practical strategies to foster clinical reasoning in students and in residents. So let's dig in to our conversation here. How would you define clinical reasoning, and how does it differ from problem solving or critical thinking?

Speaker 2:

Yeah, so this is such an important question and it's also very challenging to answer. So in 2020, some medical education researchers looked at how clinical reasoning was defined across the health professions literature and they found over 100 different definitions for clinical reasoning. So they kind of fell into similar buckets, right, but it's obvious that it's a hard thing to define, right? I actually want to start by talking about critical thinking. I think that's really the foundation for all problem solving that happens, right? Can you look at what's happening and make connections and figure out a solution? That's kind of their general skill, and most of us have that general skill, right.

Speaker 2:

But to be able to raise in clinically, you have to gain a specific set of knowledge related to the area in which you're going to's problem solving right, general problem solving. But someone who's trained as a pharmacist has the expertise and the knowledge to fully understand what that medication is expected to do, how to evaluate the specifics of the headache that the patient has, right, what are the risks and benefits? So, taking those things into consideration, that's the clinical reasoning process, where it's much more detailed and specific.

Speaker 1:

Got it. That makes sense. So what I what my jotted down here in my notes is that clinical reasoning equals critical thinking plus some important foundational knowledge. Yeah, and that's what differentiates you from me. When my family comes to me and asks me medication questions and they think I'm going to know it because I work with pharmacists, but I'm not one. So I've got the critical thinking skills and I can do the research and you know and all that kind of stuff, but not not the you know, not the foundational knowledge that would allow me to go to that next step of clinical reasoning. Is that a good metaphor?

Speaker 2:

Yeah, and I think even as we move away from our education right. Different knowledge goes away if we aren't using it right. So I'm taking care of many diabetes patients. I can reason with those, but as soon as you put me in an inpatient setting with someone who's had sepsis, I am pretty clueless, right. So even your knowledge helps decide, or helps you know, what you feel safe reasoning about, right.

Speaker 1:

Right, yeah, yeah, I can also really appreciate the idea that there's all these definitions around clinical reasoning and or clinical reasoning and what kind of challenge that poses In my own research around professionalism same issue. Yes, you know a huge continuum of definitions of professionalism and then we ask students to be professional and they're like, yeah, what does that mean to you?

Speaker 1:

Right so yeah, yeah, no, that makes sense. Well, so we're starting to lay foundation, I think, for this next question that I have for you. But what are some of the common challenges that you think preceptors face when they're trying to either teach or assess clinical reasoning? You know in their learners, whether they're working with pharmacists or students or residents.

Speaker 2:

Yeah, so I think it's really that expert novice gap that makes it so challenging to teach clinical reasoning we were just talking about. As an expert in diabetes, I have the knowledge. I've seen patients with diabetes over and over again. I can predict what the outcomes are going to be. Right, I'm an expert. It's pretty intuitive if I walk into clinic. Okay, this is how we're going to do things today. This is what I expect to happen. Here's the meds that are right. So I have this. It's almost second nature, right, it happens fairly quickly. I've done it so many times. So, as an expert. But our novice learners right, their knowledge is a little more shallow, right, and the number of times they've seen these types of problems is a lot less. It's going to take them a lot of time to find the knowledge that they need. Fill those knowledge gaps potentially right.

Speaker 2:

I forget what kind of medicine that is. I forget how that works, right? Or oh, I should look up those guidelines, right? It's going to take them time. And then they have all this information. How do they pick what information is important, right? So the novice it takes. It takes that extra time, I think, as an expert, it's so easy for us, as preceptors, to forget what it was like to be a novice right and and how maybe painfully slow it is to kind of reason through these problems.

Speaker 2:

I think that gap makes it challenging to teach our students clinical reasoning. It's easy to say, well, you just, I just know that, right, well, our students don't just know it. So how can we catch?

Speaker 1:

them up, right, right, right, because you're really teaching them. You're you're teaching them clinical expertise. At the same time, you're trying to teach them this additional layer of reasoning and judgment, and all of that. So it's kind of two separate skills really.

Speaker 2:

Yeah, I think the thing. Another thing that came up when I was thinking about this question was how so much of it happens in our head. So we, we know what we want, but it's really hard to explain to someone out loud what we want, right? Like not only are there so many definitions when we say clinical reasoning, but like well, I just, I just do it, it's just second nature, right?

Speaker 2:

It's happening in your head and you, as the preceptor, may not know what's happening in the learner's heads, so you just know their output. Whatever they decided on was well, that is wrong, right? So clearly something went wrong internally in their clinical reasoning process. But what exactly can be challenging to get at?

Speaker 1:

Right, right, and you may make incorrect assumptions. Right, about what that gap is about. Right, yeah, can you give any examples, kate, of some you know techniques, some teaching techniques that have worked well for you to foster some of this clinical reasoning, taking into account, you know, this sort of expert novice gap that we're talking about?

Speaker 2:

So I think the first thing that comes to mind I do.

Speaker 2:

I do more teaching in the classroom these days than I do in the clinical setting so I wanted to share one classroom example, and that's using patient cases, and there's good ways to do that and bad ways to do that. But I think one of the ways that I've really seen be successful to help build clinical reasoning is to give the students a patient case and then I give them four reasonable answers. Right, Something that would possibly make sense, but I'm not sure. Right, the student isn't sure whether it's the exact right answer. So, and as we know, in practice there are many times when there's more than one right answer. So I, when I give the students the cases and these potentially correct answers, I ask them to pick and then defend their answer, Like why did?

Speaker 2:

you pick A over B. B looks pretty good to me, right Like, or what are the differences there? And why did you feel A over B? B looks pretty good to me, right Like, or what are the differences there? And why did you feel that this answer was more appropriate or better to go with first than one of these other answers? I think when we expect our students kind of have this open-ended like, you could do anything that can be overwhelming to learners. So giving them specific answers to look at and then defend can help them put together. Okay, this is the rationale behind my choice, or the evidence that I'm using to pick A over B right.

Speaker 2:

And I think that practicing that in the classroom really sets them up well for rotations where there is no multiple choice right, right, right.

Speaker 1:

Yeah, I mean I can also see that sort of activity working in the experiential site, though, especially early on, right Early on with a new practice. You know practice area or specialty or focus or whatever, yeah, where they maybe aren't coming to the table with as much clinical knowledge on this specific thing, whatever it is. But you know, but giving them, and so then are you kind of, you're kind of helping them back into the the, you know the thinking that that they use to get to A, b or C or D right, right Okay.

Speaker 1:

Yeah, yep, no, makes sense.

Speaker 2:

Helping them. I think explain why is really important. Right, so they're taking exams often that they don't have to explain. Right, it's a multiple choice exam. You just pick one and you're either right or wrong. Well, explain why, Tell me why. So it does take some investment and some time to not only develop these cases and answers, but also to listen to the students' answers.

Speaker 1:

Right, right, well, and you know, in the experiential setting, I think it, it it. Obviously it takes time to do this. You know to have these interactions, but you also have the ability to look at the patient in front of you and say, well, we could do this or we could do that. Talk me through.

Speaker 2:

You know these options and you know, talk through it out loud. Yeah. So there's a great tool where they kind of took all what we just talked about and kind of condensed it into something called the one minute preceptor and it's it's really a nice short, quick thing that can be used, you know, between patients on rounds or between patient visits at the clinic setting Right. So I explained that to a little more in the article, but really it's just there's five micro skills. You ask the student first okay, what are you going to do right For this patient? You've had time to look it up, what are you going to do? And then you ask the student why you get that supporting evidence right, that supporting evidence right. Then as the preceptor, you can reinforce what's done right and correct their mistakes, and then you can just teach general rules.

Speaker 2:

So, for example, in diabetes clinic, right, I could say, well, what do you want to do for this patient? Well, I think it's time to start basal insulin, okay, well, tell me why, right. And then they have some rationale. I can say, okay, so I like this part of the plan. I think we have to wait on this part of the plan because of these risks. In general. What I do is. I make sure that any patients whose A1C is over 10, I'm definitely thinking about that basal insulin. So I that's the general rule we're going with here Right? So it can be really nice and short and succinct and get a key pearl for your practice area across to the student.

Speaker 1:

What other examples I mean? Do you find that it's effective to sort of share your own thinking, like processing out loud, especially in some of those earlier learning experiences?

Speaker 2:

Yes, and I again. If we go back to the fact that as clinical pharmacists, you know, as experts we're doing this all the time really quickly. So you don't have to make the teaching of clinical reasoning complex. You can literally just talk aloud what you are doing while you're making the decisions right, and it's going to depend on your context. So I noticed this patient's A1C was over 10. So I'm going to start looking at basal insulin and what is covered by their insurance and what other risks they might have, right? So instead of just sitting at your computer and making decisions right or talking to the patient and then making decisions, just taking that extra few minutes to say aloud to the student your rationale for the decisions that you're making related to the patient and then making decisions just taking that extra few minutes to say aloud to the student your rationale for the decisions that you're making related to the patient, that's something that, even as a preceptor, it helped me reinforce my own knowledge and evidence base for the decisions that I was making.

Speaker 1:

So yeah, yeah, that makes sense. Yeah, so lots and lots of transparency. Yeah, yeah, so lots and lots of transparency. Yeah, yeah, any other? Any other important strategies come to mind that you've used?

Speaker 2:

So I think another strategy that's used both in the classroom and in the experiential setting can be soap notes. So I think there's the danger of students wanting to put every single thing they know about every guideline, about every possible thing that might happen, into a soap note. So I, when I use soap notes, I try to provide the students with an example of what I expect, and then I always explain to the student. Look, this example is only one page long, so you can't go on forever. But when you turn in your soap note, let's make sure that we're discussing it so that you can give me your rationale. The student will then have the or the learner will then have the opportunity to talk aloud what their process was.

Speaker 2:

They couldn't write it all down on the paper right, but they can still have that opportunity to share that with me. I'm not just grading or looking at the outcome right, what drug did they pick? But I'm also thinking about that process that they are using to make the decision of what drug to use for the patient.

Speaker 1:

Right, right, okay, so that's a good transition into talking about assessment, I think. So. What would you say are some of the most common barriers preceptors face in assessing clinical reasoning?

Speaker 2:

Yeah, I think going back again a little bit to the fact that it happens a lot in the student's head or in the learner's head and it's hard to get it out on paper, can make it hard to assess how they are reasoning right, right, how they are making the decisions. And then I think the other one too, is is just not as preceptors Well, I'll know it when I see it. Again like professionalism right. Well, I will know it when I see it.

Speaker 2:

But I have a hard time explaining what I'm really looking for, right, so it it can take some work, I think. I think experiential offices could help lead some of that work of like. When we say clinical reasoning, what do we mean, right? When we say our student, well, so we talk a lot about entrustment. Do I trust this student to care for patients in this setting, right? Yes or no? And part of that is I trust them because they've made good decisions over and over again, right?

Speaker 1:

Right, right, yeah, so what's so? What are the strategies for for doing that assessment of their, of their skills in this, in this way?

Speaker 2:

Yeah. So again, I think soap notes can be a tool, but with some, maybe, addition of a discussion around that right.

Speaker 2:

You could also have the students do a more formal case presentation or something short and sweet like that one minute preceptor where it's. It's just just a quick little. Here's what I decided and why right. And so either one of those can work, depending on your time. I think having the student in a real life setting and watching them right, that's going to be the most realistic. So you know, we might do something like OSCEs at the college right, where it's a standardized patient, it's pretty controlled. But as soon as they get out at the college right where it's a standardized patient, it's pretty controlled. But as soon as they get out on experiential right, that's where we're going to see not only can the student make a good clinical decision, but can they roll with resistance or can they deal with distractions right, like all those things kind of go into being able to reason clinically in the real world.

Speaker 1:

Right, right, right. Well, and that makes me think of sort of another angle. I mean, does clinical reasoning encompass understanding the patient in front of you? Beyond, you know how they're presenting from a clinical standpoint, like what barriers might they have to affording medications? What health beliefs might they have? You have, what are all the other factors? Is that all part of this too? For the learner, definitely.

Speaker 2:

Yeah, definitely I think, because as pharmacists, we've made a commitment to care for patients right, and we keep our patients at the center of everything we do. We can't make decisions that totally ignore our patient's ability to access the medication or understand the medication or the device or things like that. So yeah, so clinical reasoning and that's why it's so complex to assess is because there's so much to take in, right.

Speaker 2:

I think, starting with those more controlled situations, can be helpful to say, oh you totally missed this one thing that I set up in this case for you to, you know, really catch and you missed it. But then once we get out into practice or into experiential right, there's so many different nuances and so I think, talking with the student, having them talk aloud of, like what are the three biggest things that you took into consideration with this patient and maybe it is three clinical things, but maybe it's two clinical things and something else, right, social determinants of health or access issues, things like that. So just more practice is going to help our students and our learners make better decisions over time, right?

Speaker 1:

Right, right, yeah, with all of the patient factors in mind. Yeah, this might be backing up a little bit, but it's. It's in my mind because you know when, when you were here in Iowa, you presented at the standard of care symposia on the patient, pharmacist, patient care process. Where does that fit into all of this from a critical, you know, a clinical reasoning perspective?

Speaker 2:

Yeah, that's a great question. I think the pharmacy education initially, that pharmacist patient care process model was a collaboration between practitioners and payers and educators, right? How do we set up a model for what pharmacists are doing in practice? Right? So there's, you know the five steps. They're collecting information, assessing that information, making plans, implementing those plans and then following up to make sure the plans are safe and effective. So the so pharmacy education uses the pharmacist patient care process kind of as a model for what the pharmacist is doing.

Speaker 2:

I think it's the assessment step and the planning step are really where the clinical reasoning occurs, the what's happening with this patient, what's the problem here, and then what are all these options for medications, potentially that I have to fix it right, whether it's starting a medication, stopping it, changing it to something else. So it's a good framework, I think, for our early learners. I totally understand how, once you're in practice, the thinking process is not always as linear as the PPCP might make it look right. But I think if the students have a good foundation of here are the things I'm going to look through and decisions that I have to make as a pharmacist, then once they get into practice, it's okay if things are a little less structured, right. I think pharmacists are often doing the things that are listed in the PPCP they might not just call it that by the same right. It goes back again to definitions, having clear definitions of what we mean when we say assess the patient for something. I think, also, a more structured process works well for people who haven't done this before, right, those novices, so. And then again, when we're experts, we may not need all that scaffolding that our learners do.

Speaker 2:

The only other thing is, I really do feel like the process is a good stepwise process for beginning learners, but it still doesn't necessarily get at like okay, but how do you make that decision? The final decision, right, how do you make that decision, the final decision, right, because the process is great for collecting every piece of information from the patient, right, or even identifying what the problem might be. But then there's still this like leap that we have to make of like okay, so this is what I'm going to do for the patient and why and I don't think the PPCP teaches that right, right, right, right. So we still have have that kind of leap of faith almost to take.

Speaker 2:

So I think when I've had fourth year students on rotation they say, oh, I haven't ever, I haven't had a lot of practice picking the one therapy that I'm going to do with. The dose and the frequency and the duration right, oh, interesting. And the frequency and the duration right, oh, interesting. Okay, that decision right, that can be a leap to take that right. So the more opportunities we can give them to do that before they get to rotations, I think that'll help them build up their confidence.

Speaker 1:

Right, you just took the words out of my mouth because I was going to say we help make them confident, but they also need the confidence to make that, to make those decisions and move forward confidently with the next step or the plan or, you know, whatever it is setting is that our students really are in.

Speaker 2:

They're almost in a playground of like I can do stuff here and mess stuff up and my, my preceptor is going to keep me safe. Right, I'm not gonna. I'm not gonna totally bomb this rotation without getting some feet, you know. But I think they, we, we need to create that safe environment where it's okay to mess up, and part of that is giving them rich feedback, right Like you picked the right drug, but here's why the dose is not correct, right.

Speaker 2:

Or at this hospital that we're at today, we have this on formulary and not that, so that's why I picked this other drug. There's no other good reason to pick it other than because it's on formulary, right. Or maybe there is a really good reason to pick something different, right, and you have both options. So I think that conversation is part of what I love about being an educator is that it's a lot of back and forth. There's a lot of learning that happens as we're talking through things. So I think that feedback is in a safe learning environment is a really important part of helping our students not only figure out how to be more competent, right, identify gaps in their thinking, but also to be more confident of like hey, I love how you went about thinking about this problem. Here's here's one part where we can fix next time, right, right right.

Speaker 1:

So yeah, yeah, no, that that's good. Anything else you can add to the? You know that create, create.

Speaker 2:

We are shifting how we evaluate students on rotation and other states have as well as the new accreditation standards for pharmacy education have come out, but they're asking us, as preceptors, to decide how much we trust our learners right and there are going to be learners where you're like. Oh, I do not trust this student to make decisions about these patients on my critical care floor right.

Speaker 2:

But if they went to a community pharmacy. I would totally trust them to make decisions there. Right? That goes back to their knowledge base, how you know their clinical thinking in that setting. So I think, as preceptors, when we think about our student like our learners is, do I trust them? It's a different approach to teaching than do they know what they need to know to be okay here. Right, right right.

Speaker 2:

Because you're almost more of a partner in. Can I teach you what you don't know, so that we can be working together right, more than I'm here to punish you for what you don't know, right? Yeah, it's a different mindset as preceptors some preceptors you know what they're doing.

Speaker 1:

Yeah, almost a little more like collegial, in a way like how? Do I bring you along from here to there. Yeah, under this sort of framework of trust, which is perfect timing, because the prior episode is all about EPAs and what those look like. So, yeah, perfect, perfect timing to bring that up, and it does change the feedback conversation too.

Speaker 2:

Yes, yeah, when it's more of a. I care about your growth and development as a pharmacist and I want you to get better at this, which is why I'm giving you hard feedback, right, Right right, right, yeah, exactly, exactly yeah.

Speaker 1:

Anything else on the feedback front, before we kind of move toward wrapping up? You know this obviously plays a pretty huge role in developing these clinical reasoning skills. Any other tips for preceptors on the feedback front? I think?

Speaker 2:

when you have a student start or a learner start a rotation with you, you can say to them hey, I care about your development, which means I'm going to give you a lot of feedback. So let's talk about what to do when you get hard feedback, right? How do you think you can react to that? Or you could even ask the learner like would you rather I send you feedback by email so you have some time to think about it before we talk face-to-face, or would you like me to just come out with it when we're face-to-face? Right? Maybe having, you know, setting up an intentional time with your learner?

Speaker 2:

I imagine most preceptors do this anyways, but let's make sure at the end of week one we take 30 minutes to discuss how the first week went, how it went from my perspective and your perspective. Right, I think it's a lot of. It is like basic human decency.

Speaker 1:

Right, right, yeah, yeah, exactly Good point.

Speaker 2:

A good point, we all would appreciate that right, but I think being intentional about it is important and just making it clear to the student that, as a preceptor, part of your job is to give them feedback, and it might not all be grades and numbers like they're used to, but it's going to be a Lots of great thoughts and ideas.

Speaker 1:

Kate, I really appreciate your perspective on all of this. You know, I think preceptors are doing these things, probably often without even thinking about it, but you mentioned the importance of intentionality. So for preceptors, who you know, want to be a little bit more intentional about focusing on these clinical reasoning skills just versus getting through the day and yes, that was a great recommendation that one was terrible. Let's move on. What's one little thing preceptors can start doing today to be more intentional about fostering these, you know, really important clinical reasoning skills in their, in their learners?

Speaker 2:

Yeah, so I think I would go back to the thing where you don't have to make it complicated. You can do what you normally do, but just talk it aloud.

Speaker 2:

Right and I think, when your learner is sitting next to you, listening to you talk aloud, they're going to pick up so much stuff, right? So if you don't want to add a whole lot to your plate, that's where I would start, yep, and then I imagine that will blossom into better conversation with your learners and you know more again, solidifying your own knowledge and evidence base.

Speaker 1:

Yeah, yeah absolutely, yeah, absolutely, and also just demonstrating your willingness to share and be transparent, I think would be helpful in making students and residents comfortable sharing their thought process when they see you doing it right, Even if it's not something they feel super comfortable you know doing. I mean, students have a range of communication skills right, or communication comfort.

Speaker 2:

So, and I think, as a preceptor, there have been times where I've said I'm not sure what to do here. I need to go talk to my clinic partner or the medical director, or let me read another article about this type of patient that I haven't seen before. Right. So I think, admitting that, like man, or like modeling, what you do when you don't know, I think is a really powerful step too.

Speaker 1:

Right, absolutely. That's why you're a pharmacist, so you can think through these issues and not just check the box out of a playbook. Right? Yeah, definitely, yeah, yeah. Well, kate, this was a pleasure. Thank you so much for joining me. I am especially during spring break, yeah really grateful. So thank you, kathy. We'll talk again soon. Thanks so much for listening in today.

Speaker 1:

There were many practical takeaways as part of today's conversation, but I'll just highlight a few that stuck with me. First, clinical reasoning combines critical thinking with foundational knowledge. It's essential for effective patient-centered care. Bridging the expert-novice gap requires patience and intentional teaching. Tools like the one-minute preceptor and modeling your thought process can help make reasoning visible and teachable, and creating a safe space for feedback encourages growth and helps build confidence in your learners. As always, remember to check out previous episodes of Preceptor Practice and don't forget to visit the full library of Preceptor by Design courses available for you on the CE Impact website. Be sure to ask your Experiential Program Director or Residency Program Director if you are a member so that you can access it all for free. And if you are a member, don't forget to claim your CE. Thanks again for listening and for the work you do to shape future pharmacy leaders. I'll see you next time on Preceptor Practice.