Application Policies and Guidelines

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ASHP Research and Education Foundation Category: Preceptor Award Application Policies and Guidelines Administered by the ASHP Research and Education Foundation Sponsored by Amgen, Inc. Copyright 2017 ASHP Research and Education Foundation All rights reserved

CONTENTS ASHP Research and Education Foundation... 3 Program Overview... 3 Category Overview... 4 Program Timeline... 4 Eligibility... 4 Selection Criteria... 5 Itemized Instructions... 6 Page 2 of 7

I. ASHP Research and Education Foundation Vision As the philanthropic arm of ASHP, our vision is that: Patient outcomes improve because of the leadership and clinical skills of pharmacists, as vital members of the health care team, accountable for safe and effective medication use. Our Mission The mission of the ASHP Foundation is to improve the health and well-being of patients in health systems through appropriate, safe and effective medication use. The priorities of the ASHP Foundation are closely aligned with ASHP, the organization that represents pharmacists who serve as patient care providers in acute and ambulatory settings. The organization s more than 40,000 members include pharmacists, student pharmacists and pharmacy technicians. For over 70 years, ASHP has been on the forefront of efforts to improve medication use and enhance patient safety. The ASHP Foundation pursues its mission and key priorities through provision of awards, research grants, educational programs, and practice tools. The ASHP Foundation has a long track record of administering research grants, education and practitioner recognition programs that use stringent external review processes to select program recipients and participants. Visit our website to learn more about the ASHP Foundation. II. Program Overview The Pharmacy Residency Excellence Awards Program has been offered since 2006. The award criteria focus primarily on innovative methods to train, mentor and motivate residents during their residency program and in the early formative years of their careers. The program is designed to: provide national recognition for residency preceptors and specific residency programs who have demonstrated innovation and excellence in the training of pharmacy residents; encourage others to strive to be innovative and achieve excellence in pharmacy resident training. The awards recipients are recognized at a reception at the ASHP Midyear Clinical Meeting. The reception provides a venue for the recipients to highlight their accomplishments. Program directors and preceptors from the over 1,000 ASHP-accredited residency programs will be invited to the reception. Announcement of award recipients will occur at the reception and be extensively promoted during the Midyear Clinical Meeting. III. Category Overview The Preceptor Award recognizes a pharmacy residency preceptor who has excelled in the training of residents. Recognition of these preceptors should enable them to serve as role models for other residency preceptors. Recipients of this award should embody the following characteristics: history of significant contributions to residency training in the role of preceptor and mentor; Page 3 of 7

demonstrated leadership qualities; respected by peers; innovative resident educator; contributor to research and service at the community and organizational levels; track record for instilling these qualities in their residents and positively influencing residents careers. IV. Timeline for the 2017 Award Cycle Applications available April 1, 2017 Application deadline June 20, 2017 Recipients notified September 2017 Announcement of Recipients December 2017 V. Eligibility Applicants should meet the following eligibility requirements: A licensed practicing pharmacist in the United States; A pharmacy residency preceptor in an ASHP-accredited program for greater than 5 years; exceeds the minimum requirements for preceptors in the ASHP Residency Accreditation Standards. Selection panel members, ASHP staff members, ASHP Foundation staff members, members of the ASHP Research and Education Foundation Board of Directors, members of the ASHP Board of Directors, contractors and lead surveyors retained by ASHP Accreditation Services Division, and the respective residency programs of any of the above, are not eligible to apply for the Pharmacy Residency Excellence Awards. NOMINATION AND SUBMISSION PROCESS Individuals may self-nominate or be recommended by other practitioners for an award and must complete an application process in accordance with the criteria established by an external expert advisory panel composed of pharmacists with extensive experience in residency training and education. Submission for this program is initiated by either: Nomination, a recommendation from your peers through the survey available on the Foundation website and via this link: ONLINE NOMINATION SURVEY or, Self-nomination with submission through the online application system available via this ONLINE APPLICATION An application must be submitted in order for the panel to consider an individual for the award, irrespective of the initial nomination. Page 4 of 7

VI. Post-Award Activities Recipient organizations are expected to participate in subsequent outreach and education efforts aimed at disseminating the accomplishments of the recipient organization. Descriptions of recipient s efforts will be communicated by the ASHP Foundation and may be used for promotional purposes for the awards program. In the winter/spring of 2018, following recognition at the 2017 Midyear Clinical Meeting, award recipients will serve as faculty in a webinar to support skills and leadership development for residency programs. The Preceptor recipient will focus on the development of individual skills including making significant contributions to residency training, developing leadership skills, using innovative education methods, and successfully contributing to research and organizational service. VII. Selection Criteria All applications will be reviewed by a panel appointed by the ASHP Foundation Board of Directors. The panel will review the applicant's materials and score them according to the following application criteria: Sustained Significant Contributions to Residency Training (25 points) Applicants should have contributions that exceed five years and are considered significant (i.e. above and beyond minimum contributions described in the residency standard for ASHP-accredited pharmacy residency programs). Significant contributions to residency training may include: participation as a volunteer in accreditation surveys of other residency programs; enrichment of pharmacy residency training on a regional or national level; and service as an investigator for pharmacy residency research projects. The applicant should also describe unique abilities or skills that contribute to a positive pharmacy residency training experience. Resident graduate information will also be used to evaluate the applicants performance. Teaching Philosophy and Methods (15 points) The applicant should describe his or her teaching philosophy and the methods through which this teaching philosophy is employed. Specific areas that should be addressed include: the applicant s personal expression of professional goals and values; how those goals and values are expressed in the training of pharmacy residents; how the preceptor uses standards to measure his or her teaching methods, activities, effectiveness and achievements in the training of pharmacy residents. Mentorship (25 points) Applicants should: have a track record and be able to describe his or her mentoring skills in such areas as Page 5 of 7

helping residents make decisions and setting and reaching goals, establishing one s own practice philosophy and skills, and having compassion for residents progress and unique situations; have a positive influence on residents careers and serve as a professional role model to residents; describe up to 3 activities that they use to enhance personal and professional development of residents; give at least three specific examples of how they have served as a mentor to a pharmacy resident through a difficult professional decision-making situation. Leadership (20 points) The applicant should: exemplify personal leadership qualities at the practice, departmental, institutional, state, and national levels; provide evidence that they are respected by his or her peers, have had an influence in residency training by demonstrating initiative in new areas and using sound leadership principles to make decisions. Active Participation (15 points) The applicant should: actively participate in research, educational initiatives and service to organizations and the community; foster interest and involvement in these activities among their residents. The biographical sketch submitted will be used to evaluate active participation of the applicant. VIII. Itemized Instructions for Grant Application 1. Applicant Information Along with the contact information requested on the application form, a recent copy of a Curriculum Vitae (CV) should be provided for the applicant. Applicants can upload the on the Additional Documents Required page. 2. Site Information Self-explanatory 3. Narrative Statements Using the space provided, respond to the five statements. The responses should be no longer than 1,500 words each. 4. Residency Graduate Information A. Using the template provided, please list all former residents of the past five years. The following is required: I. Names of the former residents and their degrees. II. Year of graduation from the residency program. III. Current title. IV. Practice Location Page 6 of 7

V. First professional position after the completion of the residency program. VI. Significant publications and presentations. VII. Current involvement in residency training. 5. Communications The ASHP Foundation is interested in continuously improving its communication capabilities. Indicate these communication vehicles through which you became familiar with this program. 6. Additional Documents Required Curriculum Vitae (CV) Upload most recent copy of CV. A letter of support from a former resident, labeled RESIDENT LETTER. A letter of support from a clinical practitioner peer, labeled PEER. A letter of support from the residency program director, labeled PROGRAM DIRECTOR. 6. Affirmation 1. Post Awards Activities - This application must be signed by the Applicant and their Residency Program Director or Director of Pharmacy. If the applicant is the Residency Program Director, the Director of Pharmacy should co-sign the application. By signing this application, you are agreeing to the expectation of the applicant s participation in outreach and education efforts aimed at sharing the excellence in residency training accomplishments. 2. Check box attesting that the information provided in this application is true and complete to the best of your knowledge. APPLICATION SUBMISSION INSTRUCTIONS Once the application is submitted, applicants should receive an e-mail notification. If this e-mail confirmation is not received, applicants should immediately contact the ASHP Foundation at foundation@ashp.org to verify receipt of the application. Application Deadline: 12:00 P.M. EDT, JUNE 20, 2017 Page 7 of 7