Module 2

[Audio] Welcome to the Career Readiness & Externships: Soft Skills for Pharmacy Technician's Critical Thinking & Problem Solving presentation. This module presents information and strategies necessary to learn critical thinking and problem solving skills. Some of the topics addressed include identifying the traits and behaviors of critical thinkers and applying these skills to workplace problems..

[Audio] In this module, you will: Understand critical thinking and its role in problem solving. Identify the traits of a critical thinker. Identify the behaviors of a critical thinker. Learn the steps of effective problem solving. Apply critical thinking and problem solving to workplace problems..

[Audio] The Module 2, Section 2.1: Time Management presentation for the Career Readiness & Externships: Soft Skills for Pharmacy Technicians program covers the basic concepts of critical thinking. This includes the importance of critical thinking in both personal and professional spaces, as well the traits and behaviors associated with effective critical thinkers..

[Audio] Critical thinking is the process of actively applying, analyzing, and evaluating information to form a well-reasoned judgment. Critical thinking evaluates all sides of an issue, action, or problem. Critical thinkers don't just accept an answer to a question but rather are curious about other possible conclusions or arguments. Analyzing all possible answers to a question leads to a clearer understanding of a subject, process, or belief. You have likely encountered the term critical thinking in your experience as a student. Educators use this term to describe thinking, learning, and analysis that go beyond the rote memorization and recall of facts..

[Audio] Critical thinking is a crucial skill to learn for professional success. You will need this analytical reasoning to process information, make decisions, and solve problems in the workplace. Critical thinking requires you to pause and engage in deliberate thinking. Often, we do not think about how we think—it happens unconsciously. Deliberate thinking is done with careful consideration and intention..

[Audio] Today's healthcare environment demands critical thinkers who can use purposeful, logical reasoning to make decisions or find solutions to problems. Using a critical-thinking process ensures the quality and soundness of your decision or solution. Critical-thinking, problem-solving, and decision-making skills are—and will continue to be—among the top workforce skills needed for pharmacy technicians. For that reason, you must know what critical thinking is and why it's important to learn and practice. It can be very easy to fall into patterns while on the job and complete tasks as if on autopilot. While many processes in the pharmacy are designed for redundancy and patient safety, they cannot be relied on by themselves. Critical thinking is one of the most important factors and the final defense to protecting the health and safety of our patients..

[Audio] Understanding the Importance of Critical Thinking in Your Personal Life. Critical thinking is a crucial skill to learn for your personal life. You need analytical reasoning to process information, make decisions, and solve challenges that affect you and your family. Most of the thinking done daily is not deliberate and occurs automatically. For example, your daily routine might include a number of steps (such as making coffee, brushing your teeth, getting dressed, etc.), but you don't usually stop and carefully consider each step and why it is important. However, you might engage in critical thinking in other areas of your life, such as when you are weighing a large decision, such as moving to a new town. In that instance, you'd carefully weigh your options, research job openings in that area, and probably even ask yourself why you might want to move. When you apply critical thinking, you make better decisions that lead to better outcomes. Critical thinking is a skill that increases academic success. If you can think critically about an essay question, for example, and form a well-reasoned response, you are more likely to get a high score. Good critical-thinking skills also illustrate to your instructors that you can apply what you have learned in class to the real world..

[Audio] Take a moment to Consider Your Decision-Making Skills. How would you rate your decision-making skills on a scale of 1 (poor) to 5 (excellent)? What guidelines do you use when making personal decisions?.

[Audio] The pharmacy setting is constantly evolving. It also has a high degree of variability. While the processes and general activities may remain the same, the challenges that arise within them are varied and require different approaches and solutions. Critical thinking is important to employers, the practice of pharmacy, and your career path. Understand the Value to Employers Technicians who can think critically are better at adapting to different situations. These situations can include patient and physician interactions, workflow, and coworker relations. A pharmacy technician who applies critical thinking in the workplace is highly valued and considered much harder to replace than one who does not. For example, when a technician sees a potential problem (such as an upcoming holiday schedule that may confuse patients) and identifies a solution (print out and announcements of the pharmacy's holiday hours)—they are providing a valuable service to their employer. Critical thinkers bring creative solutions to the workplace and think quickly on their feet, which are both skills that pharmacy employers value..

[Audio] Understand the Value to Pharmacy Practice The ability to analyze processes and think about how they fit together in today's pharmacy allows for innovation and improvement. Critical thinkers can suggest new ways of doing things in the field, identify potential pitfalls in execution of initiatives, and help improve patient care. The field of pharmacy practice is constantly changing. New laws are enacted, new brand name drugs come to the market, generics become available for popular drugs, and technology evolves. Pharmacy technicians should always be ready to learn new skills, and they should be able to think critically about those skills. Critical thinkers may ask why certain changes will improve the field. Critical thinkers assess new technology and not only adapt to using it but also think of other areas in which the technology could be applied or even improved. Successful pharmacy technicians can use critical-thinking skills to prioritize problems and make key decisions that improve patient care and even save lives..

[Audio] Understand the Value to Your Career Path. Many specialized roles that exist for technicians require critical-thinking skills to be successful. These roles involve higher authority, more complex activities, and increased compensation. Automation implementation specialists, technicians performing medication therapy management, and supervisors all regularly encounter challenges that use critical thinking to solve them effectively. Critical thinking can also be used to assess the culture and values of an employer to determine how well they align with your own personal values and work ethic..

[Audio] Almost all the interactions and tasks that can be done by a technician employ critical-thinking and problem-solving skills. For that reason, you need to know how to engage in the process of critical thinking. There are many traits and behaviors common to critical thinkers. Even if you do not currently possess these traits or behaviors, you can cultivate them to grow into a critical thinker. Many studies and articles have shown which traits are necessary to develop to be an effective critical thinker. These include being a truth seeker, open minded, focused, curious, and many others. These traits can be improved to increase your critical-thinking abilities. Seek the Truth A technician who constantly verifies the information available based on facts, evidence, and reason is a seeker of truth. Statements are not taken at face value but supported with evidence-based research. Completing continuing education courses and reading pharmacy technology journals are behaviors that should be developed..

[Audio] Have an Open Mind There are always two, if not more, viewpoints and sides to every story or situation. Elements such as prejudices, biases, and stereotypes can factor into these different perspectives, both in good and bad ways. A critical thinker considers all these elements and is willing to reconsider viewpoints as necessary. Exhibit Analytical Reasoning When analyzing a problem or situation, a critical thinker tries to anticipate as many outcomes as possible, as well as arguments both for and against action on the situation or problem. This analysis prioritizes the problem and allows for it to be approached in the best manner. Remain Organized and Focused To analyze effectively and ensure that all aspects of a situation or problem have been explored, being organized and having focus is required. Focus enables a critical thinker to concentrate on a subject through to its completion, while avoiding distractions and being organized allows for this focus to be applied to the necessary areas of a problem..

[Audio] Possess Self-Confidence Having self-confidence is what enables a critical thinker to trust in the analysis and course of action. Another aspect that involves self-confidence is the ability to admit when you are wrong or have made a mistake. Accountability can be considered a mark of self-confidence. Display Curiosity A critical thinker constantly questions the way things operate in the workplace. Why does a process work or not work? Is there a better way to complete a task or innovate a process? If something is working very well, how can it be applied to other areas? Critical thinkers are willing to put forth the effort to implement changes where necessary or reinforce things that are beneficial. Demonstrate Maturity Wisdom comes from both maturity and experience and is another trait of a critical thinker. The ability to think critically under pressure can be challenging, but maturity calms the emotions that impair the ability to find a solution to a problem. This experience does not have to come from the specific industry but from life in general..

[Audio] Take a moment to consider whether you are a critical thinker. Consider the traits of an effective thinker. Which traits do you currently possess? Which will take some effort on your part to cultivate?.

[Audio] Development of the traits for critical thinking is the first step in becoming an effective critical thinker. The next is to focus on the behaviors that promote critical thinking. These behaviors include recognizing problems, communicating and collaborating, analyzing, asking the right questions, and many others. By being aware and focusing on the actions and thought processes listed below, critical thinking becomes a more routine action in your interactions both personally and professionally. Recognize Problems to Solve or Decisions to Be Made Sometimes employees do not even recognize there is a problem, either with themselves or with the process they are performing. This lack of awareness does not exist with critical thinkers, as they are constantly analyzing their work and environment to assess effectiveness. Communicate and Collaborate Effectively Thinking about a problem or process is the first step; articulating it and collaborating is the second. Being able to clearly express what your critical thinking has uncovered and working together with your coworkers and supervisors is essential to being able to address the situation..

[Audio] Analyze the Relevance and Validity of Information When discovering information on a subject or situation, there may be a large amount to sift through. A critical thinker knows how to determine the relevance and authenticity of the various data points. This allows them to use the pertinent information to reach a decision or solve the problem. Ask Vital Questions The curiosity trait discussed previously leads to questioning. Asking the right questions is a behavior of a person who thinks critically. Effective questioning not only identifies problems and solutions, it can also determine if a question needs to be asked in the first place..

[Audio] The questions that a reporter or author asks when writing a story, are the foundation to build their stories. They are commonly known as the "five Ws and H"— who, what, where, when, why, and how. Table 2.1 illustrates some examples of how the five Ws and H can be applied. These are general statements but are adaptable to patient interactions, analysis of a process in an institutional setting, coworker dynamics, etc..

[Audio] Regulate Emotions It can be easy to let emotions have control over actions, especially in high-stress situations or interactions. Reacting to the emotions of others, while natural, is not the strategy of a critical thinker and problem solver. Regulating emotions by being proactive and analytical is a behavior that critical thinkers exhibit. Connect Pieces of Information to Find a Combined Meaning Finding and understanding various pieces of information that surround a subject is not enough for critical thinking to apply. These pieces of information must be compared to each other to identify cause-and-effect relationships and the bigger picture in general. Consider a Solution, Decision, or Conclusion Once a decision is reached based on careful analysis, connections, etc., thought must also be dedicated to that decision or solution. Weighing the pros and cons or outcomes of a potential decision is an important part of critical thinking. Many times, people make a decision without considering the consequences, and the solution does not work out as well as it could have..

[Audio] How Would You Gauge Your Critical-Thinking Skills? Consider each statement and whether it applies to you and your own behaviors. I make a logical plan of action. I discern a fact from an opinion. I examine a problem from different perspectives. I recognize bias, stereotyping, and prejudice in information I read. I evaluate the merits of an argument or line of reasoning. I control my emotions when making an argument or a decision. I concede to others when I am wrong. I identify inconsistencies or errors in reasoning. I approach problems or decisions in a systemic, organized manner. I identify resources to help me solve a problem or make a decision. I collaborate with others to find a solution or make a decision. I ask questions to gain insight into the thinking of others. I remain motivated when trying to solve a problem or make a decision. How you responded to these statements will help you reflect on your own behaviors and determine if you need to continue working on these skills..

[Audio] The Module 2, Section 2.2: Problem Solving presentation for the Career Readiness & Externships: Soft Skills for Pharmacy Technicians program covers the basic concepts of problem solving and the strategies required to become an effective problem solver..

[Audio] While critical thinking tends to focus on long-term planning, problems, and scenarios, the behaviors and traits used are also the tools employed to solve shorter-term individual problems, which are an everyday occurrence for pharmacy technicians. Solving everyday problems is an essential task for any technicians. Problem solving is the systematic process for responding to a situation by crafting a solution. There are different systems that can be used to solve problems effectively, but most employ similar strategies. By learning a system and using it consistently, a solution can be found for most problems encountered with a minimum amount of difficulty. Learning more about a problem is the primary way in which to solve it. The steps that are taken include identification, understanding, application, and analysis. These steps are modeled after those in Bloom's Taxonomy..

[Audio] Figure 2.1 illustrates the levels in Bloom's Taxonomy. Bloom's Taxonomy is a set of principles and hierarchies that classify the process of learning, which you may have already encountered in your pharmacy technician education. The levels in Bloom's Taxonomy are Remember, Understand, Apply, Analyze, Evaluate, and Create..

[Audio] The following steps can be used to solve problems both short and long term by using critical thinking behaviors and traits. First, identify a decision that needs to be made, an issue that needs to be addressed, a problem that needs to be solved, or a course of action that needs to be taken Second, seek information to clarify and better understand the decision, issue, problem, or course of action Third, formulate a potential decision, solution, conclusion, or course of action Fourth, consider the pros and cons of the decision, solution, conclusion, or course of action And Fifth: arrive at the best decision, solution, conclusion, or course of action.

[Audio] The steps involved in problem solving use the behaviors and traits belonging to effective critical thinkers, as shown in Figure 2.2. The figure shown is the first half of Figure 2.2. Take a moment to review this information..

[Audio] The figure shown here is the second half of Figure 2.2..

[Audio] As we go more in-depth into the problem-solving steps, we will examine a scenario from the field as a reference and apply the steps to solve the problem. The scenario: Several instances of suspected anthrax exposures due to bioterrorism have led some nurses to stockpile Levaquin by using diversion. You are the automation technician in charge of Pyxis operations. How would you proceed?.

[Audio] Identification of a problem involves several steps. Not following steps can lead to impulsive reactions or acting under less-than-optimal conditions. While speed may be of the essence, it should not supersede analysis of the issue. These steps can be followed rapidly, but all of them should be followed to come to an accurate understanding of the problem. Articulating or defining the issue, deciding why it is important to address, and making observations of the situation lead to proper identification of a problem. Define the Problem What is the problem you want to solve? How can you use your knowledge/experience to address this problem? At this point, you must not define the problem in terms of the solution—just define the problem itself. In the example scenario, the problem to be solved is nurses diverting Levaquin within the hospital. This is occurring after a rash of anthrax-laced letters was discovered being sent throughout the country. As the automation technician, you have the knowledge of how Levaquin is dispensed on the nursing floors and the access to fix the problem..

[Audio] Recognize the Motivation for Solving the Problem If there is a legitimate need to solve the problem, then the effort put forth to do so is worth it. Part of identification is to determine if the problem is in fact serious enough to merit further actions. Sometimes you may find that solving a problem is not worth the hassle. In the case of the diversion, there is a need. Levaquin is an expensive medication, and the effort to keep it in stock for patients who need it, not to mention the extra phone calls that must be made when it is out of stock, justifies solving the problem. There are also ethical issues involved in drug diversion, further warranting that the problem be solved..

[Audio] Make Observations Observing ties back to the process of questioning. You must step back and make careful observations and ask key questions. Who is involved in the problem? How often does the problem occur? When did the problem start? Where does it occur? In the example scenario, the Pharmacy and the Nursing Departments are involved with the problem. The problem is encountered during every fill of the Pyxis machines, and it started once media attention focused on the threat of anthrax poisoning and the public became aware of the potential risk. Review of reports from the Pyxis reveal that the diversion is most likely occurring in three of the eight nursing units in the facility..

[Audio] Understanding the problem in its entirety can happen in conjunction with identification. The steps involved in understanding will lead to the next steps of the problem-solving process. It will also help in articulating the problem to coworkers and supervisors. Many problems encountered are not solved in a vacuum, and enlisting the aid of others is necessary. The more you understand the problem, the better you can express its significance to others. Full understanding comes from being able to state a problem's scope and root cause. Identifying how others view the problem and gathering as much available information about the problem leads to complete understanding..

[Audio] Identify Its Scope and Significance Once you know the nature of a problem, you can assess its significance. This is also known as triaging. How large is the problem? How significant is it? Should addressing this problem be a priority? The diversion scenario is very significant, and while perhaps not institution wide, it affects a significant portion of the institution and several departments. Determine Its Root Cause The root of a problem is not always immediately clear and may be interpreted differently by people with different perspectives on the situation. Determining why it is a problem is part of determining its root cause and ultimately its solution. The root cause of the example scenario is fear of anthrax poisoning. It is a problem due to the high cost of the missing medication, but more importantly, its diversion is potentially affecting care to patients who already have an infection and have been prescribed the medication..

[Audio] Recognize Others' Perspectives To enlist the aid of others, as mentioned above, it is important to assess the perspectives of all parties involved. How do they feel about this problem? What experiences have they had with this problem? How did they try to solve this problem, if at all? In the example scenario, one must consider the perspectives of other technicians and pharmacy staff. The buyer is upset at having to order extra Levaquin, as it puts the department over its budget. The central technician is annoyed at having to field extra calls about missing doses of the medication. Nursing administration does not consider it as great a problem and is worried about other areas of care. The nursing units in question do not want to admit that some of their staff may be stealing medication..

[Audio] Gather Information The more information you have about the situation, or those like it, the better you can solve or address it. "Don't reinvent the wheel" is a saying that exists for a very good reason. If there is a protocol or solution that someone else has applied to the problem, perhaps in another setting or a different but similar scenario, that can be used for the existing problem. Conferring with experienced individuals and conducting independent research and fact finding are methods to gather information. In the example, pulling reports on inventory discrepancies, researching control mechanisms for diversion, and talking with pharmacy leadership are all methods of gathering information..

[Audio] By synthesizing the information gathered and using it for further analysis, options for resolution start to become available. This synthesis occurs by organizing the data found and making sure that it is reliable and valid. Having organized data will also allow you to begin to see patterns in the information. Identifying patterns can help you develop a solution. Organize the Information Organizing will not only allow you to process all the data obtained but also enable you to present a coherent picture of the problem to those who need to be made aware of it. Coworkers and supervisors appreciate an organized, concise appraisal of a situation. With the example scenario, you must organize the reports of access to the medication and cost in excess ordering and gather data regarding similar diversion scenarios. Organizing this information can also help identify if there is any information missing that needs to be obtained before moving forward..

[Audio] Determine Reliability and Validity of the Information When researching a problem, some of the data may not be reliable and must be discarded. If the source is not reliable, the data is not valid. Fortunately, reporting systems in automation are very accurate and reliable, if employees are using them properly. In this case, it would be prudent to check to see if there were any incidences of human error, such as improper filling of the Pyxis machine..

[Audio] Observe Patterns in the Information When information is gathered and organized efficiently, it is much easier to analyze it for patterns or trends. Disorganized data can be taken out of context and can be essentially worthless. For the Levaquin scenario, the reports generated are very effective at showing patterns in the use and access to the medication. Specific units and nurses can be looked at to determine if there are patterns or correlations between missing stock and their access to the medication..

[Audio] By understanding the nature of a problem, the data involved, and the patterns inherent in them, possible solutions can be crafted and examined for viability. Ways to examine solutions include brainstorming different paths that can be taken and then weighing the pros and cons for each option. In the Levaquin scenario, since the data points to specific units and nurses for access, the potential solutions can be to restrict access for those particular nurses, those units, or the entire institution..

[Audio] Brainstorm Solutions In a field such as pharmacy, there is typically more than one method or solution to a given problem. Brainstorming different ways to solve a problem ensures that there are a variety of solutions to choose from. The first idea is not always the best one. However, if it is the best idea, that is verified by exploring all possible alternatives. While restriction of access is the first option that came to mind, it may not be the only one available. Since the diversion is a result of fear of anthrax, education is a potential remedy. Perhaps a training session with the specific departments on the nature of anthrax poisonings and bioterrorism statistics can help alleviate the fear. Another question that needs to be answered is, if access restriction is chosen, what is the best way to restrict access? Should the drug be hand delivered from the pharmacy? Should the drug be classified as a controlled substance and loaded into the Pyxis machine with the same control mechanisms as a CII medication?.

[Audio] Assess the Strengths and Weaknesses of Each Solution Potential solutions to problems have consequences when implemented and must be considered carefully when choosing a course of action. A pros and cons list is very useful in assessing available options..

[Audio] In the institutional scenario, the pro of controlling access to Levaquin is that it will be much more difficult to divert, as there is a count taken every time it is accessed. Restriction would prevent excess ordering and allow the pharmacy to stay under budget with the weekly and monthly drug orders. The cons are that it would take longer for nurses to get this medication for dispensing and for the technician to load it into the Pyxis machine. This delay has the potential to increase frustrations in both departments..

[Audio] Once a solution is decided upon, it must be examined in further detail before being put into use. The more comprehensive the examination, the more likely the solution will be effective. Creating an action plan is the final step to engage in solving a problem. It is an organized checklist of steps that are accomplished to complete the solution. Depending on the scope of the solution, this could be quite detailed or as small as a bulleted list of items. It is very useful for summarizing the solution and ensuring that all parties involved understand what is being done about the problem. An action plan for the example scenario would be to have timelines for training and implementation of the new process, checklists of key personnel and departments involved and their roles, and a plan for follow-up and review of the process..

[Audio] An example of the action plan for the Levaquin scenario is illustrated in Figure 2.3.

[Audio] Identify Barriers to Implementing the Solution By determining potential barriers to using a solution, they can be avoided entirely. Identifying barriers will also help you figure out the best way to implement a solution. Things that should be addressed include time constraints, budget, resources, and training. For the anthrax situation, lack of understanding for the new process and nursing compliance are barriers. A training plan with the nursing and pharmacy departments should be developed that explains the situation, the need for control, and the process being implemented..

[Audio] Monitor the Progress of the Action Plan It is true that no plan survives first contact with the enemy. Whether in sports, war, or work, variables are always in play, and even the most well-laid plans need adjustment and modification. Follow-up is key to ensuring a solution works. Is the action plan on track? Are changes needed in the plan? Is the solution successful? For the Levaquin protocol, follow-up reviews were set for 30, 60, and 90 days after implementation. Inventory numbers would be checked to determine effectiveness, and staff would be surveyed to assess mood and compliance with the process, as well as address any questions or concerns..

[Audio] The Module 2, Section 2.3: Module Summary presentation of the Career Readiness & Externships: Soft Skills for Pharmacy Technicians program provides a brief summary of this module..

[Audio] Module Summary Critical thinking is a valuable skill that can be used both personally and in the pharmacy setting. By exhibiting the right traits and practicing certain behaviors, you will improve your ability to think critically. Problem solving is a skill that uses critical thinking to systematically come up with a solution to a situation. Critical thinking and problem solving go hand in hand and will be many chances to engage critical-thinking and problem-solving skills in your career as a pharmacy technician. These abilities, when properly honed, will make you a valuable employee to any pharmacy..