Advanced Pharmacy Practice Experience (APPE)March 15, 2016Lecture #3

Session OutlineFuture lectures

Site Specific Requirements

OCP – Placement Site Documentation

Transition to APPE course – PHM 400H1

Policies and Procedures

Professionalism

Future LecturesMarch  24 – 12 – 1 p.m. PB B150 ‐ presentation by eHealth on the Drug Profile Viewer and procedure for signing up for an account.  Attendance is required.

March 29 – 5:30 – 6:30 p.m. – assessment, rotation structure, rotation expectations, APPE manual, IPE activities and Transition to APPE course

Site Specific Requirements in CORESite specific requirements to be completed as soon as possible and at least 1 month prior to starting rotations or there is a risk the rotation will be cancelled

In CORE, go to ‘Scheduling > Rotation Schedule’

Click on ‘preceptor/site’ link for each site assigned

Click on the ‘Single Site’ heading (see screen shot)

In the ‘description’ section you will find any ‘site specific’ information and ‘Preceptor/Site Documents’ documents (if applicable) to click and open 

Check your site again prior to the start of the rotation to ensure all site‐specific requirements are met

Conflict of InterestFamily member or close personal friend working in same site (for multi‐site institutions, may not be concern)

Consider whether the person you know would be working in same area as yourself and would have any influence, direct or indirectly, on providing information about your performance assessment

Would there be a perception from others that your presence in the same site as the other person would lead to any bias or sense of unfair treatment?

Email OEE to identify/check on above concerns you may have

Photos on COREPlease upload a photo if you have not already done so

Preceptors really appreciate ‘meeting’ you when they log in

Many preceptors and site coordinators will have lots of student rotations – your photo helps to get to know everyone

See ‘Account Photo’ link on your home page 

OCP – Document Placement SitesProfessional responsibility of members to declare any and all workplaces

Students engaged in practice part‐time, summer job or experiential rotations need to declare workplaces

Students must document information on OCP’s online system

This information becomes visible through the College’s public register so it must be accurate

Add workplace at start of new practice site and the site needs to be removed from profile when student no longer practicing at site

Please contact client services if you have questions ‐ocpclientservices@ocpinfo.com

TRANSITION TO ADVANCED PHARMACY PRACTICE EXPERIENCEPHM400H1

MAY 2-5, 2016

NARDINE NAKHLA

COURSE COORDINATOR

• Nardine Nakhla, PharmD

Lecturer, PharmD Program

Education Coordinator, Continuous Professional Development

Office Hours: By appointment only (room #629)

Office Phone Number: 416.978.2341.

Email: nardine.nakhla@utoronto.ca

GENERAL COURSE OVERVIEW

• Designed to strengthen and integrate your knowledge, skills and attitudes in preparation for APPE rotations

• Review, build on, consolidate and apply previous knowledge, skills and behaviours acquired throughout the curriculum and EPEs in the areas of patient care, communication, collaboration, management, advocacy, scholarship, and professionalism.

• Composed of: lectures (didactic, case-based interactive), workshops, and other skill-based activities

• Total Contact Hours: 38 hours • ONLINE COMPONENT (preparatory work prior to transition week): 8 hours

• IN-CLASS COMPONENT (includes lectures, discussions and workshops): 30 Hours (over 4 days)

• Successful completion is required prior to starting APPE rotations

COURSE LEARNING OBJECTIVES

• Care Provider (Intermediate):

• demonstrate proficiency at collecting patient data in the course of conducting complete patient assessments and medication reconciliation

• interpret data in order to complete patient assessments, including determining DTPs

• demonstrate ability to address DTPs & complete a care plan

• utilize an evidence-based approach in patient workups

• demonstrate the ability to document the provision of care

• Communicator (Intermediate)

• demonstrate ability to present patient cases

• demonstrate ability to communicate effectively

• Collaborator (Intermediate)

• demonstrate understanding of the role of, and how to work effectively with other members of the inter-professional and intra-professional patient care teams

• demonstrate understanding of the role of pharmacists in health care organizations and the larger health care system

• Manager (Introductory)

• recognize systems and infrastructure within institutional and community pharmacies (e.g. drug distribution, formulary)

• recognize the role pharmacists in contributing to other professional responsibilities

• Advocate (Intermediate)

• discuss the role of pharmacists in advancing the health and wellbeing of individuals

• demonstrate understanding of how pharmacists provide expanded scope of practice

• Scholar (Intermediate)

• retrieve, analyze and synthesize relevant and current data and literature, using information technologies and library resources to solve drug therapy problems

• provide information and clinical recommendations utilizing methods which integrate the best research evidence

• Professional (Advanced)

• demonstrate an understanding of the principles and practice of ethics and law as they apply to the practice of pharmacy

• exhibit professionalism at all times

GOAL OF THE COURSE

To engender students’ practical skills and strategies to help prepare

them for the role of advanced pharmacy practice students.

PHARMACISTS ARE…

• qualified health professionals who help people make the best use of their medications “in order to safely achieve desired health outcomes at home, in the community and in hospitals. They research and work collaboratively with other health care providers to deliver optimal health care solutions through effective use of health care products and services.

• By incorporating best care principles that are patient-centred, outcome-oriented and evidence-based, their professional pharmacy practice emphasizes drug therapy management of diseases and symptoms and the promotion of wellness and disease prevention.”1

1Canada’s Health Care Providers, 2000 to 2009, A Reference Guide, Canadian Institute for Health Information. Page 159. Available from: https://secure.cihi.ca/free_products/CanadasHealthCareProviders2000to2009AReferenceGuide_EN.pdf Accessed March 14, 2016.

REQUIRED RESOURCES / ONLINE MODULES

Topic Developer NotesProfessionalism/Ethics (1 hr) OCP Review prior to Monday’s COE case-based lecture

AFPC Informatics for Pharmacy Students e-resource:

Domain 3 Knowledge Management & Technology . Topic 3.2 - Electronic Resources & Decision Support Tools (2 hrs)

M Rocchi Access: The URL for the e-Resource is http://afpc-education.info/moodle. Create an account. Please see the LOGIN box on the right hand side of the landing page, and choose "Create new account". This year's enrolment key is “Boon”. NOTE: new accounts may take time to process access, so create ASAP! Proof of Completion: Honour system; review before May 2,2016.

UHN Confidentiality Module + ConnectingGTA (1 hr)

UHN Network http://www.uhnmodules.ca/for_staff/computer_education/privacy_elearning/modules/UHN%20Privacy%20for%20Learners/player.html & http://www.uhn.ca/corporate/For_Staff/Privacy_eLearning Proof of Completion for each: to be handed in

Infection Control (30 min) L Dresser Online PPT Presentation

Primary Care: Orientation to Ambulatory Practice (1 hr)

J Hunchuck Review prior to Tuesday’s Ambulatory Care Cases

Hospital Site Expectations (1 hr) D Cheng & M Al-Sukhni

Review prior to Tuesday’s Hospital Cases

Community Site Expectations (30 min) K Tan Review prior to Tuesday’s Community Cases

Critical Appraisal Assignment -Preparatory Work (1 hr)

P Liu Read Assigned Study before Wednesday’s Lecture

• No textbook required

• List available on course outline and/or schedule:

• 8 hours total

• Complete before 9am May 2, 2016

• Content assessed on course exam

PHM400H1: TRANSITION TO APPE

COURSESCHEDULE–SPRING2016

MONDAY,May2,2016 Topic Speaker Time Location Introduction to PHM400H1 Nardine Nakhla 9:00 – 9:30 am PB B150 Introduction to APPEs Annie Lee 9:30 – 10:00 am PB B150 Professionalism & NEW Code of Ethics

Anne Resnick 10:00 – 11:00 am PB B150

Scenarios on Professionalism & COE L Raman Wilms & Alison Thompson

11:00‐11:45 am PB B150

Reflective Practice Lecture Zubin Austin 11:45 – 12:30 pm PB B150 Reflective Practice Cases & Examples; “My life as a former APPE student”

Anja Kovacevic (Class of ’16)

12:30 ‐ 1:00 pm (+ lunch) PB B150

Lunch n’ Learn with Anja & other former APPE students: 1:00‐2:00pm

Topic Facilitator(s) Time Location How to “present a patient” to a preceptor or prescriber: Interactive lecture with practice cases where students will present patients

Marie Rocchi 2:00 – 2:45 pm PB B150

Drug Information Refresher: Interactive lecture with how to use the resources available to find the answers to various DI questions; how to access drug info efficiently; etc.

Marie Rocchi

2:45 – 3:15 pm PB B150

Intro to Case #1 (Hospital) – includes BPMH & MedRec review (students to workup case at home and post to Blackboard)

Karen Cameron (+ her APPE student)

3:15 – 5:00 pm (Large group problem‐based or case‐based learning format)

PB B150

COURSE ASSESSMENTS

Assessment Details Due Date

1 UHN Confidentiality Module (online)- submit proof of completion May 2 (5:00pm)

2 Case #1 Care Plan Submission- including BPMH/Med Rec May 2 (11:59pm)

3 Critical Appraisal Group Assignment- one submission per group May 3 (11:59pm)

4 Oral Presentation on one Patient Case May 4

5 Transition to APPE course exam (MCQ- includes online content) May 5

6 Case #4 Documentation Submission May 6 (9am)

You must pass each assessment to pass this course.Missed or unsuccessful assessments will delay APPE rotation

commencement!

BLACKBOARD

• Course site will be up and running soon… stay tuned!

• Groups will be listed on Blackboard

QUESTIONS

A special thanks to the OEE coordinators for presenting

on my behalf!

Please email me with any questions or concerns:

nardine.nakhla@utoronto.ca

Policies and Procedures – Rotation DatesRotations start May 9 and run year round with 3 study blocks (only 2 study blocks can be consecutive)

Each student has 35 weeks – 10 weeks Community, 10 weeks hospital (at least 5 weeks adult inpatient), 5 weeks other direct patient care and 2 x 5 weeks elective

Holiday break – Dec. 19 – 30, 2016 (Inclusive)

Students not on rotation for statutory holidays (eg. Family Day, Good Friday, Victoria Day etc.)

Note: Easter Monday is not a U of T holiday – if site closed, need to make up time

Policies and Procedures ‐ Attendance

Minimum of 40 hours/week at site (usually over 5 days)

Possible weekends and evenings

Expect an additional 10‐ 15 hours/week required for rotation preparatory ‘homework’

May be difficult to continue with part‐time jobs during rotations

If absent or late, must notify preceptor.  

Policies and Procedures ‐ Attendance

If necessary for medical or emergency issues, 1 personal day is allowed/rotation, with preceptor notice/approval

Absence for >1 day‐ need to contact OEE office, send in petition to Registrar’s office and make‐up time

Petition form available on Registrar’s webpage:

http://www.pharmacy.utoronto.ca/pharmd/petitions

Student to enter all absences into CORE using  ‘Absences’ menu item

Policies and Procedures ‐Conferences

If attending a conference (PDW, PPC, OPA etc) a conference request form must be filled out

The form is completed by the student and preceptor with make‐up dates indicated if necessary

Students are allowed 2 conference days/ year, pending approval by preceptor and experiential faculty

Form is reviewed by faculty for approval

Form will be available in manual and posted in CORE

Policies and Procedures – Non‐Primary Site (NPS) Visit

If visiting another site during the rotation, a non‐primary site visit form must be submitted and approved by experiential faculty

Learning Objectives need to be stated 

Form will be available in manual and posted in CORE

Policies and Procedures ‐AccidentsAll students during rotations have accident coverage

Students must have signed the ‘Student Declaration of Understanding’ for WSIB or private insurance coverage prior to rotations

Students must immediately report any placement related injury or disease to the preceptor and contact the OEE

Policies and ProceduresIn the event of an accident:Student – seek immediate medical attention and report to preceptor at earliest opportunity

Preceptor – contact appropriate institutional/corporate offices and OEE

Experiential Faculty – will follow up

Professionalism Guidelines – APPE ManualProfessionalism assessed at mid‐point and final assessment

Definitions/examples of expectations

Definitions/examples of Unacceptable Behaviours

Standards of Professional Practice Behaviour for All Health Professional Students – U of T policyhttp://www.governingcouncil.utoronto.ca/Assets/Governing+Council+Digital+Assets/Policies/PDF/ppsep012008i.pdf

Code of Ethics for Members of the Ontario College of Pharmacistshttp://www.ocpinfo.com/regulations‐standards/code‐ethics/

Each rotation site’s corporate, institutional, departmental or practice documents pertaining to professionalism. Contact your preceptors for these documents. 

Policy and Procedures ‐ProfessionalismProfessionalism must be demonstrated throughout rotations

Poor Professional behavior could result in:

◦ Grounds for remedial work, denial of promotion and/or dismissal from the program

◦ A report to OCP and merit intervention

◦ Discipline for breach of policies (confidentiality, dress code etc.) at practice site

◦ Legal action if contravention of Personal Health Information Protection Act (PHIPA)

Definition and Examples of Expectations in Professionalism – Example A

1. Empathy, consideration and compassion:

is sincere in understanding and responding to others' feelings

puts others needs above his/her own takes necessary time to explain information is able to identify underlying feelings

6. Recognition of the importance of self-evaluation and life long learning: listens to, acknowledges, accepts and applies constructive

criticism takes initiative in undertaking tasks accepts responsibility and demonstrates accountability without

repeated reminders recognizes limitations and seeks help attends learning events/rounds inquisitive - seeks to understand goes beyond minimum expectations; shows desire to learn

2. Respect for human rights: acknowledges and respects different belief

systems and lifestyles avoids assumptions based on stereotypes or

prejudgement strives to provide equal access to information,

assistance, and care contributes to an inclusive and welcoming

environment

7. Awareness of the effects that differences in age, gender and cultural and social background may have: individualizes approach to, and treatment of, patients to reflect

sensitivity to their unique differences demonstrates understanding of these effects through discussion

with TA

3. Respect for and the ability to work harmoniously with the patient/client: acts courteously listens actively is patient uses appropriate language and non-verbals (e.g.

speaks effectively, not condescending, meek or overly assertive)

8. Respect for colleagues and others: completes assigned tasks on time/fulfils obligations without

prompting displays open-ness to other's views non-judgmental conscientious appreciative of other's experiences is tactful and modest

4. Concern for the psycho-social aspects of the patient’s/client’s illnesses: explores, discusses and supports issues from

the patient's perspective (e.g. does explicitly in care plans)

is able to identify individual's social and psychological context of illness

9. Appropriate professional and personal conduct: all behaviour embodies honesty, integrity, conscientiousness

and reliability dresses professionally is punctual - arrives on time for shifts and meetings; notifies TA

if unable to arrive on time or meet a deadline acts competently and confidently attends to personal hygiene and appropriate grooming (as

defined by the TA, site policies and professional norms) complies with fragrance sensitivity policies

5. Respect for confidentiality: does not discuss any patient information in

'public' area where may be overheard removes all patient identifiers on documentation

or in verbal case presentations discreet/cautious with all information related

to individual patients and site-specific information

complies with all site policies related to patient information and documentation

Definition and Examples of Unacceptable Behaviours – Example B

violating the Criminal Code referring to oneself as, or holding oneself to be, more qualified than one is failing to be available while on call or on duty failing to respect patient’s/client’s rights breaching confidentiality failing to keep proper records failing to accept responsibility and/or communicate the need for preventing or

resolving a drug-related problem failing to provide transfer of responsibility for patient/client care falsifying records conducting sexual impropriety with a patient, caregivers, their families or colleagues being impaired by alcohol or drug while participating in patient/client care, on duty or

on call demonstrating any other conduct unbecoming of a practising pharmacist demonstrating infractions of the Human Rights Code

 

Questions?If you have specific questions about rotation placements or to schedule an appointment with a faculty experiential coordinator please email oee.phm@utoronto.ca

If you have any academic concerns or issues during an APPE placement, please contact oee.phm@utoronto.ca to speak with a faculty member.