ippe core institutional manual pharm 7641 · requirements and deadlines are located in the core...

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University of Utah College of Pharmacy Experiential Education Program

IPPE Core Institutional Manual

PHARM 7641

Director, Krystal Moorman, PharmD, BCPS [email protected], 801-581-4590

Experiential Program Specialist, Carrie Kirkpatrick, RN, BSN

[email protected], 801-213-3421

Experiential Program Specialist, Elle Popescu [email protected], 801-213-3353

Experiential Program Assistant, Emily Clifford

[email protected], 801-581-5502

[email protected]

mailto:[email protected]





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Table of Contents

1 Title page 2 Table of Contents 3 Description 4 Objectives 5 Assignments 8 Evaluations 9 Immunization Requirements 11 Checklist of Student Experiences 15 Initial and Final Student Self-Assessments (preview)

25 Evaluation of Student – Core Institutional Midpoint and Final (preview)

38 Evaluation of Preceptor (preview)

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IPPE Description

Introductory Pharmacy Practice Experiences (IPPEs) are designed to expose students to contemporary pharmacy practice models. This includes interprofessional practice involving shared decision-making, professional ethics and expected behaviors, and direct patient care activities. IPPEs should help students understand what constitutes exemplary pharmacy prior to beginning Advanced Pharmacy Practice Experiences (APPEs).

IPPE objectives, assignments, and evaluations are based on the Accreditation Council for Pharmacy Education Standards 2016.

IPPE Rotation Types:

Core Community (community pharmacy)

Core Institutional (hospital pharmacy)

Students are required to complete one rural experience during either the IPPE year or the APPE year

IPPE Duration: Each IPPE rotation is 4 weeks long and requires a minimum of 160 clock hours. The total clock hours required for both IPPE rotations is 320 hours.

IPPE Grading: Students receive credit or no credit. There is no letter grade given for IPPEs.

IPPE Site Requirements: All documentation needs to be uploaded into CORE ELMS.

Annual Regulatory Training (e.g., HIPAA, Bloodborne Pathogens)

Criminal Background Check

Current BLS Certificate

APhA Immunization Certification

Intern License

Immunizations (refer to page 9 for details)

IPPE Additional Requirements (site-specific):

Training or Paperwork: Some sites require additional paperwork and/or training. The requirements and deadlines are located in the CORE ELMS Document Library. It is the student’s responsibility to manage and complete the requirements by the deadlines. Failure to complete the requirements on time may result in a delayed or cancellation of the rotation.

Drug screen: Some sites require either a 5-panel or 10-panel drug screen. Students can get screened at any location. If a student takes prescription medications that may cause positive results, the student must provide the office a signed physician’s note verifying that it is a prescribed medication.

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IPPE Core Institutional Objectives

1. Accurately Dispense Medications (order fulfillment) Demonstrate a commitment to patient safety by assuring accurate preparation, labeling, dispensing, and distribution of prescriptions. 2. Basic Patient Assessment Collect, record, and assess subjective and objective patient data to define health-and medication-related problems.

3. Medication Information Demonstrate knowledge of commonly used medications, formulations, and drug products.

4. Ethical, Professional, and Legal Behavior Demonstrate knowledge of and sensitivity towards the unique characteristics of each patient. Comply with all federal, state, and local laws related to pharmacy practice. Demonstrate ethical and professional behavior. 5. General Communication Abilities Demonstrate effective communication in interactions with patients, their families and caregivers, and other healthcare providers. Communication should be consistent with education level, cultural issues, and be empathetic. Elicit feedback validating understanding of communication. 6. Patient Education Provide effective health and medication information to patients and/or caregivers and confirm patient and/or caregiver understanding of the information being provided.

7. Drug Information Analysis and Literature Research Apply knowledge of medical references, study design, and literature analysis and retrieval to provide accurate, evidence-based drug information.

8. Health and Wellness – Public Health Know and apply principles of health and wellness when providing individual and population-based health and wellness information.

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IPPE Core Institutional Assignments

All assignments must be initiated and completed by the student. If the preceptor is required in order for an assignment to be completed, the student is responsible for communicating what is needed at the start of the rotation and ensuring it is submitted.

The following will result in a grade of “NC” (no credit) and students will need to make up the IPPE rotation during an off-block, if a rotation is available, or the following year prior to beginning APPE rotations:

Submitting one assignment more than two days late

Submitting two or more assignments late

Reflective portfolios that fail to reflect on student practice experience

Cheating or copying assignments

Failing to attend reflective sessions

1. Initial and Final Student Self-Assessments

Based on the Core Institutional Objectives, students will identify their level of knowledge or experience with given tasks at the beginning and end of their rotation.

The student and preceptor will be able to identify areas to focus on during the rotation.

The student can compare their knowledge and experience from the beginning to end of the IPPE rotation.

The initial and final self-evaluations are located in the Evaluations section of CORE ELMS. Click on “Self Evaluations.” A preview of the self-evaluations are on pages 15 and 20.

Initial Self-Assessment Instructions: 1. The student must complete the self-assessment during the beginning of the rotation. 2. The preceptor and student should discuss the initial self-assessment in person within the

first week of the rotation.

Deadline: First Friday of Rotation (by 11:59pm)

Final Self-Assessment Instructions: 1. The student must complete the self-assessment during the last week of rotation. 2. The preceptor and student should compare the initial and final self-assessments in

person within the last week of the rotation.

Deadline: The end of Week 4 (Sunday, 11:59pm)

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2. Reflection Sessions Reflection sessions are an open forum to discuss and reflect on the IPPE experience, with peers, to encourage deeper insight and more complex learning. Students are expected to actively listen and engage in the session, although sharing during an open discussion is not required. Attendance at the Reflective Sessions is mandatory and students will participate in the sessions that correspond with the rotation they completed. Scheduled: Last Friday of each block

COMMUNITY Rotation Reflection Sessions: INSTITUTIONAL Rotation Reflection Sessions:

June 8, 2018 from 4:00pm-5:00pm in HSEB 2938

June 8, 2018 from 4:00pm-5:00pm in HSEB 2680

July 6, 2018 from 4:00pm-5:00pm in HSEB 2938

July 6, 2018 from 4:00pm-5:00pm in HSEB 2680

August 17, 2018 from 4:00pm-5:00pm in HSEB 5100B (Please make note of room change.)

August 17, 2018 from 4:00pm-5:00pm in HSEB 2680

3. Checklist of Student Experiences The checklist identifies areas that need to be discussed, demonstrated, or performed during the rotation in order to meet the IPPE Core Community Objectives. The checklist is on page 11. At a minimum, each item needs to be discussed with the preceptor. Instructions:

1. The student should review the checklist with their preceptor and start completing it during Week 1. During Week 2 (mid-point), the checklist should be reviewed again to identify what areas still need to be discussed, demonstrated, or performed before the end of the rotation.

2. During Week 4, the preceptor and student must sign the checklist.

Deadline: The student must upload the completed and signed checklist to CORE ELMS (Field Encounters section) by the end of Week 4 (Sunday, 11:59pm).

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4. Evaluation of Preceptor

Preceptor evaluations are very important to the success of the Experiential Education Program. We rely on student’s assessment of their learning experience and use the information to help train our preceptors. These are completed anonymously online in CORE ELMS in the Evaluations section.

• Without constructive comments, evaluations will be considered incomplete.

Deadline: The end of Week 4 (Sunday, 11:59pm)

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IPPE Core Institutional Evaluations

Previews of the student and preceptor evaluations are on pages 25 and 38. We recommend reviewing the evaluations at the start of the rotation. Evaluations must be completed in CORE ELMS. Student Instructions: Complete the IPPE Evaluation of Preceptor in CORE ELMS by Sunday after rotation completion by 11:59pm. Preceptor Instructions: Mid-point Evaluation:

Complete the IPPE Evaluation of Student during Week 2 in CORE ELMS.

Discuss the evaluation with the student by the end of Week 2 to identify goals and concerns.

Final Evaluation:

Complete the Final Evaluation of the Student during Week 4 in CORE ELMS.

Discuss the evaluation with the student on the last day of rotation.

If you need to make adjustments to the Final Evaluation, you must do so within 1 week of the final rotation date.

Grading In order to receive credit for the course, students must achieve an average score of 3 on the final evaluation and successfully complete all assignments as noted above. Students that receive a grade of “NC” (no credit) will need to make up the IPPE rotation during an off-block, if a rotation is available, or the following year prior to beginning APPE rotations.

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Student Immunization Requirements

Students must provide official documentation from a healthcare provider or local health department to fulfill the immunization requirements. All documentation must be uploaded to

CORE ELMS™ and kept current. The student is responsible for ensuring their immunizations

are up to date. 1. Tuberculosis (TB) For Admission:

All incoming students must have a baseline TB-test completed. There are 3 options:

Two-step TST (two separate Tuberculin Skin Tests, aka PPD tests) OR

QuantiFERON ® Gold blood test OR

T-SPOT®.TB blood test

If the student has a positive baseline result, the student must have a chest x-ray read by

a radiologist.

o If the chest x-ray is normal, the student never needs to take another TB test.

o If the chest x-ray is abnormal, the student needs to be cleared by their physician or

local health department. Students cannot go on rotation without clearance.

For Rotations:

Students must have an annual TB test completed only if the student’s baseline or

previous TB test was negative.

o If the student has had a negative two-step skin test, then they only need to have

1 skin test completed annually.

The student should keep their TB tests consistent every year (e.g., If the student takes a

two-step skin test as the baseline, then he/she should continue to have a skin test done

every year rather than switch to a blood test).

2. Hepatitis B

Approved Hepatitis B vaccines are Engerix-B, Recombivax HB ®, or Twinrix ® (combined

Hepatitis A and Hepatitis B for adults). Students must provide documentation of:

o 3 Hepatitis B vaccinations AND a titer after 30 days of getting the last vaccine to

confirm immunity OR

o Documentation of Twinrix ® vaccinations AND a titer after 30 days of getting the

last vaccine to confirm immunity:

Standard Schedule - Administered at 0, 1, and 6 months (3 shots) OR

Rapid Schedule - Administered at 0, 7, and 21-31 days AND a booster

dose 12 months after the first dose (4 shots)

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Students who have not completed the full series by the start of the school year are

required to complete the series. The full series and titer must be completed before

students can go on rotation.

3. Measles (Rubeola), Mumps, and Rubella (MMR)

2 MMR vaccinations OR

Proof of immunity to Measles (Rubeola), Mumps, and Rubella through a blood test

4. Annual Influenza vaccine:

Must provide documentation every year

5. Varicella (Chicken Pox):

2 Varicella vaccinations OR

Proof of immunity to Varicella through a titer OR

Documentation of past Varicella disease by a healthcare provider or local health

department

6. Tdap:

1 Tdap vaccination within 10 years

A TD booster is required once the Tdap vaccination expires (after 10 years)

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Checklist of IPPE Core Institutional Student Experiences

Week 1 – the student and preceptor should review the checklist and start completing it. Week 2 - the checklist should be reviewed again to identify what areas still need to be discussed, demonstrated, or performed before the end of the rotation. At a minimum, each item needs to be discussed by the preceptor.

Areas of Experience Discussed w/Student

Preceptor Demonstrated

Student Performed

Drug Distribution

Methods of transmitting medication orders to pharmacy (e.g., couriers, pneumatic tube, telephone, fax)

Drug distribution system

o Manual picks

o Unit dose system

o Automated dispensing cabinets

o Other automation

Dispensing procedures

o Regular and emergency order procedures

o New order batches

o Interpretation of order and product selection

o Differences in control by category of drug:

Legend drugs

Controlled drugs (DEA drugs)

OTC drugs

o Labeling (regular and auxiliary)

o Charging-crediting

o Checking

Inspection of medication on nursing units:

o Regular stock

o Emergency stock and kits

o Controlled drugs-security

o Frequency and methods of recording the inspection

Automatic stop orders (organization, enforcement, drugs covered)

After hours dispensing control

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o Emergency kits

o On-call pharmacist

o Drug cabinets – limited access

Sample drug control methods



Student Performed

Parenterals and sterile products:

o Compounding IV admixtures

o Pharmaceutical calculations

o Equipment overview

o Personnel requirements (training)

Outpatient Dispensing

Availability of services (e.g., employees, general public)

Prescription receiving procedures and limitations (i.e., written, telephones, house staff prescriptions only)

Procurement and Inventory Control

Formulary vs. nonformulary drugs

Biotechnology drugs

Procedures on:

o Product specifications

o Contracts and bidding

o Pricing and discounts

Source of supply:

o Direct order

o Wholesaler

o Other practitioners

Ordering procedures

Receiving, checking, pricing

Merchandise return policies and procedures

Outdated product procedures

Recall procedures

Inventory location and storage:

o Systems of arrangement

o Location of OTC products

o Special storage areas

Laws, Regulations, and Procedures for Special Classes of Drugs

Controlled drugs (review of regulations):

o Ordering procedures

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o Storage and inventory requirements (nursing and pharmacy)

o Disposition records (nursing and pharmacy)



Student Performed

Manufacturing Activities

Prepackaging (e.g., equipment, labeling, records, personnel)

o Solids

o Liquids

Related Professional Activities

Pharmacy and therapeutics committee:

o Rationale, organization, functions

o Role of the pharmacist

o Frequency of meetings

Hospital formulary system:

o Rationale and operation

o Addition and deletion procedures

Hospital formulary:

o Type used

o Implementation

Drug Information:

o Methods of communication used (e.g., bulletins, response to specific questions)

o Literature resources

o Use of references by pharmacists

o Adverse drug reaction monitoring and procedures

o ADR reporting forms (MedWatch)

Related Administrative Activities

Quality improvement program:

o Process for monitoring and evaluation of the quality and appropriateness of care

o Drug utilization evaluations (DUEs)/Medication utilization evaluations (MUEs)

o Medication reconciliation

Hazard communication standards (HCS):

o Components of the standard

o Material safety data sheets (MSDS)

Clinical Activities

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Interaction with other health care professionals in patient care areas

Nursing medication rounds and nursing conferences

Attendance at medical rounds and nursing conferences

Student Signature Date

Preceptor Signature Date

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IPPE Initial Student Self-Evaluation - Core Community 2018

General overview

Initial Description:

Identify your level of knowledge or experience with the below activities. Deadline: Friday of Week 1 (11:59pm)

How to apply scoring

Scale:

Extensive

Moderate

Minimal

None

Section Weight: 0.00%

Self-Reflection

Choose three areas you would like to improve upon during this rotation. At least one should come from the CAPE Outcomes (document located in the Document Library in CORE ELMS).

Question Comments : *Comment Required

NO SCORE SELECTED

Describe three specific career goals and how you hope this rotation will help you reach those goals.


NO SCORE SELECTED

Accurately Dispense Medications (order fulfillment)

Demonstrate a commitment to and a valuing of patient safety by assuring accurate preparation, labeling, dispensing, and distribution of prescriptions and medication orders.

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Evaluate the accuracy of an order and verify that the information is correct and complies with state and federal law.

NO SCORE SELECTED

Evaluate appropriateness of medication orders by correlating the order with patient- specific data and drug information.

NO SCORE SELECTED

Accurately prepare and dispense medications pursuant to a new prescription, prescription refill, or drug order.

NO SCORE SELECTED

Provide safe, accurate, and time-sensitive medication distribution.

NO SCORE SELECTED

Determine appropriate storage of medications before and after dispensing.

NO SCORE SELECTED

Perform accurate pharmaceutical calculations, especially involved in the preparation of compounded oral, topical, rectal or ophthalmic preparation, and calculation of appropriate doses.

NO SCORE SELECTED

Assist a patient or caregiver in problems related to prescription medication coverage, health insurance, or government healthcare programs

NO SCORE SELECTED

Basic Patient Assessment

Collect, record, and assess subjective and objective patient data to define health and medication-related problems.

Collect complete and accurate patient-specific information from patient record.

NO SCORE SELECTED

Communicate with patient to obtain, record, and interpret a history that includes the following:

drug allergies and reactions

medications being taken including prescription, non-prescription, and herbal products

doses being used

adherence to therapy

NO SCORE SELECTED

Evaluate a patient's medication profile to identify medication-related problems including the following:

contraindicated drugs (due to allergies, disease, etc.)

inappropriate doses

duplicate medications

drug-drug, drug-disease, and drug-herb interactions

NO SCORE SELECTED

General Drug Knowledge

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Demonstrate knowledge of commonly used medications, formulations, and drug products.

Summarize key information related to the use of common medications including the following:

brand and generic name

dosage forms

usual dosing ranges

mechanism of action

common drug interactions

common adverse effects

NO SCORE SELECTED

Identify appropriate medication information sources for professional and patient use.

NO SCORE SELECTED

Ethical, Professional, and Legal Behavior

Demonstrate knowledge of and sensitivity towards the unique characteristics of each patient. Comply with all federal, state, and local laws related to pharmacy practice. Demonstrate ethical and professional behavior in all practice activities.

Demonstrate caring, ethical, and professional behavior when interacting with peers, professionals, patients, and caregivers.

NO SCORE SELECTED

Demonstrate sensitivity and responsiveness to culture, race/ethnicity, age, socioeconomic status, gender, sexual orientation, spirituality, disabilities, and other aspects of diversity and identity when interacting with patients, caregivers, and other healthcare professionals.

NO SCORE SELECTED

Comply with federal, state, and local laws and regulations related to pharmacy practice.

NO SCORE SELECTED

Practice ethically, including maintaining patient confidentiality, responding to errors in care, and professional misconduct (including plagiarism).

NO SCORE SELECTED

Demonstrate empathy, assertiveness, effective listening skills, and self-awareness.

NO SCORE SELECTED

Accept responsibility for patient care.

NO SCORE SELECTED

General Communication Abilities

Demonstrate effective communication in interactions with patients, their families and caregivers, and other healthcare providers. Communication should be

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consistent with education level, cultural issues, and be empathetic. Elicit feedback validating understanding of communication.

Communicate effectively (using verbal, non-verbal, and written communication as appropriate) with patients, caregivers, and other healthcare providers.

NO SCORE SELECTED

Patient Education

Provide effective health and medication information to patients and/or caregivers and confirm patient and/or caregiver understanding of the information being provided.

Appropriately and accurately provide basic medication counseling to a patient or caregiver.

NO SCORE SELECTED

Assess the ability of patients to obtain, process, understand, and use health- and medication-related information.

NO SCORE SELECTED

Counsel patients on proper self-care and preventive care.

NO SCORE SELECTED

Communicate alternative therapeutic strategies to the prescriber to correct or prevent drug-related problems.

NO SCORE SELECTED

Assist a patient in correctly selecting an over-the-counter preparation.

NO SCORE SELECTED

Provide accurate response to drug information requests written and verbally.

NO SCORE SELECTED

Demonstrate and/or describe proper administration technique for various drug delivery systems (eg, inhalers, eye drops).

NO SCORE SELECTED

Drug Information Analysis and Literature Research

Apply knowledge of medical references, study design, and literature analysis and retrieval to provide accurate, evidence-based drug information.

Collect accurate and comprehensive drug information from appropriate sources to make informed, evidence-based, patient-specific, or population-based recommendations.

NO SCORE SELECTED

Describe the type of content in commonly used drug and medical information resources.

NO SCORE SELECTED

Health and Wellness

Know and apply principles of health and wellness when providing individual and population-based health and wellness information.

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Participate in activities that promote health and wellness and the use of preventive care measures.

NO SCORE SELECTED

Promote to patients the importance of health, wellness, disease prevention (e.g., immunizations, tobacco cessation), and management of their diseases and medication therapies to optimize outcomes.

NO SCORE SELECTED

Provide preventive health services (eg, immunizations, tobacco cessation counseling).

NO SCORE SELECTED

Additional Comments

Any additional comments, please provide them in the text box below:

Question Comments :

NO SCORE SELECTED

Evaluation Score Summary

Title: Score Weight Adj. Score

Primary Evaluation 0.00 0.00% 0.00 Required

SCORE: 0.00 0% 0.00

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IPPE Final Student Self-Evaluation - Core Institutional 2018

General overview

Final Description:

Identify your level of knowledge or experience with the below activities. Deadline: The end of Week 4 (Sunday, 11:59pm)

How to apply scoring

Scale:

Extensive

Moderate

Minimal

None


Self-Reflection

Reflect on your goals from the beginning of the rotation. Did you improve upon your three defined areas of growth? Please provide specific examples that demonstrate how you improved, or explain why you did not improve.


NO SCORE SELECTED

What challenges did you experience in this rotation? What did you learn from them?


NO SCORE SELECTED

What is the most important thing you learned on this rotation?


NO SCORE SELECTED

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How has this rotation helped reinforce or change your future career goals?


NO SCORE SELECTED


Accurately Dispense Medications (order fulfillment)

Demonstrate a commitment to and a valuing of patient safety by assuring accurate preparation, labeling, dispensing, and distribution of prescriptions and medication orders.

Evaluate the accuracy of a medication order and verify that the information is correct and complies with state and federal law.

NO SCORE SELECTED

Evaluate appropriateness of medication orders by correlating the order with patient- specific data and drug information.

NO SCORE SELECTED

Accurately prepare and dispense medications pursuant to a drug order.

NO SCORE SELECTED

Provide safe, accurate, and time-sensitive medication distribution.

NO SCORE SELECTED

Determine appropriate storage of medications before and after dispensing.

NO SCORE SELECTED

Compound parenteral and non-parenteral drug products using accurate calculations, pharmaceutical components, and techniques.

NO SCORE SELECTED


Basic Patient Assessment

Collect, record, and assess subjective and objective patient data to define health and medication-related problems.

Collect complete and accurate patient-specific information from patient record.

NO SCORE SELECTED

Communicate with patient to obtain, record, and interpret a history that includes the following:

drug allergies and reactions

medications being taken including prescription, non-prescription, and herbal products

doses being used

NO SCORE SELECTED

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adherence to therapy

Evaluate a patient's medication profile to identify medication-related problems including the following:


inappropriate doses



NO SCORE SELECTED


General Drug Knowledge

Demonstrate knowledge of commonly used medications, formulations, and drug products.

Summarize key information related to the use of common medications including the following:

brand and generic name

dosage forms

usual dosing ranges

mechanism of action

common drug interactions

common adverse effects

NO SCORE SELECTED

Cite the spectrum and common indications for commonly used antibiotics.

NO SCORE SELECTED

Identify target drug concentrations for Narrow Therapeutic Index drugs.

NO SCORE SELECTED

Identify appropriate medication information sources for professional and patient use.

NO SCORE SELECTED


Ethical, Professional, and Legal Behavior

Demonstrate knowledge of and sensitivity towards the unique characteristics of each patient. Comply with all federal, state, and local laws related to pharmacy practice. Demonstrate ethical and professional behavior in all practice activities.


NO SCORE SELECTED

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NO SCORE SELECTED


NO SCORE SELECTED


NO SCORE SELECTED


NO SCORE SELECTED


NO SCORE SELECTED


General Communication Abilities

Demonstrate effective communication in interactions with patients, their families and caregivers, and other healthcare providers. Communication should be consistent with education level, cultural issues, and be empathetic. Elicit feedback validating understanding of communication.


NO SCORE SELECTED


Patient Education

Provide effective health and medication information to patients and/or caregivers and confirm patient and/or caregiver understanding of the information being provided.

Appropriately and accurately provide basic medication counseling to a patient or caregiver.

NO SCORE SELECTED

Assess the ability of patients to obtain, process, understand, and use health- and medication-related information.

NO SCORE SELECTED


NO SCORE SELECTED

Communicate alternative therapeutic strategies to the prescriber to correct or prevent drug-related problems.

NO SCORE SELECTED

Assist a patient in correctly selecting an over-the-counter preparation.

NO SCORE SELECTED

Provide accurate response to drug information requests written and verbally.

NO SCORE SELECTED

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Demonstrate and/or describe proper administration technique for various drug delivery systems (eg, inhalers, eye drops).

NO SCORE SELECTED


Drug Information Analysis and Literature Research

Apply knowledge of medical references, study design, and literature analysis and retrieval to provide accurate, evidence-based drug information.

Collect accurate and comprehensive drug information from appropriate sources to make informed, evidence-based, patient-specific, or population-based recommendations.

NO SCORE SELECTED

Describe the type of content in commonly used drug and medical information resources.

NO SCORE SELECTED


Health and Wellness

Know and apply principles of health and wellness when providing individual and population-based health and wellness information.


NO SCORE SELECTED

Promote to patients the importance of health, wellness, disease prevention, and management of their diseases and medication therapies to optimize outcomes.

NO SCORE SELECTED


Additional Comments


Question Comments :

NO SCORE SELECTED



Primary Evaluation 0.00 0.00% 0.00 Required

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SCORE: 0.00 0% 0.00

IPPE Evaluation of Student - Core Institutional 2018

General overview

Mid-point Evaluation:

Complete the Mid-point Evaluation of the Student during Week 2.

Discuss the evaluation with the student by the end of Week 2 to identify goals and concerns.

Final Evaluation:

Complete the Final Evaluation of the Student during Week 4.

Discuss the evaluation with the student on the last day of rotation.

If you need to make adjustments to the Final Evaluation, you must do so within 1 week of the final rotation date.

How to apply scoring How to apply scoring

The student needs an overall average of 3 to pass.

1 = Student can observe only

2 = Requires maximum preceptor guidance to perform

3 = Requires moderate preceptor guidance to perform

4 = Requires minimum preceptor guidance to perform

5 = Performs independently of preceptor guidance


Student collects information to identify a patient's medication-related problems and health-related needs, including: MIDPOINT FINAL

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Collect a medical history from a patient or caregiver.

Question Comments (Midpoint):

Question Comments (Final):

NO SCORE SELECTED NO SCORE SELECTED

Collect a complete medication history from a patient or caregiver (including allergies, prescriptions, over the counter medications, herbal medications, and doses).




Discuss a patient's experience with medication (eg, effectiveness, adverse effects).




Determine a patient's medication adherence.





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Student analyzes information to determine the effects of medication therapy, identify medication-related problems, and prioritize health-related needs, including: MIDPOINT FINAL

Student can interpret laboratory test results (based on topics students has covered in the curriculum to date).




Student can identify drug interactions.




Perform a comprehensive medication review (CMR) for a patient to identify medication-related problems including:


inappropriate doses






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Assess a patient’s health literacy.





Student collaborates as a member of an interprofessional team, including: MIDPOINT FINAL

Explain to a patient, caregiver, or professional colleague each team member’s role and responsibilities.




Communicate a patient’s medication-related problem(s) to another health professional.






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Communication should be consistent with education level, cultural issues, and be empathetic. Elicit feedback validating understanding of communication.





Student participates in identifying cause of errors and adverse drug events, including: MIDPOINT FINAL

Assist in the identification of underlying system-associated causes of errors.




Report adverse drug events and medication errors to stakeholders.




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Ensure that patients have been immunized against vaccine-preventable diseases, including: MIDPOINT FINAL

Administer and document CDC-recommended immunizations to an adult patient.




Determine what vaccines a patient is eligible for based on CDC/ACIP guidelines.





Student knows and applies principles of health and wellness when providing individual and population-based health and wellness information, including: MIDPOINT FINAL



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Promote to patients the importance of health, wellness, disease prevention, and management of their diseases and medication therapies, to optimize outcomes.





Educate patients and professional colleagues regarding the appropriate use of medications, including: MIDPOINT FINAL

Lead a discussion regarding a recently published research manuscript and its application to patient care.




Develop and deliver a brief (less than 1 hour) educational program regarding medication therapy to health professional(s) or lay audience.


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Educate a patient regarding the appropriate use of a new medication, device to administer a medication, or self-monitoring test.




Educate a patient on the use of medication adherence aid.





Use evidence-based information to advance patient care, including: MIDPOINT FINAL

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Appropriately and accurately provide effective health and medication information to patients and/or caregivers and confirm patient and/or caregiver understanding of the information being provided.




Collect accurate and comprehensive drug information from appropriate sources to respond to drug information questions.





Oversee the pharmacy operations for an assigned work shift, including: MIDPOINT FINAL

Identify pharmacy service problems and/or medication safety issues.




Maintain the pharmacy inventory.


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Interpret pharmacy quality and productivity indicators using continuous improvement quality techniques.




Assist in the preparation for regulatory visits and inspections.





Fulfill a medication order, including: MIDPOINT FINAL

Accurately prepare, label, dispense, and distribute prescriptions.




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Enter patient-specific information into an electronic health or pharmacy record system.




Prepare commonly prescribed medications that require basic sterile compounding or basic non-sterile compounding prior to patient use.




Determine if a medication is contraindicated for a patient.




Identify and manage drug interactions.




Determine the patient co-pay or price for a prescription.


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Ensure that formulary preferred medications are used when clinically appropriate.




Obtain authorization for a non-preferred medication when clinically appropriate.




Assist a patient to acquire medication(s) through support programs.





Demonstrate ethical and professional behavior in all practice activities, including: MIDPOINT FINAL

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Create a written plan for continuous professional development, including: MIDPOINT FINAL

Perform a self-evaluation to identify professional strengths and weaknesses.




Additional Comments


Comments (Midpoint): Comments (Final):

Overall Evaluation Comments

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Midpoint Comments: Final Comments:


Title: Midpoint Score Final Score Weight Adj. Final Score

Primary Evaluation 100.00% Required

FINAL SCORE: (F) 100% (F)

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IPPE Evaluation of Preceptor 2018

General overview

Please select the number that best corresponds with the level of agreement you have with the preceptor-specific criteria. Please respond to all items as thoughtfully and honestly as possible. Evaluations will be de-identified.


Preceptor: Leadership

The preceptor accepts personal responsibility for patient outcomes.

Question Comments :

NO SCORE SELECTED

If applicable, the preceptor delegated tasks appropriately.

Question Comments :

NO SCORE SELECTED

The preceptor demonstrates effective managerial and leadership relationships with pharmacist colleagues and staff.

Question Comments :

NO SCORE SELECTED

The preceptors demonstrates nondiscriminatory behavior and practice.

Question Comments :

NO SCORE SELECTED

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The preceptor advocates for their service/pharmacy to leaders in their organization.

Question Comments :

NO SCORE SELECTED


Preceptor: Role Modeling

The preceptor monitors the quality of their professional practice.

Question Comments :

NO SCORE SELECTED

The preceptor demonstrates aspects of humility related to their own limitations.

Question Comments :

NO SCORE SELECTED

The preceptor demonstrates personal motivation to develop and advance their own knowledge base.

Question Comments :

NO SCORE SELECTED

The preceptor practices evidence-based medicine.

Question Comments :

NO SCORE SELECTED

42

The preceptor provides patient-centered care.

Question Comments :

NO SCORE SELECTED

Preceptor demonstrates ethical decision making.

Question Comments :

NO SCORE SELECTED

The preceptor serves as a patient advocate.

Question Comments :

NO SCORE SELECTED

The preceptor uses critical thinking to solve problems.

Question Comments :

NO SCORE SELECTED

The preceptor provides medication, disease, and health education to patients.

Question Comments :

NO SCORE SELECTED

The preceptor interacts with patients and interdisciplinary team members in a professional manner.

NO SCORE SELECTED

43

Question Comments :

Preceptor demonstrates patient assessment skills.

Question Comments :

NO SCORE SELECTED

Preceptor effectively communicates with patients and colleagues.

Question Comments :

NO SCORE SELECTED

Preceptor has appropriate level of drug therapy knowledge in the area in which they practice.

Question Comments :

NO SCORE SELECTED

Preceptor demonstrates a caring attitude toward patients.

Question Comments :

NO SCORE SELECTED


Preceptor: Teaching

The rotation objectives were clearly stated by preceptor.

Question Comments :

NO SCORE SELECTED

44

The rotation objectives were met by preceptor.

Question Comments :

NO SCORE SELECTED

The rotation content was well organized by preceptor.

Question Comments :

NO SCORE SELECTED

The experience was well-coordinated among other members of the team.

Question Comments :

NO SCORE SELECTED

The preceptor discussed their own clinical reasoning process.

Question Comments :

NO SCORE SELECTED

The preceptor monitored the quality of teaching activities.

Question Comments :

NO SCORE SELECTED

Activities, projects, and assignments were meaningful and reinforced learning objectives of the clerkship.

NO SCORE SELECTED

45

Question Comments :

Preceptor requested feedback from student about their site/rotation.

Question Comments :

NO SCORE SELECTED

The preceptor identified and responded to each student's specific learning needs.

Question Comments :

NO SCORE SELECTED

Preceptor demonstrates a caring attitude toward students.

Question Comments :

NO SCORE SELECTED

The preceptor's expectations of student were reasonable.

Question Comments :

NO SCORE SELECTED

The preceptor coached student pharmacist behavior through effective, constructive, and timely feedback.

Question Comments :

NO SCORE SELECTED

46

The preceptor provided opportunities for self-directed learning.

Question Comments :

NO SCORE SELECTED

The preceptor required and evaluated student self-assessment.

Question Comments :

NO SCORE SELECTED

The preceptor treated students as colleagues-in-training.

Question Comments :

NO SCORE SELECTED

The preceptor encouraged questions.

Question Comments :

NO SCORE SELECTED

Preceptor effectively orients student to practice site and clearly communicates expecations.

Question Comments :

NO SCORE SELECTED

Preceptor makes students feel welcome at practice site (e.g. introduces to team members, includes students in applicable activities).

Question Comments :

NO SCORE SELECTED

47

The amount and quality of time spent with the student is appropriate.

Question Comments :

NO SCORE SELECTED

The preceptor was available for consultations.

Question Comments :

NO SCORE SELECTED

An evaluation was discussed, face-to-face between student and preceptor at mid-point and the end of the experience.

Question Comments :

NO SCORE SELECTED

Do you feel your evaluation was a fair and reasonable assessment of your performance?

Question Comments :

NO SCORE SELECTED


Evaluation of Site

I felt like was part of the team at this site.

Question Comments :

NO SCORE SELECTED

48

Other team members at the site made me feel welcome.

Question Comments :

NO SCORE SELECTED

The site has adequate patient volume and diversity for student learning.

Question Comments :

NO SCORE SELECTED

I had access to the patient information necessary to provide care.

Question Comments :

NO SCORE SELECTED

I had the opportunity to interact with other health care professionals at this site. (Please identify what types of other health care professionals in the comments section provided.)

Question Comments :

NO SCORE SELECTED

I had access to appropriate drug and medical information resources at this site. (If resources were not provided, accessing the library remotely would still mean access was provided.)

Question Comments :

NO SCORE SELECTED

There is adequate space for student involvement, pharmacy activities, and interaction with pharmacists, other health care professionals and patients at this site.

NO SCORE SELECTED

49

Question Comments :

This site displays a professional image.

Question Comments :

NO SCORE SELECTED

Describe at least three strengths of this experience:

Comments : *Comment Required

Describe at least three ways to make this experience a more effective learning opportunity:

Comments : *Comment Required

Confidential Comments (for EE staff only)

The comments in this section are only viewable by the Experiential Education staff at the College of Pharmacy and is intended to alert the staff to problems or concerns regarding your preceptor, the rotation, or the site.

This section is not and will never be viewable by the preceptor. This section is confidential, but not anonymous. As such, the Experiential Education staff may contact you for additional information regarding your feedback.

Comments :


Number of Hours Studying

50

Approximate number of hours per week I spent studying/preparing for this rotation:

NO SCORE SELECTED


Number of Hours Worked

Number of hours I spent at my rotation site each week:

NO SCORE SELECTED


Expected Grade

My expected rotation grade:

NO SCORE SELECTED

Overall Evaluation Comments

Comments: *Required



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