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The University of Houston College of Pharmacy

Doctor of Pharmacy

Ambulatory Care Advanced Pharmacy Practices Experiences

Manual and Syllabi

Office of Experiential Programs

The University of Houston

College of Pharmacy

4849 Calhoun Road, Room 3044

Houston, Texas 77030

(832) 842‐8337

(832) 842‐8330 Fax

Summer 2019 – Spring 2020

2

Table of Contents

Office of Experiential Programs Contact Information ............................................................................................................ 3

PHAR 5644 Medication Therapy Management ...................................................................................................................... 4

PHAR 5658 Association Management .................................................................................................................................... 7

PHAR 5659 Specialized/Unique Pharmacy Practice .............................................................................................................. 10

PHAR 5660 Pharmaceutical Industry .................................................................................................................................... 13

PHAR 5662 Academic Scholarship ........................................................................................................................................ 16

PHAR 5663 Pharmacy Management ‐ Outpatient ................................................................................................................ 19

PHAR 5664 Legal and Regulatory .......................................................................................................................................... 22

PHAR 5668 Managed Care .................................................................................................................................................... 25

PHAR 5670 Community Pharmaceutical Care ...................................................................................................................... 28

PHAR 5672 Clinical Pharmaceutical Research ...................................................................................................................... 31

PHAR 5673 Veterinary Pharmaceutical Care ........................................................................................................................ 34

PHAR 5675 and PHAR 5696 Ambulatory Care Disease State Management and Primary Care ............................................ 37

PHAR 5686 Psychiatry ‐ Outpatient ...................................................................................................................................... 41

PHAR 5691 Drug Information – Outpatient .......................................................................................................................... 44

PHAR 5693 Advanced Community Pharmacy ....................................................................................................................... 47

APPENDIX .......................................................................................................................................................................... 51

The QuEST/SCHOLAR‐MAC process – OTC Counseling ................................................................................................. 51

Documentation of OTC Consults Form: ........................................................................................................................ 52

DEA 222 Forms ............................................................................................................................................................. 53

Major Interaction Form ................................................................................................................................................. 55

Exam Topics ....................................................................................................................................................................... 56

Advanced Community Pharmacy Study Guide ............................................................................................................. 56

PHAR 5695 Geriatrics – Outpatient ...................................................................................................................................... 71

Drug Information Response Form ......................................................................................................................................... 74

Evaluation Forms for Ambulatory Care APPEs ...................................................................................................................... 75

Journal Club Evaluation Form ........................................................................................................................................... 75

Presentation Evaluation Form .......................................................................................................................................... 77

Drug Information Inquiry Evaluation Form ....................................................................................................................... 78

SOAP Note Evaluation Form ............................................................................................................................................. 80

Advanced Community Assignments Rubric ...................................................................................................................... 83

3

Office of Experiential Programs Contact Information

Please feel free to contact anyone listed below with questions or concerns. If there are any issues regarding a rotation,

site, or preceptor, please contact Dr. Tolleson, as soon as possible, for assistance.

Shane Tolleson, PharmD Director, Ambulatory‐Based Advanced Pharmacy Practice Experiences

(832) 842‐8369 (office)

E‐mail: [email protected]

Nancy Ordonez, PharmD Assistant Dean for Experiential Programs

(832) 842‐8337 (office)

E‐mail: [email protected]

Dmitry Vishnevetsky Program Manager

(713) 743‐6229 (office)

Email: [email protected]

Lupita Curiel Program Coordinator II

(832) 842‐8337 (office)

Email: [email protected]

4

PHAR 5644 Medication Therapy Management HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Ambulatory Care Medication Therapy Management Advanced Pharmacy Practice Experience is to

provide opportunities for students to build upon knowledge and skills acquired through didactic education and

Introductory Pharmacy Practice Experiences and apply them in direct patient care activities in the ambulatory care

setting. Students will actively participate in direct patient care using the elements of JCPP Pharmacist Care process which

includes obtaining patient medical and medication histories, providing drug regimen reviews, interviewing patients,

evaluating therapy adherence, developing medication management plans, monitoring patients' therapeutic outcomes,

consulting with physicians and non‐physician providers, and providing education to patients and health care

professionals. This course takes place in a community pharmacy or community pharmacy management office setting.

Team members may include pharmacists, physicians, physician assistants, nurse practitioners, nurses, and other

healthcare providers. This experience will be directed and evaluated by one or more preceptors.

Interprofessional Experience: The pharmacist is a member of an interdisciplinary team that serves the patient’s interest

above all other concerns. Team members may include pharmacists, physicians, physician assistants, nurse practitioners,

nurses, and other healthcare providers. This experience may be directed and evaluated by one or more preceptors.

PROFICIENCIES:

1. Apply pharmacotherapy principles and foundational knowledge to deliver patient‐centered care

2. In collaboration with the health care team, provide safe and effective patient care to a diverse patient

population following a consistent JCPP pharmacist patient care process

3. Administer medications to a diverse patient population

4. Ensure continuity of care during patient transitions between care settings

5. Apply pharmacy practice management skills related to human resources and informatics

6. Provide education to patients, caregivers, health care professionals, students, and the public (individuals and

groups) on prescription medications, self‐care products which may include alternative therapies, devices,

dietary supplement, and complementary medications using culturally competent methods

7. Communicate with health professionals effectively in oral and written format using appropriate

documentation methods and systems

8. Display professional behavior, self‐awareness, advocacy, and commitment to the profession

ASSESSMENTS:

1. Preceptor evaluations of student

a. Mid rotation

b. End of rotation

2. Intern self‐evaluations

5

a. Start of rotation – due by day 1 of rotation

b. Mid rotation – due before Monday of week 4 of rotation

c. End of rotation – due by Thursday of week 6 of rotation

3. Case Logs – due by Tuesday of week 6 of rotation:

a. To be graded by APPE Director

b. Interventions will be graded on quality and completeness. E‐value Case Logs will be utilized for

interventions.

c. You are encouraged to document all interventions at your site, not just the minimum that is required.

d. Minimum total requirement: 10

i. Submit a variety of drug related problems (DRPs) and interventions reflective of the learning

experience

ii. Recommended intervention types: Chronic Medication Adjustment, Complete Medication

Review (CMR) interventions

iii. Recommended DRP types: Drug‐Drug Interaction

e. For instructions on submitting a comprehensive case log, see video regarding Case Logs or Case Logs

slides in Blackboard

4. Assignments

a. 2 SOAP Notes

i. 1 SOAP note from before midpoint

ii. 1 SOAP note from after midpoint

iii. To be graded by preceptor using the standard rubric

iv. May be in format other than SOAP that is utilized by site

v. Must complete first note before next one is completed

vi. Student to upload completed evaluation form and HIPAA compliant/deidentified notes (if

permitted by site) via Evalue Portfolio – Non‐Reflective Folder – Written Assignment link by the

last onsite day of Week 6.

vii. Save file for upload as “SOAP‐APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX ‐

Course number

b. 1 Drug Information Request

i. Use standard Drug Information Response form

ii. To be graded by preceptor using the standard rubric

iii. Student to upload completed evaluation form and completed Drug Information Response form

via Evalue Portfolio – Non‐Reflective Folder – Written Assignment link by the last onsite day of

Week 6.

iv. Save file for upload as “DIQ‐APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX ‐

Course number

c. 1 Presentation

i. Examples of presentation include, but not limited to: patient case presentation, disease state

presentation, journal article evaluation, or other formal presentation as approved by preceptor.

ii. To be graded by preceptor using the appropriate rubric for presentation type

iii. Student is to upload completed evaluation form and handout/presentation slides to Evalue

Portfolio as directed on the evaluation form by the last onsite day of Week 6.

d. Others assignments or projects as deemed appropriate by preceptor for APPE

OTHER REQUIRED DOCUMENTS:

1. Hours logged properly in eValue

a. Minimum 240 hours

6

b. All verified by preceptor(s)

2. Student of Site Evaluation

3. Student of Preceptor Evaluation

GRADING PROCEDURES:

Grading will occur via electronic APPE evaluations on E‐Value. Students will receive a grade at midpoint that does not

count towards the final grade on a transcript. The grade received at midpoint evaluation will be utilized for student self‐

reflection and to set goals for the second remaining half of the rotation. Students will receive a final grade on the last

day of the APPE that will be transferred to the student’s transcript. Grading occurs via an automatic calculation present

in electronic evaluations in E‐Value.

Grading Criteria

The grading criteria is competency based. Minimal passing performance is 70%. A total of 500 points may be achieved

upon completion of the assigned APPE. These points are composed of scores as delineated below. The following

maximum point values may be achieved in each of the areas:

Final Evaluation from preceptor (rubric) 300 Points

Assignments 100 Points

Projects, assignments, interventions, evaluations Pass/Fail

Practice Experiential Director Grade* 100 Points

TOTAL 500 Points

*Practice Experiential Director Grade – Accountability points described in P&P manual

In order to receive a passing grade for the rotation the intern:

1. Must NOT receive three (3) or more Needs Improvement (NI) ratings on the end of rotation evaluation

2. Must NOT receive one Significant Deficits Exists (“SD”) rating on the end of rotation evaluation

3. Must earn points for a passing grade of “C” or above

Grading Scale:

A letter grade is assigned based on the total points earned.

Letter Grade Total APPE Rotation Points Percentage A 450 – 500 points 90 – 100% B 400 – 449 points 80 – 89% C 350 – 399 points 70 – 79% D 325 – 349 points 65 – 69% repeat APPE F Less than 325 points Below 65% repeat APPE

ADDITIONAL RESOURCES: Refer to Ambulatory Care APPEs Blackboard course

7

PHAR 5658 Association Management HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Association Management Advanced Pharmacy Practice Experience is to provide opportunities for

students to build upon knowledge and skills acquired through didactic education and Introductory Pharmacy Practice

Experiences and apply them in pharmacy association management. Students will actively participate in daily association

management practices, contributing to the various programs, products and services offered to pharmacy association

members. Practice sites may include NACDS, APhA or NCPA.




PROFICIENCIES:

1. Demonstrate proficiency in foundational sciences related to health care and pharmacotherapy

2. Review and revise coursework including lectures, skills labs, or other labs using a variety of instructional

strategies

3. Develop assessment for the measurement of student mastery of material presented

4. Communicates verbally and nonverbally with students, faculty, healthcare team and/or organization


ASSESSMENTS:


a. Mid rotation

b. End of rotation





3. Assignments

a. 1 Presentation




8



b. Other assignments or projects as deemed appropriate by preceptor for APPE







GRADING PROCEDURES:






Grading Criteria








TOTAL 500 Points






Grading Scale:


9



10

PHAR 5659 Specialized/Unique Pharmacy Practice HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Specialized/Unique Pharmacy Practice Experience is to provide opportunities for students to build upon

knowledge and skills acquired through didactic education and Introductory Pharmacy Practice Experiences and apply

them in a specialized or unique pharmacy practice environment. Students will actively participate in unique pharmacy

practices, contributing to the various programs, products and services offered to pharmacy association members.

Practice sites may include mail order pharmacies, specialty pharmacies or independent pharmacies.

PROFICIENCIES:

1. Apply foundational knowledge to manage safe and effective patient‐centered care

2. Apply principles of pharmacy practice management to pharmacy operations

3. Apply the systems approach to medication safety activities to identify and report medication errors

4. Apply pharmacy practice management skills related to human resources, medication resources, informatics,

pharmacy workload and financial performance

5. Communicate with healthcare personnel in a face to face, written or electronic media to reach optimal

outcomes


ASSESSMENTS:


a. Mid rotation

b. End of rotation





3. Assignments

a. 1 Presentation







11







GRADING PROCEDURES:






Grading Criteria








TOTAL 500 Points






Grading Scale:


Letter Grade Total APPE Rotation Points Percentage A 450 – 500 points 90 – 100%

12

B 400 – 449 points 80 – 89% C 350 – 399 points 70 – 79% D 325 – 349 points 65 – 69% repeat APPE F Less than 325 points Below 65% repeat APPE


13

PHAR 5660 Pharmaceutical Industry HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Pharmaceutical Industry Advanced Pharmacy Practice Experience is to provide opportunities for students

to build upon knowledge and skills acquired through didactic education and apply them in the pharmaceutical industry

setting. Students will actively participate in providing a medical information service while demonstrating knowledge

drug information systems, application of the primary drug literature in responding to drug information requests, and

effective oral and written communication skills. Team members may include pharmacists and physicians. This rotation

experience will be directed and evaluated by one or more preceptors.

Inter‐professional Experience: The pharmacist is a member of an interdisciplinary team that serves the patient’s interest



PROFICIENCIES:


2. Apply knowledge of the structural and functional dimensions of communicating medical information to health

care providers

3. Apply pharmacy practice management skills related to human resources, medication resources, informatics, and

customer relations

4. Communicate with health professionals effectively in oral and written format using appropriate documentation

methods and systems


ASSESSMENTS


a. Mid rotation

b. End of rotation





3. Assignments

a. 6 Drug Information Request

i. 1 request per week

ii. Use standard Drug Information Response form

14


iv. Student to upload completed evaluation form and completed Drug Information Response form


Week 6.

v. Save file for upload as “DIQ‐APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX ‐

Course number

b. 1 Presentation






c. Other assignments or projects as deemed appropriate by preceptor for APPE

GRADING PROCEDURES






Grading Criteria








TOTAL 500 Points






15

Grading Scale:




16

PHAR 5662 Academic Scholarship HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Academic Scholarship Experience is to provide opportunities for students to build upon knowledge and

skills acquired through didactic education in the academic setting. Students will actively participate in the daily details

of preparing for education of students in the PharmD program.

PROFICIENCIES:

1. Demonstrate proficiency in foundational sciences related to health care and pharmacotherapy

2. Review and revise coursework including lectures, skills labs, or other labs using a variety of instructional

strategies

3. Develop assessment for the measurement of student mastery of material presented

4. Communicates verbally and nonverbally with students, faculty, healthcare team and/or organization


ASSESSMENTS:


a. Mid rotation

b. End of rotation





3. Assignments

a. 1 Large Group Educational Delivery

i. Deliver educational content on an assigned topic to a group of students or other suitable

audience of greater than 60 individuals for at least estimated 45 minute time block

ii. To be graded by preceptor using the standard presentation rubric



b. 1 Small Group Educational Delivery

i. Deliver educational content on an assigned topic to a group of students or other suitable

audience of no greater than 35 for at least estimated 30 minute time block

ii. To be graded by preceptor using the standard presentation rubric



c. Assessment Questions

17

i. Develop and review questions for examination or other assessment for assigned topic

d. 1 Journal Club

i. Article discussed must be over healthcare profession education topic

ii. To be graded by preceptor using the Journal Club grading rubric



e. Other assignments or projects as deemed appropriate by preceptor for APPE







GRADING PROCEDURES:






Grading Criteria








TOTAL 500 Points






18

Grading Scale:




19

PHAR 5663 Pharmacy Management ‐ Outpatient HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Pharmacy Management Advanced Pharmacy Practice Experience is to provide opportunities for students

to build upon knowledge and skills acquired through didactic education and Introductory Pharmacy Practice Experiences

and apply them in pharmacy management. Students will actively participate in the managerial aspects of a community

pharmacy with an emphasis on financial, operational, and human resource management, to provide the knowledge and

skills necessary for initiating and maintaining a successful pharmacy practice. Practice sites may include chain

pharmacies or hospital outpatient pharmacies.




PROFICIENCIES:

1. Apply foundational knowledge to manage safe and effective patient‐centered care

2. Apply principles of pharmacy practice management to pharmacy operations




5. Communicate with healthcare personnel in a face to face, written or electronic media to reach optimal

outcomes


ASSESSMENTS:


a. Mid rotation

b. End of rotation





3. Assignments – due by last onsite day of week 6 of rotation

a. 1 Presentation



20











GRADING PROCEDURES:






Grading Criteria








TOTAL 500 Points






Grading Scale:

21




22

PHAR 5664 Legal and Regulatory HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Legal and Regulatory Advanced Pharmacy Practice Experience is to provide opportunities for students to

build upon knowledge and skills acquired through didactic education and Introductory Pharmacy Practice Experiences

and apply them on this rotation. Students will actively participate in the governmental framework within which

pharmacy is practiced, as well as acquire an understanding of the laws, regulations, and the ethical responsibilities

applicable to pharmacists so that they will be able to protect the public and ensure patient wellbeing. Practice sites

include Texas State Board of Pharmacy and Safety Net Pharmacy Association.




PROFICIENCIES:

1. Apply foundational knowledge to evaluate safe and effective patient‐centered care

2. Manage and prioritize workload

3. Participate in the daily function of the regulatory process of the organization

4. Communicate with pharmacists and health professionals effectively in oral and written format using appropriate



ASSESSMENTS:


a. Mid rotation

b. End of rotation





3. Assignments

a. 1 Presentation




23










Grading Procedures:






Grading Criteria








TOTAL 500 Points






Grading Scale:

24




25

PHAR 5668 Managed Care HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Managed Care Advanced Pharmacy Practice Experience is to provide opportunities for students to build

upon knowledge and skills acquired through didactic education and Introductory Pharmacy Practice Experiences and

apply them on this rotation. Students will gain practical experience and knowledge on managed care and the healthcare

system as a whole and actively participate in providing managed prescription drug benefit analysis in US healthcare

programs, including Medicare, Medicaid, and employer‐based programs. Practice sites include managed care sites such

as the Texas Children’s Managed Care Program.




PROFICIENCIES:

1. Apply foundational knowledge to evaluate safe and effective patient‐centered care

2. Provide safe, effective and cost‐effective patient care to a diverse patient population following a consistent JCPP

pharmacist patient care process in collaboration with the health care team



5. Apply knowledge of managed care principles

6. Communicate with pharmacists and health professionals effectively in oral and written format using appropriate



ASSESSMENTS:


a. Mid rotation

b. End of rotation





3. Assignments

a. 1 Presentation

26













Grading Procedures:






Grading Criteria








TOTAL 500 Points






27

Grading Scale:




28

PHAR 5670 Community Pharmaceutical Care HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Community Pharmaceutical Care Advanced Pharmacy Practice Experience is to provide opportunities for


Experiences and apply them in direct patient care activities in the community pharmacy setting. Students will actively

participate in direct patient care using the elements of JCPP Pharmacist Care process which includes obtaining patient

medical and medication histories, providing drug regimen reviews, interviewing patients, evaluating therapy adherence,

consulting with physicians and non‐physician providers, providing education to patients and health care professionals.

This experience will be directed and evaluated by one or more preceptors. Practice sites include independent

community pharmacies, chain compounding pharmacies, community specialty pharmacies, or health facility pharmacies.




PROFICIENCIES:


2. Provide safe, effective and cost‐effective patient care to a diverse patient population following a consistent JCPP

pharmacist patient care process in collaboration with the health care team

3. Accurately calculate and prepare medication products using correct techniques






groups) on prescription medications, self‐care products which may include alternative therapies, devices, dietary

supplement, and complementary medications using culturally competent methods


methods and systems


ASSESSMENTS:


a. Mid rotation

b. End of rotation

29








interventions.




experience

ii. Recommended intervention types: Disease/Condition Education, Drug Information




4. Assignments

a. 1 Presentation













GRADING PROCEDURES:






Grading Criteria





30




TOTAL 500 Points






Grading Scale:




31

PHAR 5672 Clinical Pharmaceutical Research HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Clinical Pharmaceutical Research Advanced Pharmacy Practice Experience is to provide opportunities for


Experiences and apply them in research based activities. Students will actively participate in bench research in the

pharmacy field as well as pharmacy practice based research. This experience will be directed and evaluated by one or

more preceptors.




PROFICIENCIES:

1. Apply pharmacotherapy principles and foundational knowledge to research

2. Apply research practice management skills related to medication use, informatics, and clinical outcomes

3. Communicate with students, health care professionals, and research personnel in oral and written format using

appropriate documentation methods and systems


ASSESSMENTS:


a. Mid rotation

b. End of rotation





6. Assignments – due by last onsite day of week 6 of rotation

a. 1 Presentation






32

b. Others assignments or projects as deemed appropriate by preceptor for APPE







GRADING PROCEDURES:






Grading Criteria








TOTAL 500 Points






33

Grading Scale:




34

PHAR 5673 Veterinary Pharmaceutical Care HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Veterinary Pharmacy Advanced Pharmacy Practice Experience is to provide opportunities for students to


and apply them in direct patient care activities in the ambulatory care setting. Students will actively participate in

veterinary patient care using the elements of JCPP Pharmacist Care process which includes obtaining patient medical

and medication histories, providing drug regimen reviews, interviewing patients, evaluating therapy adherence,

developing medication management plans, monitoring patients' therapeutic outcomes, consulting with physicians and

non‐physician providers, and providing education to veterinary patient’s caregivers and health care professionals. This

course takes place in veterinary pharmacy practice setting. Team members may include pharmacists, veterinarians,

nurses, and other healthcare providers. This experience will be directed and evaluated by one or more preceptors.

Practice sites include college of veterinary medicine and independent compounding pharmacies.




PROFICIENCIES:


2. In collaboration with the health care team, provide safe and effective patient care to the veterinary patient

population following a consistent JCPP pharmacist patient care process

3. Accurately calculate, compound and prepare sterile and non‐sterile medication products using correct

techniques



6. Apply pharmacy practice management skills related to human resources and informatics

7. Provide education to veterinary patient caregivers and health care professionals (individuals and groups) on

prescription medications using culturally competent methods


methods and systems


ASSESSMENTS:


a. Mid rotation

35

b. End of rotation








interventions.




experience

ii. Recommended intervention types: Disease/Condition Education




4. Assignments

a. 2 SOAP Notes










Course number






Week 6.


Course number

c. 1 Presentation






d. Other assignments or projects as deemed appropriate by preceptor for APPE



36





GRADING PROCEDURES




day of the APPE that will be transferred to the student’s3transcript. Grading occurs via an automatic calculation present


Grading Criteria








TOTAL 500 Points






Grading Scale:




37

PHAR 5675 and PHAR 5696 Ambulatory Care Disease State Management and

Primary Care HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Ambulatory Care Advanced Pharmacy Practice Experience is to provide opportunities for students to


and apply them in direct patient care activities in the ambulatory care setting. Students will actively participate in direct

patient care using the elements of the JCPP Pharmacist Care process, which includes obtaining patient medical and

medication histories, providing drug regimen reviews, interviewing patients, evaluating therapy adherence, developing

medication management plans, monitoring therapeutic outcomes, consulting with physicians and non‐physician

providers, and providing education to patients and health care professionals. This course takes place in an ambulatory

care, multidisciplinary practice setting. Practice sites may include hospital‐based clinics, physician group practices,

community or public health clinics, managed care facilities that provide health care directly to patients, or similar

practice settings. Team members may include pharmacists, physicians, physician assistants, nurse practitioners, nurses,

and other healthcare providers. This experience will be directed and evaluated by one or more preceptors.




PROFICIENCIES:


2. In collaboration with the health care team, provide safe, effective and cost‐effective patient care to a diverse

patient population following a consistent JCPP pharmacist patient care process



5. Apply the systems approach to medication safety activities to identify and report medication error





supplements, and complementary medications using culturally competent methods


methods and systems


38

ASSESSMENTS:


a. Mid rotation

b. End of rotation








interventions.




experience

ii. Recommended intervention types: Chronic Medication Adjustment, Disease/Condition

Educations




4. Assignments

a. 2 SOAP Notes










Course number






Week 6.


Course number

c. 1 Journal Club

i. To be graded by preceptor using Journal Club evaluation rubric

ii. Student to upload completed evaluation form and handout/presentation slides via Evalue

Portfolio – Non‐Reflective Folder – Journal Club Review link by the last onsite day of Week 6.

39

iii. Save file for upload as “JC‐APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX ‐ Course

number

d. 1 Case Presentation

i. To be graded by preceptor using Case Presentation evaluation rubric

ii. Student to upload completed evaluation form and handout/presentation slides via Evalue

Portfolio – Non‐Reflective Folder – Presentations link by the last onsite day of Week 6.

iii. Save file for upload as “PRES‐APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX ‐

Course number

e. Other assignments or projects as deemed appropriate by preceptor for APPE







GRADING PROCEDURES






Grading Criteria








TOTAL 500 Points




40



Grading Scale:




41

PHAR 5686 Psychiatry ‐ Outpatient HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Psychiatry Pharmacy Advanced Pharmacy Practice Experience is to provide opportunities for students to



psychiatric patient care using the elements of JCPP Pharmacist Care process which includes obtaining patient medical

and medication histories, providing drug regimen reviews, interviewing patients, evaluating therapy adherence,

developing medication management plans, monitoring patients' therapeutic outcomes, consulting with physicians and

non‐ physician providers, and providing education to veterinary patients’ caregivers and health care professionals. This

course takes place in psychiatry pharmacy practice setting. Team members may include pharmacists, physician, nurses,

and other healthcare providers. This experience will be directed and evaluated by one or more preceptors.




PROFICIENCIES:


2. In collaboration with the health care team, provide safe, effective and cost‐ effective patient care to a diverse








groups) on prescription medications, self‐ care products which may include alternative therapies, devices,

dietary supplements, and complementary medications using culturally competent methods


methods and systems


ASSESSMENTS:


a. Mid rotation

42

b. End of rotation








interventions.




experience

ii. Recommended intervention types: Chronic Medication Adjustment, Disease/Condition

Education interventions




4. Assignments

a. 2 SOAP Notes










Course number






Week 6.


Course number

c. 1 Presentation






d. Other assignments or projects as deemed appropriate by preceptor for APPE


43






GRADING PROCEDURES:





in electronic evaluations in E‐ Value.

Grading Criteria








TOTAL 500 Points






Grading Scale




44

PHAR 5691 Drug Information – Outpatient HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Drug Information Advanced Pharmacy Practice Experience is to provide opportunities for students to



providing a drug information service while demonstrating knowledge drug information systems, application of the

primary drug literature in responding to drug information requests, and effective oral and written communication skills.

Team members may include pharmacists and physicians. This rotation experience will be directed and evaluated by one

or more preceptors.




PROFICIENCIES:


2. Apply knowledge of the structural and functional dimensions of a Drug Information Service




methods and systems


ASSESSMENTS:


a. Mid rotation

b. End of rotation





3. Assignments

a. 6 Drug Information Request

i. 1 request per week

45

ii. Use standard Drug Information Response form


iv. Student to upload completed evaluation form and completed Drug Information Response form


Week 6.

v. Save file for upload as “DIQ‐APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX ‐

Course number

b. 1 Presentation






c. Other assignments or projects as deemed appropriate by preceptor for APPE







Grading Procedures:





in electronic evaluations in E‐ Value.

Grading Criteria








TOTAL 500 Points


46





Grading Scale:




47

PHAR 5693 Advanced Community Pharmacy HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Advanced Community Advanced Pharmacy Practice Experience is to provide opportunities for students

to build upon knowledge and skills acquired through didactic education and Introductory Pharmacy Practice Experiences

and apply them in direct patient care activities in the community pharmacy setting. Students will actively participate in

direct patient care using the elements of JCPP Pharmacist Care process which includes obtaining patient medical and

medication histories, providing drug regimen reviews, interviewing patients, evaluating therapy adherence, developing

medication management plans, monitoring patients' therapeutic outcomes, consulting with physicians and non‐

physician providers, and providing education to patients and health care professionals. This course takes place in a

community pharmacy setting. Practice sites include moderate volume community pharmacies with adequate OTC. This

experience will be directed and evaluated by one or more preceptors.




PROFICIENCIES:

1. Apply pharmacotherapy principles and foundational knowledge to deliver patient‐ centered care

2. Appropriately prepare, dispense, and administer medications to a diverse patient population

3. Identify, document and manage medication safety issues

4. Consult and advise patients and caregivers on prescription medications, self‐care products, alternative

therapies, devices, dietary supplements, and complementary medications

5. Manage the medication use system effectively

6. Participate in the promotion of public health

7. Collaborate with interprofessional healthcare members to optimize patient health and medication outcomes

8. Apply pharmacy practice management skills related to human resources, medication resources, pharmacy

data systems, pharmacy workload and financial performance


groups) on prescription medications, self‐care products which may include alternative therapies, devices,

dietary supplement, and complementary medications using culturally competent methods

10. Communicate with a diverse patient population, caregiver, and health care professional to reach optimal

outcomes


48

ASSESSMENTS:


a. Mid rotation

b. End of rotation








interventions.

c. You are encouraged to document all interventions at your site, not just the minimum that is

required.



experience

ii. Recommended intervention types: Counseling, Device; Counseling, Pediatric; Drug Information

iii. Recommended DRP types: Medication Error


slides.

4. Assignments

a. 3 Self‐Care (OTC) Educations

i. Use standard form in Appendix titled “Documentation Form for OTC Consult”

ii. Preceptor to give feedback for first 2 OTC consults and grade final OTC consult using grading

rubric

iii. Student to upload completed evaluation form and completed final documentation form via

Evalue Portfolio – Non‐Reflective Folder – Advanced Community link by the last onsite day of

Week 6.

iv. Save file for upload as “OTC‐APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX ‐

Course number

b. 1 RPh and technician schedule for one week.

i. To be graded by preceptor using the standard rubric

ii. Student to upload completed evaluation form and completed schedule via Evalue Portfolio –

Non‐Reflective Folder – Advanced Community link by the last onsite day of Week 6.

iii. Save file for upload as “SCHED‐APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX ‐

Course number

c. 1 DEA 222 Form

i. Use either a de‐identified form from store or the blank one in the Appendix to document form

completion.


iii. Student to upload completed evaluation form and completed 222 form via Evalue Portfolio –

Non‐Reflective Folder – Advanced Community link by the last onsite day of Week 6.

iv. Save file for upload as “222‐APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX ‐

Course number

d. 2 Major Interactions

i. Use standard form in Appendix titled “Major Interaction Form,” complete with resolution


49

iii. Student to upload completed evaluation form and completed interaction form via Evalue

Portfolio – Non‐Reflective Folder – Advanced Community link by the last onsite day of Week 6.

iv. Save file for upload as “INTRX‐APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX ‐

Course number

e. Others assignments or projects as deemed appropriate by preceptor for APPE


1. Advanced Community Assignments Grading Rubric – due by last onsite day of week 6 of rotation

a. Preceptor to complete the grading rubric for the 4 assignments – each out of 100 points. The preceptor

will enter grades from the assignments on EValue Preceptor End of Rotation evaluation.

b. Student to upload completed evaluation form and completed Drug Information Response form via

Evalue Portfolio – Non‐Reflective Folder – Advanced Community link by the last onsite day of Week 6.

c. Save file for upload as “AC‐APPE#PHAR5693LastNameFirstName”; # = Rotation block






GRADING PROCEDURES:






Grading Criteria

Grading Criteria is competency based. Minimal passing performance is 70%. A total of 500 points may be achieved upon

completion of the assigned APPE. These points are composed of scores as delineated below. The following maximum

point values may be achieved in each of the areas:


Final Exam 100 points




TOTAL 500 Points

50



1. Must earn a minimum of 70% on the Advanced Community Pharmacy examination




Grading Scale:




51

APPENDIX

The QuEST/SCHOLAR‐MAC process – OTC Counseling

Qu – Quickly and accurately assess the patient; ask about current complaint using the SCHOLAR process:

o S – Symptoms – what are the main and associated/related symptoms?

o C – Characteristics – what are the symptoms like?

o H – History – what has been done so far? Has this ever happened before, and if so, what was done?

What was successful, what wasn’t?

o Onset – when did this particular problem start?

o L – Location – where is the problem?

o A – Aggravating factors – what makes it worse?

o R – Remitting factors – what makes it better?

E – Establish that the patient is an appropriate candidate for self‐care. Use the following to guide your decision:

o No severe symptoms (subjective assessment, but important)

o No symptoms that persist or return repeatedly

o No self‐treating to avoid necessary medical care

S – Suggest appropriate self‐care strategies

o Medications

o General care measures

T – Talk with the patient

o Medication Action

o Administration

o Adverse effects and their management

o What to expect from treatment

o What is appropriate follow‐up: when, with whom, for what

M – Medications – ask about OTC and Rx meds, and natural products/vitamins/therapeutic foods, etc.

A – Allergies – ask about all allergies (meds, environmental, chemical, etc.)

C – Conditions – ask about medical conditions, diseases – when diagnosed, how treated, etc.

Determine a plan for follow‐up and assessing response, where appropriate.

52

Documentation of OTC Consults Form: Documentation of OTC Consults:

Student Name: Date:

Assessment

Symptoms:

Symptom severity (circle one):

Mild Moderate Severe 1 2 3 4 5 6 7 8 9 10

Characteristics:

History:

Onset:

Location:

Aggravating Factors:

Relieving/Remitting Factors:

Allergies:

Meds (Rx and OTC):

Medical Conditions

Is the patient a candidate for OTC therapy (explain):

Suggest a product: What was recommended? List product, dosing, other pertinent information: Product/Dosage form:

Dose for patient/condition:

Notes:

TALK/Counseling:

Follow‐up: When and with whom?

RPh to call patient (circle one)? Yes No Date/Time for Follow‐up:

53

DEA 222 Forms

55

Major Interaction Form Major Interaction Form

Student Name: Date:

Drug:

Description of Interaction:

Category/source:

Resolution:

56

Exam Topics Students will take the exam online on ExamSoft

1) Product identifications including trade name, generic name, primary indication, usual d o s i n g schedule, and

side effects.

2) Pharmacy law questions as it applies to community practice.

3) Questions covering OTC products, third party programs, patient counseling, and pharmaceutical care topics.

4) Required Reading material

5) Math exam ‐ questions including:

a) Prescription markups

b) Gross profit calculations

c) Miscellaneous commercial calculations

d) Temperature conversions

e) W/W, W/V, V/V problems

Advanced Community Pharmacy Study Guide Over The Counter (OTC)

What OTC products can be recommended to a person with diabetes?

What OTC Products can be recommended to a person with hypertension?

What OTC Products can be recommended to a woman who is pregnant? During the 1st trimester: During the 3rd

trimester:

Throughout the entire pregnancy:

What OTC medications can be used during lactation?

Pediatrics

57

What is the pediatric dosing for the following drugs?

Aspirin

Acetaminophen

Ibuprofen

Trimethoprim/Sulfamethoxazole

Amoxicillin (otitis media)

Erythromycin

Pseudoephedrine

Analgesics/Antipyretics

List the OTC analgesic/antipyretic drugs that may be given to infants 0 to 2 years with dosing, potential side effects, and

contraindications:

List the OTC analgesic/antipyretic drugs that may be given to children 2 years and up with dosing, potential side effects,

and contraindications:

For the following analgesics list: OTC Brand Names, OTC length of use, maximum OTC dose, side effects, and

contraindications:

Acetaminophen

Aspirin

Ibuprofen

Ketoprofen

58

Naproxen Sodium

What herbal or nutraceutical products are available OTC for analgesic, antipyretic, or joint pain? List their brand name,

active ingredients, label uses, and recommended dosage.

Antacids & H2 Antagonists

Name the use and common side effects with the following product ingredients:

Sodium Bicarbonate

Calcium Carbonate

Aluminum Magnesium

Aluminum and Magnesium Hydroxides

What medications can interact with antacid products?

59

Name the MAJOR active ingredients in the following products: Gas‐X, Gaviscon, Mylanta, Mylicon, Rolaids

List the H2 antagonist products available OTC including: Brand Name, active ingredients, recommended dosage,

contraindications for use, and side effects.

What proton pump inhibitor is available OTC for heartburn? What is its length of use OTC, contraindications for use, and

side effects?

Laxatives/Antidiarrheals/Antigas/Hemorrhoidal Products

What is the mechanism of action of each of the following laxatives, active ingredients, recommended dosage, and give

an example of each one:

Stimulants

Bulk‐forming

Emollient

Lubricant

Saline enemas

Suppositories

What advice would you give to patients concerning laxative products?

60

List the anti‐gas products available OTC with brand name, active ingredient and dose.

List the antidiarrheal products available OTC with brand name, active ingredient, dose, and mechanism of action of the

active ingredient.

List the hemorrhoidal products available OTC with brand name, active ingredient, and dose.

Cough/Cold/Allergy Products

List the brand name and generic name of products in the following categories also name the use, a major side effect, a

contraindication and suggested dosing (if it is a combination product, list in all categories that apply)

Antihistamines

Drowsy

Non‐Drowsy

Decongestants

Antitussives

61

Expectorants

Cough suppressants

What is the difference between a humidifier and a vaporizer?

Vitamins/Minerals

What are the fat‐soluble vitamins?

What are the water‐soluble vitamins?

Calcium Supplements – list the brand name, strengths, and recommended dosage

Calcium citrate

Calcium lactate

Calcium gluconate

62

Calcium carbonate

Which of the calcium supplements has the best absorption?

Which of the calcium supplements has the least effect on the stomach? i.e., stomach pain and nausea, etc.

Name the major drug interactions with calcium products:

Iron Supplement – list the Brand Name, strengths, and recommended dosage

Ferrous sulfate

Ferrous gluconate

Ferrous fumarate

Which of the iron supplement has the best absorption? Name the major drug interactions with iron products:

Herbal Products

What are the uses, side effects and contraindications of the following:

Glucosamine Chondroitin

63

DHEA

St. John’s Wort

Zinc lozenges

Ginseng Ginkoba

Garlic Echinacea

Golden Seal

Green Tea Extract

Sleep Aids and Sedative Products

What is the major active ingredient of the following? List dosage and recommend length of use.

Nytol

Sominex

Tylenol PM

Unisom

What is Melatonin and what is its mechanism of action?

64

List OTC topical products for analgesia, active ingredients and recommended use:

List OTC topical antibacterial products, active ingredients, and recommended use:

List OTC topical antiseptic products, active ingredients, and recommended use:

List OTC topical anti‐itch products, active ingredients, and recommended use:

List OTC topical antifungal products, active ingredients, and recommended use:

List OTC vaginal antifungal products, active ingredients, and recommended use:

65

List OTC wart products, active ingredients, and recommended dosage:

Other OTC Products/Areas

What is Syrup of Ipecac and how should it be used?

What is the product “Swimmer’s Ear”?

What is “pinkeye” and what OTC preparation(s) can be use for it?

What is the best treatment for an insect bite?

What is “Dr. Smith’s Ointment” and what is it use for?

List 3 ear and 5 eye products; give their use, active ingredients, major side effects and contraindications.

Define and explain the following and give examples:

1. Return on Equity:

66

2. Gross Margin Percentage:

3. Current ratio:

4. Quick ratio:

5. Inventory turnover:

6. Break even analysis of a business:

7. Prescription pricing using the:

a) Markup method

b) Professional fee method

c) Sliding scale method

8. Inventory control terms:

a) Acquisition cost

b) Procurement costs

c) Carrying costs

9. What is a prime vendor?

10. What is a “gross profit?”

67

SAMPLE COMMERCIAL CALCULATONS

1. Calculate the retail price on a prescription item (exclusive of additional professional fees, cost of the container,

etc) if the item costs $3.50 and a 100% markup on the cost is desired.

2. What percent of gross profit would be realized on the item in problem 1?

3. Calculate the selling price of an article which was bought at $6.00 per dozen, if the overhead was 25% of the

gross sales and the new profit was 8% of the selling price.

4. The gross sales of a store are $380,000 per year and the total overhead is $120,000. At what price must an

article be sold if it costs $8.00 per dozen and the store is to make a 10% net profit?

5. An order of toys cost $350.00 plus $20.00 freight. The selling price for the whole lot is $550.00, and other

overhead expenses are 25% of sales. What percent net profit is realized?

68

6. A solution manufacturer packs 6 bottles of the solution to each case. The bottles of solution cost the buyer

$1.50 each, less a 40% trade discount. On the purchase of 48 cases or more, an additional 15% discount is given, plus a

2% cash discount. Calculate the buyer’s cost of 12 dozen cases of the merchandise, bought under the foregoing terms, if

the freight on the shipment is prepaid.

SAMPLE COMMERCIAL CALCULATIONS/ANSWERS

1. Calculate the retail price on a prescription item (exclusive of additional professional fees, cost of the container,

etc) if the item costs $3.50 and a 100% markup on the cost is desired.

Cost = $3.50

$ 3.50 x 100% = $3.50, the amount of markup

$ 3.50 + $ 3.50 = $7.00, the retail price

Answer: $7.00

2. What percent of gross profit would be realized on the item in problem 1?

$ 3.50 (mark‐up)/ $7.00 (selling price) x 100% = 50 %

Answer: 50%, the percent of the gross profit based on the selling price.

3. Calculate the selling price of an article which was bought at $6.00 per dozen, if the overhead was 25% of the

gross sales and the new profit was 8% of the selling price.

12 articles cost $6.00

69

$6.00 divided by 12 = $0.50, cost of one article 100% = s e l l i n g price

100% ‐ { 25% (overhead) + 8% (net profit) } = cost 100% ‐ 33% (gross profit) = 67%, the cost of the article

$0.50 = 67% of the selling price X = 100% of the selling price 67 X = 50

X = $0.746 or $0.75, the selling price of the article

Answer: $0.75, the selling price of the article

4. The gross sales of a store are $380,000 per year and the total overhead is $120,000. At what price must an

article be sold if it costs $8.00 per dozen and the store is to make a 10% net profit?

12 articles cost $8.00

$8.00 divided by 12 = $0.67, the cost of one article

$120,000/$380,000 x 1 0 0 % = 31.5%, the overhead

31.5% (overhead) + 10 % (net profit) = 4 1 . 5 % markup or GP

100% (total sales) ‐ 4 1 . 5 % (gross profit) = 5 8 . 5 %, the cost of the article based on

the selling price

Therefore: $0.67 (cost)/1.14 = 58.5%

Answer: $1.14, the selling price of the article based on the given overhead, if a 10% net profit is to be realized

5. An order of toys cost $350.00 plus $20.00 freight. The selling price for the whole lot is

$550.00, and other overhead expenses are 25% of sales. What percent net profit is realized?

Total costs = $350.00 + $ 20.00 = $ 370.00 Overhead = $550.00 x 0 .25 = $ 137.50

70

Total expense = $370.00 + 1 3 7 . 5 0 = $ 507.50

$550.00 ‐ $ 507.50 = $42.50

$42.50/$550.00 X 100% = 7 . 7 3 %

Answer: 7.73%

6. A solution manufacturer packs 6 bottles of the solution to each case. The bottles of solution cost the buyer

$1.50 each, less a 40% trade discount. On the purchase of 48 cases or more, an additional 15% discount is given, plus a

2% cash discount. Calculate the buyer’s cost of 12 dozen cases of the merchandise, bought under the foregoing terms, if

the freight on the shipment is prepaid.

12 dozen cases = 12 x 12 = 144 cases

144 x 6 (bottles/case) = 864 bottles bought 1 bottle costs $1.50 less a 40% trade discount

$1.50 x 0.40 = $0.60, the amount of trade discount on one bottle

$1.50 x 0.60 = $0.90, the cost per bottle less the trade discount

$0.90 x 0.15 = $0.135, the amount of the quantity discount

$0.90 ‐ $0.135 = $0.765, the cost per bottle less the quantity discount

$0.765 x 0.02 = $0.0153, the amount of the cash disc.

$0.765 ‐ $0.0153 = $0.75, the net cost per bottle

$0.75 x 864 bottles = $648.00, the net cost of the lot of merchandise

Answer: $648.00, the net cost of the lot of merchandise

71

PHAR 5695 Geriatrics – Outpatient HOURS CREDIT: 6

COURSE PURPOSE:

The goal of the Geriatric Advanced Pharmacy Practice Experience is to provide opportunities for students to build upon

knowledge and skills acquired through didactic education and Introductory Pharmacy Practice Experiences and apply

them in direct patient care activities in the ambulatory care setting. Students will actively participate in direct patient

care using the elements of JCPP Pharmacist Care process which includes obtaining patient medical and medication

histories, providing drug regimen reviews, interviewing patients, evaluating therapy adherence, developing medication

management plans, monitoring patients' therapeutic outcomes, consulting with physicians and non‐physician providers,

and providing education to long term care patients and health care professionals. Team members may include

pharmacists, physicians, and other healthcare providers. This experience will be directed and evaluated by one or more

preceptors. Practice settings include long term care facilities and hospital outpatient areas.




PROFICIENCIES:


2. In collaboration with the health care team, provide safe, effective and cost‐effective patient care to a diverse









supplement, and complementary medications using culturally competent methods


methods and systems


ASSESSMENTS:


a. Mid rotation

72

b. End of rotation








interventions.




experience

ii. Recommended intervention types: Chronic Medication Adjustment



slides.

4. Assignments

a. 2 SOAP Notes










Course number






Week 6.


Course number

c. 1 Presentation









73




GRADING PROCEDURES:






Grading Criteria








TOTAL 500 Points






Grading Scale:




74

Drug Information Response Form Drug Information Response Form

Student Name: _______________________

Site Name: ___________________________ APPE #: _____ APPE Name: _______________________________

REQUEST INFORMATION

Date received: ____________ Requestor Name: ___________________

Time received: ___________ Call back/pager number: _____________

Requestor profession/relation (check all that apply): __MD/DO __DDS __Nurse __Pharmacist __Preceptor __Patient __Public __Other: _____________ How received (check all that apply):

__Phone __Voice mail __Email __Fax __In‐person __Other: ________________ Priority (check one): __Urgent __High __Routine __Low

QUESTION/REQUEST:

RESPONSE WITH SUPPORTING INFORMATION:

REFERENCES:

75

Evaluation Forms for Ambulatory Care APPEs

Journal Club Evaluation Form TEXAS CONSORTIUM ON EXPERIENTIAL PROGRAMS JOURNAL CLUB EVALUATION FORM

STUDENT NAME:_____________________________________________

DATE:____________________________________

SCORING

CRITERIA SCORE COMMENTS

Background Demonstrated knowledge of covered disease state and medication(s) Identified pertinent prior studies and results relating to trial Justified necessity of trial

Methods Explained and critiqued hypothesis, objectives and methods Identified the study population Interpreted and critiqued statistics Addressed validity of methodology

Results Discussed efficacy and safety outcomes Evaluated the statistical and clinical significance of results

Discussion/Conclusion Critiqued authors’ discussion/conclusion Developed personal conclusion using background information and results of trial Addressed strengths and weakness of trial Considered contribution of trial to clinical practice Determined whether a specific patient or patient population falls within the study population Indicated whether the results of the study can be applied to specific patient or patient population. If not, identified what additional information was needed to do so. Provided therapeutic recommendations for study population & specific patient or population

Preparation Worked from notes and was not “reading” the presentation

Exceeds Expectations (EE) – 10 points )

Meets Expectations (ME) – 8.7 points

Needs Improvement (NI) – 7 points

Significant Deficits Exist (SD) – 5 points

Student has excelled in performing competency Student performs above expectations and requires minimal guidance from preceptor

Student performed the competency at an acceptable level Student has met expectations but requires occasional guidance from preceptor

Student has not consistently demonstrated the competency at an acceptable level Student requires frequent guidance from preceptor

Student has rarely demonstrated the competency at an acceptable level Student requires continual guidance from preceptor and often does not complete tasks

76

Answered direct questions appropriately Showed confidence regarding subject matter Used outside information to enhance quality of analysis

Presentation Format Points presented logically Well organized Addressed all major sections of trial Quality and quantity of data presented relevant to trial Oriented audience to data tables and graphs

Presentation Style Appropriate volume Used eye contact Communicated answers to questions in an informed, authoritative, and respectful manner Appropriate pace; not rushed or garbled Used correct grammar and proper syntax

OVERALL COMMENTS:

TOTAL SCORE: ______/ ______ FINAL: ______ % EVALUATOR NAME:

_____________________________________________

If student receives 2 or more “NI” or any “SD” or overall score of below 70%, student must follow up with Office of

Experiential Programs.

Students: Upload completed evaluation form and handout/presentation slides via Evalue Portfolio – Non‐Reflective

Folder – Journal Club Review. Save file as “JC‐APPE#PHAR56XXLastNameFirst Name”. Due last onsite day of Week

6. #=Rotation block; XX=course number.

Presentation Evaluation Form TEXAS CONSORTIUM ON EXPERIENTIAL PROGRAMS PRESENTATION EVALUATION FORM 2019‐2020

STUDENT NAME:_____________________________________________ DATE:____________________________________

SCORING

Exceeds Expectations (EE) – 10 points Meets Expectations (ME) – 8.7 points Needs Improvement (NI) – 7 points Significant Deficits Exist (SD) – 5 points

Student has excelled in performing

competency.

Student performs above expectations

and requires minimal guidance from

preceptor

Student performed the competency at

an acceptable level

Student has met expectations but

requires occasional guidance from

preceptor

Student has not consistently

demonstrated the competency at an

acceptable level

Student requires frequent guidance from

preceptor

Student has rarely demonstrated the

competency at an acceptable level

Student requires continual guidance from

preceptor and often does not complete

tasks

TOTAL SCORE: ______/ ______ FINAL: ______ % EVALUATOR NAME: ____________________________________________________

If student receives 2 or more “NI” or any “SD” or overall score of below 70%, student must follow up with Office of Experiential Programs.

Student to upload completed evaluation form and handout/presentation slides via Evalue Portfolio – Non-Reflective Folder – Presentations link by the last onsite day of Week 6. Save file for upload as “PRES-APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX - Course number

Style SCORE COMMENTS

Handout(Appropriate length; arrangement; references listed in appropriate format; clear; accurate)

Audiovisuals

(Clear; appropriate; appealing; organized)

Delivery/Language

(appropriate rate/volume; utilized eye contact; absent of distracting mannerisms; spoke clearly; prepared;

professional appearance; avoided reading presentation; grammatically correct; good transitions)

Organization

(Clear arrangement of ideas; good transitions)

Content SCORE COMMENTS

Research & Knowledge

(Depth of research; analysis of material; appropriate references)

Discussion of Topic

(Appropriate recommendations; rationale of conclusions; summarized material; essential elements presented)

Questions & Answers

(ability to defend responses to questions; understanding of questions asked; ability to handle difficult questions)

Overall Comments

78

Drug Information Inquiry Evaluation Form TEXAS CONSORTIUM ON EXPERIENTIAL PROGRAMS DRUG INFORMATION INQUIRY EVALUATION FORM

STUDENT NAME:_____________________________________________ DATE:____________________________________

SCORING

CRITERIA SCORE COMMENTS Drug Information Question Clearly defined the drug information question Summarized the question or therapeutic dilemma Identified and retrieved pertinent data and information

Literature Sources Utilized appropriate literature sources Utilized a variety of primary, secondary, and tertiary literature sources (if available) Interpreted primary, secondary, and tertiary literature appropriately (e.g., does not indicate that one case study is applicable to an entire population)

Literature Review and Evaluation Critiqued the literature utilized to answer the question Summarized available data

Conclusion/Answer/Response Reached an evidenced‐based conclusion Applied information from critical analysis of literature (e.g., recommendation matches literature review) Applied therapeutic and pharmacologic knowledge

Format of Presented Material Written – Organized, concise response that is grammatically correct and has no typographical errors Verbal – Organized, concise explanation using appropriate language for the inquirer and good pace, volume, and tone of voice Fielded questions effectively Cited references

Exceeds Expectations (EE) – 10 points ) Meets Expectations (ME) – 8.7 points Needs Improvement (NI) – 7 points Significant Deficits Exist (SD) – 5 points

Student has excelled in performing competency Student performs above expectations and requires minimal guidance from preceptor

Student performed the competency at an acceptable level Student has met expectations but requires occasional guidance from preceptor

Student has not consistently demonstrated the competency at an acceptable level

Student has rarely demonstrated the competency at an acceptable level Student requires continual guidance from preceptor and often does not complete tasks

79

CRITERIA SCORE COMMENTS

Professionalism Worked independently (minimal assistance required) Prepared for follow‐up questions Displayed initiative to understand information surrounding the specific drug information question (e.g., if asked about a hypertension medication, student is also able to describe guideline recommendations for hypertension management) Used available resources to critically think and make a final recommendation/conclusion (e.g., does not end question with “there needs to be more studies”)

Timeliness in response Answered question in an appropriate time based on the acuity of the situation

OVERALL COMMENTS:

TOTAL SCORE: ______/ ______ FINAL: ______ % EVALUATOR NAME: _____________________________________________

If student receives 2 or more “NI” or any “SD” or overall score of below 70%, student must follow up with Office of Experiential Programs.

Student to upload completed evaluation form and handout/presentation slides via Evalue Portfolio – Non-Reflective Folder – Written Assignment link by the last onsite day of Week 6. Save file for upload as “WA-APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX - Course number

SOAP Note Evaluation Form TEXAS CONSORTIUM ON EXPERIENTIAL PROGRAMS

PATIENT ENCOUNTER (SOAP NOTE) EVALUATION FORM

STUDENT NAME: DATE:

SCORING

Exceeds Expectations (EE) –

10 points )

Meets Expectations (ME) –

8.7 points

Needs Improvement (NI) –

7 points

Significant Deficits Exist (SD) –

5 points

Student has excelled in

performing competency

Student performs above

expectations and requires

minimal guidance from

preceptor

Student performed the

competency at an

acceptable level

Student has met

expectations but requires

occasional guidance from

preceptor

Student has not consistently

demonstrated the

competency at an acceptable

level

Student requires frequent

guidance from preceptor

Student has rarely

demonstrated the competency

at an acceptable level

Student requires continual

guidance from preceptor and

often does not complete tasks

SCORE COMMENTS

I.

Patient Interview Information – Subjective Information Chief Complaint

History of Present Illness

Past Medical History

Family History

Social History

Medications

Allergies (including reaction)

81

II. Patient Interview & Chart/Patient Profile Info. ‐ Objective Information Vitals

Actual, ideal, and adjusted (if necessary) body weight and

heightPhysical Exam (if applicable)

Relevant Labs (please state if missing or unable to obtain)

III. Identification of Disease & Drug Therapy Problems List of disease states in an appropriate order of priority

List of medications

List of preventative health related issues

IV. Assessment of identified problems & establishment of

specific goals for each problem

Appropriate goals in line with current consensus guidelines

and literature

Assessments and goals succinct and complete

V. Development of the Action Plan

Alteration of Dosing Regimens (if applicable) including

name, dose, route, & frequency of administration.

Desired outcomes (time frame for results, magnitude of

results)

Side effects/Adverse reactions

Recommended laboratory, vitals, or physical exam monitoring (including frequency of labs) Time frame for the patient to return for next visit.

VI. Verbal Communication Skills Audible

Enunciation

Appropriate rate and tone to reflect interest

Easy to understand/listen to

Proper pronunciation and use of medical terms

Lack of distracting mannerisms

Shows polish, poise as a speaker

Outstanding eye contact (e.g. rarely uses notes)

82

VII. Overall SOAP Note Logically organized

Comprehensive summary of patient encounter, assessment, and plan

VIII. Response to Questions Questions were correctly answered

Clear justification was given for each of their responses

TOTAL SCORE: ______/ ______ FINAL: ______ % EVALUATOR NAME:_______________________________________

If student receives 2 or more “NI” or any “SD” or overall score of below 70%, student must follow up with Office of

Experiential Programs.

Student to upload completed evaluation form and handout/presentation slides via Evalue Portfolio – Non-Reflective Folder – Written Assignment link by the last onsite day of Week 6. Remove (or black out) all patient identifiers before upload. Save file for upload as “SOAP-APPE#PHAR56XXLastNameFirstName”; # = Rotation block; XX - Course number

OVERALL COMMENTS:

Advanced Community Assignments Rubric

Instructions: Circle the score for each criteria that best reflects the student’s performance.

Self‐Care OTC Counseling (out of 100 points) 25 POINTS 22 POINTS 19 POINTS Patient Assessment (25 points) - Obtained assessment information about symptoms, allergies, current medications and

medical conditions for assessment -

Accurately and completely gathered ALL

relevant patient information components.

Accurately and completely gathered MOST relevant

patient information components.

Did not accurately and completely gather most of the relevant patient

information components.

Establish patient candidate for OTC Therapy (25 points) - Appropriate discussion of primary patient problem (epidemiology, treatment, etc.) - Depth of research and utilization of primary literature - Analysis of material (article was properly analyzed and interpreted) - Appropriateness of references from primary literature and guidelines

Accurately and completely established

OTC candidate

Did not accurately and completely established

OTC candidate

OTC Counseling (25 points) - Appropriateness of recommendations

Counseled on drug product – dose, monitoring parameters

Accurately and completely discussed ALL

relevant information

Accurately and completely discussed MOST relevant

information

Did not accurately and completely discuss most relevant information

Communication Style & Professionalism (25 points) - Appropriate volume and articulates words well - Maintains eye contact - Appropriate pace; not rushed or garbled; Uses correct grammar and proper syntax; No

distracting mannerisms - Professional demeanor and appearance

Completely addressed ALL communication & professionalism criteria

Addressed MOST communication &

professionalism criteria

Did not address most communication &

professionalism criteria

Scores – Add all the scores under each column

Grade = Add all the scores from all the columns (out of 100 points. This is the grade to enter on EValue Preceptor End of Rotation grade for assignments.

DEA Schedule 222 Form (out of 100 points) 25 points 22 points 18 points - Fill out the Name of Supplier, Address, City, State

Accurately and complete

Mostly Accurately and complete

Not Accurate and complete

- Date filling out form

Accurately and complete Mostly Accurately and

complete Not Accurate and

complete

- Number of packages, size, strength, dosage form



complete

- Enter the number of lines used



complete

PHAR 5693 Advanced Community Assignments Rubric

Student: ________________________________________________________________

Course: _______________________ Evaluator: _______________________________

84

- Signature of agent



complete


Grade = Add all the scores from all the columns (out of 100 points. This is the grade to enter on EValue Preceptor End of Rotation grade for assignments

Pharmacist & Technician Schedule for 1 week (out of 100 points) 25 points 22 points 18 points - Pharmacist: Gathered preferences from pharmacist with regards to schedule



complete

- Technician: Gathered preferences from technicians with regards to schedule



complete

- Schedule criteria: Established criteria for number of pharmacists & technician per shift



complete

- Communication: Professional in communication with both pharmacists and technicians when gathering preferences and communicating the final schedule



complete



Major Drug Interaction Form (out of 100 points) 25 points 22 points 18 points Identified drugs involved in interaction



complete

Described drug interaction Accurately and complete



Category of drug interaction severity (Major, Moderate, Minor) Accurately and complete



Resolution of drug interaction Accurately and complete





Overall Comments:

Student to upload completed evaluation form and assignment documents via Evalue Portfolio – Non‐Reflective Folder – Advanced Community link by the last onsite day of Week 6. Remove (or black out) all patient identifiers before upload. Save file for upload as “AC‐APPE#PHAR5693LastNameFirstName”; # = Rotation block

the university of houston college of pharmacy doctor of ......4. assignments a. 2 soap notes i. 1...

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