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Quick Assignment Index
Student Performance Evaluation (SPE) (55%)
Explanation: In addition to frequent informal feedback student performance in this course will be formally evaluated at the midpoint and at the end of the rotation.
Expectations: The clinical instructor will use the Midpoint evaluation to provide formative feedback around the 3-week point in the course. The Final evaluation will be summative and reflect performance throughout the rotation. This score will factor into the student’s course grade.
Evaluation: The clinical instructor will use the online SPE tool to evaluate the student. The score will be entered in the Grading Record. More information about the Student Performance Evaluation is in the General Manual.
Pharmacist’s Patient Care Process (PPCP) Documentation (15%)
Explanation: The Pharmacist’s Patient Care Process helps achieve a patient-centered approach to health care that underscores the importance of collaboration (teamwork) between pharmacists and other healthcare professionals to optimize patient health and medication outcomes. This allows for comprehensive evaluation of the patient and documentation of the care provided.
Expectations: All patients on the team should be monitored using the framework provided by the Pharmacist’s Patient Care Process. Applying the PPCP model should be consistent with the practice of the pharmacists and the institution.
A suggested duration of monitoring is 5 days or length of stay whichever is less. However, there may be situations when the Clinical instructor deems it appropriate to follow the patient for a longer period of time and this is to their discretion.
The documentation is in any format deemed appropriate by the Clinical instructor and their institution. The 5 steps of the PPCP will form the basis for assessing the student’s therapeutic drug monitoring proficiency. Reassessment happens throughout the patient’s stay in the hospital. Information collected about the patient, plan modification, and monitoring must be updated on a daily basis. Documentation can be entered directly into the patient’s health record or into an external documentation system at the discretion of the institution.
See the Appendices for more detailed information about the PPCP Model and the PPCP Monitoring Philosophy.
Evaluation: Students are required to complete and formally document in-depth notes throughout the rotation. Two of these will be graded. Both scores will be reported on the Grading Record for this activity.
See the Appendices for the PCCP Evaluation Form.
Case Presentation (10%)
Explanation: This presentation is an opportunity to share and discuss a patient’s disease state and therapeutic management with their instructor and colleagues. The case will provide each student with the opportunity to practice public speaking.
Expectation: A 30-minute presentation will be completed during the clerkship rotation. The patient to be presented will be selected by the student with input from the Clinical instructor. The date/time and method of delivery will be determined by the Clinical instructor. Students are expected to stand throughout the presentation in a style consistent with presenting a formal lecture. Create slides using a technology platform like PowerPoint.
If you are assigned to a site with multiple 740 students please attend the case presentations of the other students whenever possible.
- See the Appendices for more detailed information about the Case Presentation
Evaluation: Evaluation of the student will be completed using the Case Presentation Evaluation Form.
Drug Information Questions (10%)
Explanation: The activity is designed to underscore the important contribution that pharmacist’s make to patient care as a drug information expert.
Expectations:
It is anticipated that a Clinical instructor or members of the interprofessional team will ask the student pharmacist many drug information questions. Questions should challenge the student requiring a review of evidence, analysis and critical thinking. The question and answer should be clinically relevant to the care of a patient on the student’s service.
Two of the questions will be assessed and scored according to the activity rubric. Students may use primary, secondary and/or tertiary sources of information as appropriate to answer the question. This activity is expected to be meaningful.
Before reporting information to the care team, the student will review the response to the question with the Clinical instructor.
Evaluation:
Two drug information questions/responses will be formally assessed by the Clinical instructor during the rotation. These scores will be recorded on the student’s electronic grading record.
- The following criteria will be considered when assigning an overall score (there is no formal rubric other than criteria listed below). Response is timely (24-hours or less is recommended, but instructor has discretion).
- Summarizes the question asked by the instructor or member of the team.
- Cites the evidence used to answer the question , including the student’s assessment of the reliability of the source of the information.
- Responds to the question with sufficient detail to result in action by the recipient.
Scoring:
| Not done | 0 |
| Unacceptable | 1 |
| Partially acceptable | 2 |
| Acceptable | 3 |
Medication Histories and Medication Consultations (5%)
Explanation: Students are expected to demonstrate that they can document medication histories and perform patient consultations. These activities will be performed under the direct observation of their Clinical instructor(s) until they have demonstrated acceptable performance allowing more independence with these skills. Practicing on a daily basis will help refine the approach and ensure their best abilities get formally evaluated.
Expectations: Students will be expected to assist with medication histories and medication consultations for all patients on their team. There may also be opportunities to serve as a consultant in other areas of the facility to assist with the same. See the Appendices for more detailed information about the evaluation forms, examples of collection tools, and pointers for successful completion
Histories: Two medication histories will be evaluated during the rotation using the patient history (admission/interview) evaluation form.
If your institution does not generally perform patient medication histories, accommodations must be made for you to complete this activity. For example, a member of the pharmacy staff could play the role of a patient.
Consultations: Two medication consultations will be formally evaluated during the rotation using the consultation evaluation form. In the event that the patient has several medications/new medications, the student will be responsible for consulting with the patient on all medications. However, the student will be evaluated on only two of them in detail. The 2 drugs to be formally evaluated must be determined by the Clinical instructor prior to the consultation.
A care transition from the hospital to any other setting has been identified as a contributing factor for medication errors and the potential for adverse drug events. This activity will be an opportunity for students to engage in the discharge medication reconciliation process. For at least 1 of the graded consultations, students must contact the patient’s home pharmacy or the facility to which the patient is being discharged. The student will perform a “hand off” by providing information about the patient’s medications (new, changed, same, discontinued) by reconciling the discharge medication summary with the pharmacy or facility being contacted. If a paper form is part of the process, the student will prepare the form manually or electronically per hospital process/policy.
Evaluation: The 2 medication histories and 2 medication consultation will be graded. Please use separate grading forms for each. These scores will be recorded on the student’s electronic grading record.
Institutional Activities (5%)
Explanation: There are some activities unique to acute care or opportunities to provide consideration of how topics apply in this setting.
Expectations:
- Recommend appropriate medication dosing utilizing practical pharmacokinetic principles.
Ideally one of the two required PPCP notes should include a pharmacokinetic drug assessment. Alternatively, a focused assessment of a patient could allow for these recommendations. Medications that are commonly monitored in the acute care setting according to recommended serum drug concentrations may include: vancomycin, tobramycin, gentamicin, phenytoin, digoxin, voriconazole, and tacrolimus or others as established by the institution. Students are expected to perform the pharmacokinetic calculations and recommend an initial dose and/or recommend a maintenance dose modification. - Management of medical emergencies.
Students are expected to perform an emergency cart (box) check for expired or soon to be expired meds and participate in the replacement of those medications according to policy. During the cart (box) check, students should observe which drugs are in the cart and should be familiar with the use of each of those medications. This will be facilitated by checking in with pharmacists and technicians in the central pharmacy who are involved.
Using the Management of Medical Emergencies Template, students must select 7 emergency medications and document the purpose of the medication, how the drug is dosed, and any special monitoring.
Examples of medications include, but are not limited to: adenosine, amiodarone, atropine, calcium chloride, dextrose 50%, dobutamine, dopamine, epinephrine, esmolol, flumazenil, lidocaine, magnesium sulfate, naloxone, nitroprusside, norepinephrine, phenylephrine, sodium bicarbonate, vasopressin, nitroglycerin. There may be institutional differences in the make-up of the emergency cart(box).
The completed template will be posted to the course page. - Medication errors and adverse drug reactions.
Students must be familiar with the institution’s internal medication error reporting system and are expected to participate in the reporting of a medication error using the institution’s internal reporting system. The student is also expected to report an adverse drug event using the institution’s internal reporting system. If it meets the serious ADE criteria additional reporting to the FDA’s MedWatch system and/ or to the ISMP Medication Error Reporting Program should be completed. - Providing pharmacist-delivered patient care to a diverse patient population.
Diversity can be found in each person’s identity, culture, background, experience, status and abilities. Here are some areas to reflect on as you consider your patients individually and collectively:- Did you find yourself more similar to or different from your patients? How did this impact your interactions with them? What if the roles had been reversed?
- What challenges and/or barriers, both anticipated and unexpected, came up in your interactions with individuals who may identify differently that yourself? How did these impact your ability to care, in order to ensure appropriate medication use and follow up? What was your approach to overcoming these?
- How might this inform future approach to providing care to populations that identify differently than yourself??
- What could you do differently in the future to provide more equitable care to your patients?
Evaluation: Each activity will be assigned a score of 0 to 12 using the Institutional Activities Rubric.
Students MUST earn a final score of 6 or better on each activity. The assignment should be repeated until a score of 6 or better is earned. If an activity must be repeated, the maximum score that can be earned is “6”. (For example, if the first attempt at completing an activity earns a score of 4 and the repeated activity earns a score of 10, the instructor will enter a score of 6 on the grading record).
These scores will be recorded on the student’s electronic grading record.
Student Rotation Self-Evaluation (Required)
Explanation: As professionals and lifelong learners developing a sound process of self-evaluation is important to your development throughout your career. Soon your assessments will be more internally driven and this is an opportunity to develop and refine your approach.
Expectations: See the Student Rotation Self-Evaluation Process for details. It is particularly valuable to compare your evaluation to that of your Clinical instructor and look for and discuss similarities and differences.
The following is an overview of the process:
- A BASELINE self-evaluation is done ONCE prior to the start of the first APPE rotation of the year. The baseline self-evaluation must be reviewed with the site Clinical instructor during the first week of the first block.
- SMART Goals must be entered by the end of week 2 for each block.
- In subsequent blocks, the post-rotation self-evaluation from the previous block must be reviewed with the site clinical instructor during the first week.
Evaluation:
A post-rotation self-evaluation must be completed at the end of each rotation. It must be reviewed by the student and Clinical instructor during the last week of each block. Failure to complete the self-evaluation will result in an “incomplete” for the block until this is satisfactorily resolved.
Reflection On Rotation (required)
Meaningful Experience During the Rotation
Explanation: Impactful moments will be different for each individual depending on the experiences they bring and gain from their rotation.
Evaluation: The reflection will be posted to the course page. It will not be formally evaluated though does serve as a snapshot of your experience and may inform changes to the rotation and its activities.
Expectations: Students will write a paragraph reflecting on a learning opportunity or memorable professional development event that occurred during the rotation.
iTOFT (Required)
Explanation: As valued members of the interprofessional team it is important to be present and positively contribute. The iTOFT tool provides feedback for the student pharmacist on their contributions to the team and its collective decision making.
Expectations: This can be used to evaluate individual or longitudinal experience within the team. At minimum it should be formally completed once by the Clinical Instructor during the rotation.
See the APPE Evaluations in the General Manual for a full description of the tool.
Evaluation: The iTOFT evaluation is accessible in the grading record. This score is not factored into the final course grade.