The following information provides explanation and expectations for some of the assignments. Readings and tools to assist you in completing your assignments are also available through the Canvas content page. The Experiential Checklists and evaluation forms can also be found in the Appendices.
In addition to informal feedback given at the completion of an assignment, clinical instructors will also provide formal feedback regarding knowledge and skill development during the IPPE experience using the 13-point student performance tool.
Drug Information/Resources
Explanation: Referencing guidelines is common practice across a multitude of pharmacy settings. The process to identify and analyze information within an unfamiliar guideline can be time consuming. The purpose of this activity is to familiarize student knowledge of guidelines to enhance the student’s ability to efficiently identify and apply pertinent information.
Expectations:
- Identify a clinical guidelines for a commonly encountered condition at the practice site. Review the guideline, then discuss key recommendations and/or highlights from a subsection (e.g. therapeutic recommendations for adults within GINA guidelines, recent guideline updates, etc.) with the preceptor.
- If applicable, compare and contrast how the national guidelines compare with the institutional guidelines
Medication Reconciliation
Explanation:Patients are often referred to a number of health care providers throughout the healthcare system, creating opportunities for miscommunication and misinformation regarding medications. Patients may inadvertently or intentionally take medications differently from how they were prescribed. It is essential that pharmacists have the skills to explore the source of discrepancies identified between what was prescribed and how their patients may be taking the medication.
Expectations:
- For the institutional rotation, students should complete at least 2 medication reconciliations (either admission med rec or discharge med rec). Remember that obtaining an accurate medication history is an important step in the medication reconciliation process.
- For community and elective rotations, students should participate in medication reconciliation as available.
Medication Counsultations
Explanation: Ensuring that patients understand how to use a new medication and evaluating the benefits and side effects of currently-used medications are important contributions of the pharmacist in patient care.
Expectations:
- Provide medication counseling on new prescriptions.
- Provide medication counseling on existing medications (prescription and over-the-counter).
- Provide patient with an updated medication list.
- Take steps to ensure patient understanding of consultation.
NonPrescription Drugs & Self-Care
Explanation: Non-prescription medications play an important role in patient care. Sometimes non-prescription medicines are recommended by prescribers, but very often sought by patients who wish to self-treat a condition. Pharmacists, particularly those in community practices, play a key role in assisting patients in making self-care decisions. Indeed, this type of patient care activity well illustrates the pharmacist as a primary care provider, the first point of contact for the patient as they seek care. In this role, the pharmacist serves to triage and provide advice about the potential benefits of self-care versus referral to other health care providers for further diagnosis and treatment.
Expectations:
- Review the document entitled QuEST Scholar Process found in Canvas.
- Use an appropriate reference (e.g. Handbook of Non-prescription Drugs) to find information.
- Assist a patient, under the supervision of the clinical instructor, in making a self-care decision.
Note: Clinical instructor may use the QuEST Scholar Process Evaluation Form to provide verbal feedback to student on self-care consult.
Pharmacokinetic Dosing & Monitoring
Explanation:Pharmacists are involved in ensuring accurate dosing of medications through therapeutic drug monitoring and pharmacokinetic calculations. Pharmacists are heavily relied upon to adjust doses of medications for drugs with complex pharmacokinetics and/or narrow therapeutic windows.
Expectations:
- Identify patient prescribed a drug(s) that requires calculations and/or pharmacokinetic drug monitoring. Common examples include:
- Anticoagulation
- Antibiotics (e.g., vancomycin, aminoglycosides)
- Pediatric weight-based dosing
- Renal dose adjustments for acute kidney injury, dialysis, continuous renal replacement therapy, etc.</li
- Immunosuppressants
- Assess appropriateness of dosing by performing necessary calculations.
- Review calculations with preceptor and discuss if a change in therapy is warranted.
- Document calculation and necessary change in medical record under supervision of preceptor.
Complex Medication Regimen Reviews
Explanation: Pharmacists are involved in performing medication regimen reviews to ensure drug therapy is both safe and effective for patients. Pharmacists should assess the following items during a medication regimen review: indication; drug dose, frequency, duration; therapeutic duplication; drug allergy or intolerance; adverse drug reactions; drug interactions; need for additional therapy; adherence and associated barriers; patient knowledge and understanding of drug therapy. Identification, assessment, and resolution of drug-related problems by a pharmacist can improve patient outcomes.
Expectations:
- Choose a medication profile in which the patient is using five or more medications.
- Review the patient’s medical record to identify drug-related problems
- Assess the drug-related problems identified and develop a plan for addressing the drug-related problems
- Discuss the developed plan with your pharmacist preceptor
- After discussion with preceptor, implement interventions by communicating with patient and care team.
Documentation
Explanation: Documentation is at the center of the Pharmacist Patient Care Process (PPCP) and is an important skill that pharmacists will utilize across practice settings. Documentation improves communication among healthcare providers, provides justification for billing and reimbursement, and allows the healthcare team to effectively monitor and evaluate patients.
Expectations:
- Students should create documentation for recommendations from the complex medication regiment review, pharmacokinetic dosing/monitoring, or other clinical interventions that they are involved in.
- The documentation can be in the form of a SOAP note, SBAR note, or another template used at clinical site.
Public Health (Immunization & Tobacco Cessation)
Explanation: Preventive care includes many screenings and interventions designed to assist healthy patients in maintaining their health. Ensuring that patients are fully immunized is one aspect of assisting patients in avoiding infectious diseases. Pharmacists, in all practice settings, are able to assess the immunization status of their patients and make recommendations. In some settings, they may be able to provide necessary immunizations.
Tobacco cessation is another intervention which can prevent illness. Again, pharmacists are often able to initiate the conversation with patients to ascertain smoking status and interest in smoking cessation. In some settings, they may also provide interventions to assist patients in quitting tobacco use.
Expectations:
- Discuss how pharmacist is involved in promoting necessary immunization for patients. As available, students should participate in the following:
- Administer vaccines under supervision of pharmacist
- Review patient profile(s) and determine what vaccines are indicated
- Outreach patients to discuss vaccines needed and schedule
- Discuss how pharmacist is involved in promoting tobacco cessation for patients. As available, students should participate in the following:
- Review available tobacco cessation products and discuss with preceptor
- Screen patient and provide tobacco cessation education as necessary
Regulatory (Pharmacy Self-Inspection
Explanation: Maintaining standards for pharmacy practice sites is an important component of ensuring patient safety. Self-inspection of practice sites is one aspect of maintaining standards.
Expectations:
- Perform an inspection of the pharmacy using tools found at the State of Wisconsin Department of Safety and Professional Services.
Clinical Inquiry
Explanation: Answering questions posed by patients and other health care providers is an important part of pharmacy practice. About 20% of questions may require a review of the primary medical literature looking for the best evidence from which an answer can be derived. The clinical inquiry assignment will provide students with an opportunity to systematically research primary and secondary medical literature to find the highest quality evidence available to answer the clinical question. In short, you will frame the clinical question into the PICO format, research the literature using evidence-based principles taught in previous courses and in 728-625, and answer the question in the format of a clinical inquiry.
Expectations:
- Students are required to attend a series of workshops that will serve as tutorials on the process of preparing a clinical inquiry. Attendance and completion of assignments associated with workshops will contribute to the final course grade.
- Students will be assigned a question by course faculty. Students must submit their final clinical inquiry paper by the specified deadline (see table below) in the appropriate drop box in Canvas.
- A Clinical Inquiry faculty member will use the Criteria for Clinical Inquiry Evaluation in evaluating and scoring the clinical inquiry.
- As listed in the Outcome Tracker, if you score less than 70%, you will be required to remediate the assignment. The following strategies will be used to remediate an assignment earning a score of less than 70:
- For students who fail to turn in their assignment by the deadline, the submitted paper will receive an initial score of zero. After the clinical inquiry faculty member evaluates and scores the late submission, the final score for the assignment will be based on a score derived from averaging (zero + score) from the submitted paper, assuming that the submitted paper was given a grade of 70% or better. The maximum final score able to be earned on a late assignment will be 50%.
If a paper submitted late does not receive a score of at least 70%, the student will be required to edit the assignment to achieve a score of at least 70% and the grade will be averaged as stated previously. - For students who submit their clinical inquiry on time, but do not earn a score of at least 70%, the clinical inquiry faculty member will ask the student to edit and resubmit the assignment. The final score for the assignment will be based on a score derived from averaging the scores of the two papers; the maximum final score able to be earned will be 70%
- For students who fail to turn in their assignment by the deadline, the submitted paper will receive an initial score of zero. After the clinical inquiry faculty member evaluates and scores the late submission, the final score for the assignment will be based on a score derived from averaging (zero + score) from the submitted paper, assuming that the submitted paper was given a grade of 70% or better. The maximum final score able to be earned on a late assignment will be 50%.
- Due dates for workshop assignments and for final clinical inquiry paper will be posted in Canvas course page.
Smart Goals & Reflections
Expectations:
- Students are expected to develop SMART goals at the start of the academic year (May 2021) and submit in Canvas
- Students are expected to complete a reflection after each IPPE rotation for a total of 4 reflections throughout the academic year. The reflection is due by 11:59pm on the last day of block.