Pharmaceutical Sciences, Faculty of
DSpace
Entry-to-Practice PharmD Program
University of British Columbia. Office of Experiential Education
Mira, Aileen
Taheri, Asal
INPATIENT PRACTICUMS HANDBOOK FOR STUDENTS AND PRACTICE EDUCATORSIntroductory and Advanced Pharmacy Practice Experiences (IPPE, APPE) – InpatientEntry-to-Practice PharmD ProgramEffective May 2018 – 2019Course Course Coordinator PHRM 272 (IPPE) Aileen Mira PHRM 472 (APPE) Asal Taheri PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 2 Table of Contents Acknowledgement ........................................................................................................................................ 4 Introduction .................................................................................................................................................. 5 SECTION 1 – GENERAL INFORMATION.......................................................................................................... 6 1.1 Office of Experiential Education ................................................................................................ 6 1.2 Policies ....................................................................................................................................... 9 1.3 Educational Outcomes ............................................................................................................. 10 SECTION 2 – INTRODUCTORY AND ADVANCED PHARMACY PRACTICE EXPERIENCES (IPPE, APPE) – INPATIENT ................................................................................................................................................... 12 2.1 Direct Patient Care Practicum Goals and Learning Objectives ................................................ 13 2.1.a Knowledge................................................................................................................ 13 2.1.b Skills (Provision of Pharmaceutical Care) ................................................................. 14 2.1.c Attitudes and Behaviors (Professionalism) .............................................................. 16 2.2 Assessment Processes.............................................................................................................. 19 2.3 Grade Assignment .................................................................................................................... 21 2.3a Supplemental Assessments ...................................................................................... 22 2.4 Overview: Inpatient Practicum Course Activities .................................................................... 23 2.5 Course Schedule ....................................................................................................................... 24 2.5.a PHRM 272 Course Schedule ..................................................................................... 25 2.5.b PHRM 472 Course Schedule .................................................................................... 26 SECTION 3 – REQUIRED COURSE ACTIVITIES .............................................................................................. 28 3.1 Handbook Instructions ............................................................................................................. 28 3.2 E*Value Learning Modules Coursework: Process .................................................................... 29 3.3 Student Introduction Resume .................................................................................................. 32 3.4 Learning Contract ..................................................................................................................... 34 3.5 Orientation to Inpatient Pharmacy Medication Distribution System – PHRM 272 ................. 37 3.6 Orientation to the Clinical Pharmacist’s Role – PHRM 272 ..................................................... 41 3.7 Orientation to the Patient Medical Record – PHRM 272 ......................................................... 44 3.8 Inpatient Pharmacy Practice Reflection – PHRM 272 .............................................................. 47 3.9 Medication Reconciliation – PHRM 272 .................................................................................. 49 3.10 Counseling – PHRM 272 ......................................................................................................... 53 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 3 3.11 Interprofessional Collaboration ............................................................................................. 55 3.12 Drug Information Response .................................................................................................. 57 3.13 Provision of Pharmaceutical Care .......................................................................................... 61 3.14 Clinical Reasoning Reflection – PHRM 472............................................................................. 64 3.15 Presentation – PHRM 472 ...................................................................................................... 66 3.16 Service .................................................................................................................................... 69 3.17 Self-Assessment – PHRM 472 ................................................................................................ 71 REFERENCES ................................................................................................................................................ 73 SECTION 4 – APPENDIX 1: REQUIRED FORMS ............................................................................................. 75 4.1 UBC Pharmacy Student Health and Safety Orientation ........................................................... 75 4.2 72 Hour Checklist ..................................................................................................................... 77 4.3 OEE Resume Template ............................................................................................................. 80 4.4 Learning Contract Form ........................................................................................................... 83 4.5 PHRM 472 E*Value Learning Modules Coursework – Clinical Reasoning .............................. 85 4.6 PHRM 472 Assessment Guide for Clinical Reasoning Reflection ............................................. 86 4.7 PHRM 472 Presentation Evaluation Form ............................................................................... 88 4.8 PHRM 472 E*Value Learning Modules Coursework – Self Assessment .................................. 89 4.9 Student Evaluation of Practice Educator and Practice Site ..................................................... 90 4.10 Student Evaluation of OEE Course ......................................................................................... 92 4.11 PHRM 272 Practice Educator Assessment of Student ........................................................... 94 4.12 Direct Patient Care Practice Educator Assessment of Student (PHRM 472) ......................... 97 SECTION 5 – APPENDIX 2: REQUIREMENTS CHECKLISTS .......................................................................... 102 5.1 Requirements Checklist for Best Possible Medication History (BPMH) Interview ................ 102 5.2 Requirements Checklist for Best Possible Medication Discharge Plan (BPMDP) Counseling 104 5.3 Requirements Checklist for Counseling ................................................................................. 106 5.4 Requirements Checklist for Drug Information Responses (DIR) ............................................ 108 5.5 Requirements Checklist for Inpatient Presentation to Practice Educator ............................. 110 5.6 Requirements Checklist for Allergy Assessment .................................................................... 112 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 4 Acknowledgement UBC’s Point Grey Campus is located on the traditional, ancestral, and unceded territory of the Musqueam people. The land it is situated on has always been a place of learning for the Musqueam people, who for millennia have passed on in their culture, history, and traditions from one generation to the next on this site. The Office of Experiential Education would like to thank the many individuals who have generously permitted the adaptation of their materials in the revision of our learner handbooks and policies, with individual recognition to Ann Thompson, Andrea Cameron, Harriet Davies and Doreen Leong. These handbooks would not have been possible without the hard work of students Alice Wang and Deanna Lo and their assistance with the compilation of materials. We would also like to recognize Marguerite Yee, Amin Bardai, Rosemin Kassam and Angela Kim-Sing for their past contributions to our program. Thank you to the following groups for their collaboration and sharing of ideas: College of Pharmacists of British Columbia British Columbia Pharmacy Association Canadian Society of Hospital Pharmacists Drug and Poison Information Centre Association of Faculties of Pharmacy of Canada Pharmacy Experiential Programs of Canada PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 5 Introduction The mission of the Office of Experiential Education is to create and facilitate the structured learning opportunities necessary for students to develop the knowledge, skills and professional attributes required for direct-patient care roles and innovative pharmacy practice upon graduation. The Office of Experiential Education is responsible for the facilitation of more than 1000 placements each year for our entry-to-practice pharmacy programs (B.Sc.(Pharm) and Pharm D) and the Canadian Pharmacy Practice (CP3) Program for our international pharmacy graduates. Working closely with our experiential education sites and partners, we aim to provide students with valuable hands-on experience within a variety of pharmacy practice settings under the supervision and guidance of qualified pharmacist practice educators. Experiential education is an integral component of student learning. Students begin experiential education with the introductory pharmacy practice experience (IPPE) practicums in the early years of the program and continue to the advanced pharmacy practice experience (APPE) practicums in fourth year. These practicums are progressive and structured to provide students with the learning experiences necessary to develop and refine the student’s communication and technical skills and the ability to apply the necessary knowledge and skills to provide evidence-based patient-centered care within the real-world work environment. By the completion of their programs, we strive for our students to gain confidence in clinical decision making, be proficient in the delivery of direct patient care and be valued as a collaborative member of the health care team. The Faculty is grateful to the many dedicated pharmacists that enthusiastically embrace our students at their practice sites each year. Our practice educators are the backbone of our experiential education program and their unwavering commitment and dedication is invaluable to the professional growth of our students. We thank each of our practice educators for their ongoing collaboration with the Faculty and the critical role they play in the clinical education of our students. Kind regards, Dr. Janice Yeung, BSc.(Pharm), ACPR, Pharm D Director, Office of Experiential Education PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 6 SECTION 1 – GENERAL INFORMATION 1.1 Office of Experiential Education Dr. Janice Yeung Director (604) 827 4846 janice.yeung@ubc.ca Ms. Tricia Murray Program Administrative Manager (604) 827 0183 tricia.murray@ubc.ca Faculty Course Coordinator & Portfolio Course Number, Description Mr. Gilly Lau Structured Practical Training & Community Engagement (IPPE) (604) 827 4044 gilly.lau@ubc.ca PHRM 171 Introductory Pharmacy Practice Experience (IPPE) – Outpatient I PHRM 473 Selected Advanced Pharmacy Practice Experience (APPE) – Outpatient Direct Patient Care Settings Ms. Kayla Fang Service Learning & Community Engagement (Non-Rx) (604) 827 0041 kayla.fang@ubc.ca Dr. Neelam Dhaliwal Practice Educator Development & Community Engagement (Rural/Remote) (604) 827 4243 neelam.dhaliwal@ubc.ca PHRM 270 Community Service Learning PHRM 271 Introductory Pharmacy Practice Experience (IPPE) – Outpatient II PHRM 371 Introductory Pharmacy Practice Experience (IPPE) – Outpatient III Mr. Paulo Tchen Student Transition (Outpatient), Community Engagement (APPE), & Community Outreach (604) 827 0173 tchen6@mail.ubc.ca PHRM 471 Advanced Pharmacy Practice Experience (APPE) – Outpatient PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 7 Ms. Aileen Mira Student Transition (Inpatient), Health Authority Engagement (IPPE) & Non-Direct Patient Care (NDPC) (604) 827 0782 aileen.mira@ubc.ca PHRM 251 Institutional Practice Skills Course PHRM 272 Introductory Pharmacy Practice Experience (IPPE) – Inpatient PHRM 473 Selected Advanced Pharmacy Practice Experience (APPE) – Non-Direct Patient Care Settings Ms. Asal Taheri Inpatient Practice & Health Authority Engagement (APPE) (604) 822 6107 asal.taheri@ubc.ca PHRM 472 Advanced Pharmacy Practice Experience (APPE) – Inpatient PHRM 473 Selected Advanced Pharmacy Practice Experience (APPE) – Inpatient Direct Patient Care Settings Mr. Larry Leung Interprofessional Education (604) 827 2482 larry.leung@ubc.ca IPE Activities are embedded or are scheduled on the Program Enhanced Activity Day (PEAD) Longitudinal Learning Mr. Jason Min Interprofessional Education (604) 827 2478 jason.min@ubc.ca IPE Activities are embedded or are scheduled on the Program Enhanced Activity Day (PEAD) Longitudinal Learning Faculty members provide support to practicum sites, practice educators, and students for any issues related to:  Course syllabi  Practicum-associated assignments and activities  Student assessment and evaluation  Student performance  Student absences  Personal injury or major illness of students on practicum  Any confidential issues related to the practicum PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 8 Should students have any questions or issues requiring discussion with a faculty member, please contact the front desk to schedule an appointment. Appointments are available Monday to Thursday, 8.30am to 3pm, Fridays 8.30am to 12 noon. Administrative Support Team Ms. Kimberly Mascarenas Senior Program Assistant (604) 822 3216 kim.mascarenas@ubc.ca Ms. Arleni Abanto Senior Program Assistant (604) 822 0433 arleni.abanto@ubc.ca Ms. Vicky Lai Front Desk (604) 822 8077 phar.oee@ubc.ca The administrative staff provides support to practicum sites, practice educators and students for:  General enquiries  Practicum scheduling and placements  Practice educator or student contact information  E*Value access  Tracking  Mailings, forms etc.  UBC Cards Off-Hours Issues If you have immediate safety concerns for yourself or others, please call 911. Crisis and After-Hours Contacts  Vancouver Crisis Line | 1 800 SUICIDE (784 2433)  Vancouver General Hospital | 604 875 4111  Campus Security | 604 822 2222  Crisis Centre BC | http://crisiscentre.bc.ca/  Victim Link | 1 800 563 0808 (services in 110 languages)  Empower Me | 24/7 accessible counselling services for students with AMS health care o Call 1 (844) 741-6389 (toll-free) from anywhere in North America to be directly connected to the Empower Me Clinical Response Center o Log in to Empower Me (https://ear.powerflexweb.com/1545/login_SC.html) using "Studentcare" as the password or o Download additional Empower Me student assistance tools through the iAspiria mobile app (http://aspiria.ca/students/?stu-link=map) by entering "Studentcare" as the Login ID and selecting "Student" in the dropdown menu  UBC Counselling Services | 604 822 3811 o On campus support Monday to Friday, 8.30am-4.30pm o https://students.ubc.ca/health-wellness/mental-health-support-counselling-services PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 9 1.2 Policies Please refer to the OEE Entry-to-Practice PharmD Program Policies, Procedures & Guidelines. Students are also expected to review the UBC E2P PharmD Program Policies and Procedures as outlined on the E2P PharmD Program Hub on Connect. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 10 1.3 Educational Outcomes The goal of the PharmD program is to graduate competent, caring pharmacists, ready to enter the rapidly evolving environment of pharmacy practice and to manage patient’s medication therapy. The learning opportunities in the program are designed to help students meet the Educational Outcomes for First Professional Degree Programs in Pharmacy articulated by the Association of Faculties of Pharmacy of Canada (AFPC) 1 and the Competencies of Entry Level Pharmacists articulated by the National Association of Pharmacy Regulatory Authorities (NAPRA) 2. The Educational Outcomes for First Professional Degree Programs in Pharmacy are structured around seven key pharmacist roles 1 : 1) Care Provider: As Care Providers, pharmacy graduates provide patient-centered pharmacy care by using their knowledge, skills and professional judgement to facilitate management of a patient’s medication and overall health needs across the care continuum. Care Provider is the core of the discipline of pharmacy. 2) Communicator: As Communicators, pharmacy graduates communicate effectively in lay and professional language, using a variety of strategies that take into account the situation, intended outcomes of the communication and diverse audiences. 3) Collaborator: As Collaborators, pharmacy graduates work collaboratively with patients and intra- and inter-professional teams to provide safe, effective, efficient health care, thus fulfilling the needs of the community and society at large. 4) Leader-Manager: As Leaders and Managers, pharmacy graduates engage with others to optimize the safety, effectiveness and efficiency of health care and contribute to a vision of a high-quality health care system. 5) Health Advocate: As Health Advocates, pharmacy graduates demonstrate care for individual patients, communities and populations by using pharmacy expertise to understand health needs and advance health and well-being of others. 6) Scholar: As Scholars, pharmacy graduates take responsibility for excellence by applying medication therapy expertise, learning continuously, creating new knowledge and disseminating knowledge when teaching others. 7) Professional: As Professionals, pharmacy graduates take responsibility and accountability for delivering pharmacy care to patients, communities and society through ethical practice and the high standards of behaviour that are expected of self-regulated professionals. The Professional role is the overarching ethos of the discipline of pharmacy. Graduates should also recognize the four domains of the Model of Practice for Canadian Pharmacists (MSOP) developed by the National Association of Pharmacy Regulatory Authorities (NAPRA) 2. These domains encompass standards against which pharmacists’ performance can be evaluated when the pharmacists are undertaking the activities imperative for safe and effective practice in their daily work. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 11 The Four Domains of MSOP for Canadian Pharmacists are: 1) Expertise in medications and medication-use 2) Collaboration 3) Safety and Quality 4) Professionalism and Ethics Students are also expected to review the UBC E2P PharmD Program Learning Outcomes as outlined on the E2P PharmD Program Hub on the learning management system Connect/Canvas. For your reference: 1AFPC Educational Outcomes for First Professional Degree Programs in Pharmacy in Canada 2017. Available at: http://www.afpc.info/system/files/public/AFPC-Educational Outcomes 2017_final Jun2017.pdf 2NAPRA Professional Competencies for Canadian Pharmacists at Entry to Practice. Available at: http://napra.ca/sites/default/files/2017-08/Comp_for_Cdn_PHARMACISTS_at_EntrytoPractice_March2014_b.pdf PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 12 SECTION 2 – INTRODUCTORY AND ADVANCED PHARMACY PRACTICE EXPERIENCES (IPPE, APPE) – INPATIENT Course Course Coordinator PHRM 272 (IPPE) Ms. Aileen Mira PHRM 472 (APPE) Ms. Asal Taheri PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 13 2.1 Direct Patient Care Practicum Goals and Learning Objectives As outlined in the AFPC Educational Outcomes for First Professional Degree Programs in Pharmacy in Canada, the provision of patient care and the role of care provider is at the heart of the discipline of pharmacy. The overarching goal of the direct patient care practicums across the four years of the UBC E2P PharmD program is to ensure that graduates have the knowledge, skills and professional attributes necessary to provide exemplary patient care. Below are the overall goals and learning objectives for all direct patient care (DPC) practicums within the UBC E2P PharmD program. 2.1.a Knowledge Goal Develop, integrate and apply the knowledge necessary to provide patient-centered pharmacy care to facilitate management of a patient’s medication and overall health needs across the care continuum. Learning Objectives The student will be able to: 1) Apply knowledge of the following to patient-specific clinical findings to make appropriate, patient-specific drug therapy recommendations: (AFPC CP1.1, SC1, SC2) a) Pathophysiology, risk factors, etiology, and clinical presentation of medical conditions, including symptoms, physical assessment, relevant diagnostics, and laboratory findings b) Pharmacology, pharmacokinetics, pharmaceutics, and evidence-based therapeutics 2) Apply knowledge of safe medication practices to optimize medication use for patients and health care delivery (AFPC CP3, LM1) 3) Apply knowledge of regulations and ethical principles through practice in accordance with the laws, ethical codes, and regulatory requirements (i.e. bylaws, professional standards, policies and/or guidelines) that govern pharmacy practice within their jurisdiction. (AFPC CP1, CP3.2, NAPRA 1.1, 1.2, 1.4, 1.5) PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 14 2.1.b Skills (Provision of Pharmaceutical Care) Goal Develop and demonstrate the clinical skills and professional judgement necessary to provide patient-centered pharmacy care to facilitate management of a patient’s medication and overall health needs across the care continuum. Learning Objectives The student will be able to: 1) Prioritize assigned work, identifying patients who are most likely to experience drug therapy problems and setting priorities to manage and balance patient care, workflow and practice requirements (AFPC LM2.2, LM4.2, PR3.1) 2) Establish and maintain a respectful, professional, and ethical relationship with the patient and/or their caregivers centered on the patient’s needs, values, desired level of care and health goals (AFPC CL1, CM1, CM2, NAPRA 2.1) 3) Gather, interpret and assess relevant history from the patient, his/her health records, caregivers, and other healthcare professionals including: (AFPC CP2.1, SC1, NAPRA 2.2, 2.3) a) Patient demographics b) Chief complaint/reason for encounter c) History of present illness d) Past medical history e) Family history f) Functional history g) Social history h) Nutritional status, dietary restrictions/needs, and exercise i) Review of systems utilizing a head-to-toe approach (i.e. signs/symptoms, physical exam, labs, diagnostics, imaging, microbiology) j) Health care team members involved in the care of the patient 4) Gather, interpret and assess a best possible medication history (BPMH), including: (AFPC CP2.1, SC1, NAPRA 2.2, 2.3) a) Allergy history b) Adverse drug reactions c) Current medications/medications prior to admission d) Past medication history e) Non-prescription medication history f) Immunization history g) Social drug history PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 15 h) Medication experience and adherence 5) Develop a prioritized medical problem list, identifying both the patient’s active and chronic issues (AFPC CP2.2, SC1, NAPRA 2.3) 6) Identify and justify a prioritized list of all actual and potential patient-specific drug therapy problems (AFPC CP2.2, HA1, SC1, SC2, NAPRA 2.3, 2.4) 7) Determine the desired outcomes and patient-specific medication-related and non-pharmacological goals of therapy, specifying measurable endpoints, target values and associated timeframes (AFPC CL1.1, CL1.3, CM1, CM2.1, 2.4, CP1.4, CP2.3, HA1, SC1, SC2, NAPRA 2.5.1) 8) Identify a prioritized list of all viable therapeutic alternatives through integration of relevant patient data, best available evidence and comparing and contrasting the pros and cons of each alternative, including assessment of efficacy, safety, patient factors, administration issues and cost. (AFPC CP1.5, CP2.3, SC1, SC2, NAPRA 2.5.2, 2.5.3) 9) Identify, justify and defend a list of appropriate, patient-specific recommendations for identified drug therapy problems (AFPC CP2.3, SC1, SC2, NAPRA 2.5.4, 6.1) 10) Create and implement a care plan in collaboration with the patient and healthcare team members through communication means as appropriate, including, but not limited to: (AFPC CL1, CL2, CM1, CM2, CP2.4, HA1, LM1.4, SC1, SC2, SC4, NAPRA 2.5, 2.6, 2.7, 3.1, 6.1, 7.1, 7.2, 8.1, 8.2, 8.3, 8.4) a) Obtaining consent b) Making appropriate patient-specific therapeutic recommendations c) Making a referral and/or consulting others d) Adapting, initiating, discontinuing, dispensing or administering medication as authorized e) Engaging the patient or caregiver through education and counselling, empowerment and self-management f) Communicating the rationale for the care plan within the circle of care 11) Develop an appropriate, patient-specific monitoring plan and/or plans for continuity of care, specifying efficacy and safety endpoints, target values, frequency and timeframes for monitoring (AFPC CL2, CP2.5, NAPRA 2.5.8) 12) Provide follow up evaluation and assessment of effectiveness, safety and patient adherence and tolerance to drug therapy (AFPC CP2.5, SC1, SC2, NAPRA 2.8) PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 16 13) Proactively document patient-related healthcare issues, care plans and medication orders/clarifications in a clear, concise, and organized manner, fulfilling professional and legal requirements (AFPC CM1, CM2, CL2.3, LM1.4, NAPRA 1.5) 14) Effectively respond to medication- and practice-related questions and educate others in a timely manner, utilizing systematic literature search, critical appraisal skills, and appropriate means of communication (verbal or written, as appropriate) (AFPC CM1, CM2, SC1, SC2, SC4, NAPRA 6.1, 6.2, 7.1, 7.3) 15) Advocate for the health and wellness of patients and the community, promoting disease prevention and facilitating patient access to the health care system and required services (AFPC LM1.1, LM3.1, HA1, HA2, NAPRA 5.1, 5.2) 2.1.c Attitudes and Behaviors (Professionalism) Goal Demonstrate the attitudes and high standards of behavior expected of self-regulated professionals for delivering pharmacy care to patients, communities and society through ethical practice. Learning Objectives The student will consistently: 1) Demonstrate the attitudes, qualities, ethical principles, commitment, and characteristics of a professional as expected by patients, other pharmacists, regulatory bodies, and other healthcare professionals including demonstration of, but not limited to: (AFPC PR1, PR2, NAPRA 1.4) a) Accountability b) Attire and appearance c) Confidentiality d) Honesty and integrity e) Punctuality 2) Demonstrate responsibility and commitment to their own learning and the ongoing refinement and advancement of critical thinking, scientific reasoning, problem-solving and decision-making skills through the demonstration of, but not limited to: (AFPC LM3, PR3, NAPRA 1.4) a) Self-directed learning b) Self-evaluation c) Personal reflection d) Receptiveness to feedback e) Adaptability and openness to change PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 17 3) Demonstrate an understanding of the role of the pharmacist within the healthcare team, practicing within their scope of practice and all legal and ethical requirements (AFPC CP1, PR1, PR2, NAPRA 1.1, 1.2) For each direct patient care practicum, students will be expected to achieve these learning objectives at the corresponding expected performance level for their respective program year which is described in the below table. The below table provides guidance on patient complexity and characteristics commensurate with year level, however, the practice educator and or pharmacist designate will determine if the expectations on “Patient Complexity” for specific course activities are met. This may or may not be within the patient characteristic parameters that are suggested below, as a number of other factors may contribute to complexity: psychological (e.g. cognitive impairment), social (e.g. affordability of treatment), biological (e.g. organs affected, degree of dysfunction), health-care system related (e.g. number of involved health care providers), etc. These dimensions should also be taken into account when assessing the student's level of performance in the care of their patients. Practicum Course Expected Level of Performance Student Characteristics3 Expected Patient Complexity Patient Characteristics PHRM 171 Novice Has incomplete understanding and minimal or "textbook" knowledge without connecting it to practice. Approaches tasks mechanistically. Little or no conception of dealing with complexity. Needs close supervision or instruction. LOW Medical Conditions: 1-3 Number of medications: 3-5 PHRM 271 PHRM 272* Advanced Beginner Has a working understanding and knowledge of key aspects. Tends to see actions as a series of steps. Appreciates complex situations, but only able to achieve partial resolution. Able to achieve some steps using own judgement, but supervision needed for overall task. LOW-MODERATE Medical Conditions: 3-5 Number of medications: 5-7 PHRM 371 MODERATE Medical Conditions: 5-7 Number of medications: 7+ PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 18 PHRM 471 PHRM 472 PHRM 473 Competent Has good working and background understanding. Now sees actions at least partially in terms of longer-term goals. Copes with complex situations through deliberate analysis and planning. Able to work independently to a standard that is acceptable though may lack refinement. Able to achieve most tasks using own judgement. MODERATE Medical Conditions: 5-7 Number of medications: 7+ * As second year students PHRM 272 students are expected to perform at the level outlined above. However, given the short duration and the observational nature of the practicum the assessment of the performance will be different compared to the other direct patient care practicums. Please review the additional information in the Assessment of Student Learning, A Guidebook for Practice Educators. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 19 2.2 Assessment Processes All assessments are guided by the programmatic assessment model for the E2P PharmD Program under the leadership of the Director of Student Assessment. The course assignments and activities are based on the course objectives, AFPC educational outcomes, and are in accordance with the UBC E2P PharmD Program’s Cognitive Model. Feedback is a critical component of a student’s growth and learning throughout their practicums. Practice educators are encouraged to provide verbal feedback and assessment of performance to the student on a daily basis. A formal formative assessment using the online Practice Educator Assessment of Student* form is completed by the practice educator at the midpoint of the practicum. This assessment reflects the practice educator’s observation and assessment of the student’s performance based on the criterion, and the rubrics and expectations of the University. The practice educator and student are expected to meet at the midpoint to formally discuss the student’s progress and review the completed formative assessment form. A formal summative assessment is completed at the end of the practicum using the same online Practice Educator Assessment of Student* form. The practice educator should consider all sources of information to assess overall student performance throughout the course of the practicum including, but not limited to, completed presentations, care plans, education and counseling, collaboration with team members, etc. By the end of the practicum, the student’s overall level of performance must be commensurate with their year level, as previously outlined. The practice educator and student are expected to meet on the last day of the practicum to formally discuss the student’s progress and review the completed summative assessment form. For two-week practicums such as PHRM 272, only one formal written summative assessment is completed at the end the practicum. All assessment forms are to be completed online on E*Value and are electronically submitted directly to the OEE upon completion. The primary practice educator and/or designate that is completing the assessment component of the course should have sufficient and multiple opportunities to interact with the student and observe their interactions to appropriately determine their level of performance in completing the course activities and learning objectives for the practicum. Depending on the practice environment and practicum itself, a student may regularly interact or be supervised by multiple pharmacists while onsite. In this case, there may be a designated pharmacist who will complete the formal midpoint and/or final assessment of the student and provide feedback after reviewing the course work and consulting with other pharmacists who have observed or interacted with the student as necessary. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 20 *Note: The Practice Educator Assessment of Student form varies depending on course. The table below outlines the OEE Practice Educator Assessment of Student Forms used in each course and the frequency of formal assessment: Course Assessment Form Frequency/Type PHRM 171 PHRM 271 PHRM 371 PHRM 471 PHRM 472 PHRM 473 (DPC) Direct Patient Care (DPC) Practice Educator Assessment of Student Midpoint Final PHRM 272 PHRM 272 Practice Educator Assessment of Student Final PHRM 473 (NDPC) Non-Direct Patient Care Practice Educator Assessment of Student Midpoint Final PHRM 473 (NDPC) LEAP Non-Direct Patient Care: LEAP - Practice Educator Assessment of Student Midpoint Final Practice educators are strongly encouraged to review the Assessment of Student Learning – A Guidebook for Practice Educators for further information on the assessment processes for the practicum courses. It is the responsibility of the student to immediately contact the course coordinator and alert them to any assessment scores below the expected level of performance at any point during the practicum to ensure appropriate support and guidance can be provided. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 21 2.3 Grade Assignment The Pharmacy 272 and 472 practicums are Pass-Fail grading. Students must be successful in ALL the required course components in order to be successful in each course, respectively. The required course components for each course include: 1) Completion of Required Practicum Hours Students must complete the practicum hours in full per the respective practicum course. 2) Practice Educator Assessment of Student Students must meet the expected level of performance for ALL criteria as outlined and described in the Practice Educator Assessment of Student* form and consistently exhibit ALL elements within the Professionalism domain to successfully complete the practicum. 3) Evidence of Learning Students must ensure that all required course activities and assignments, as described in this handbook, are completed satisfactorily and safely. The required submission components to demonstrate evidence of learning and verification of activity completion for each of the required course activities for the practicum courses must be submitted online in E*Value in a professional and organized manner by the specified deadline for submission, which is on the last OEE scheduled practicum block date at 11:59pm. The University of British Columbia grants the degree and therefore assigns the final course grade. Although satisfactory academic performance is a prerequisite to advancement, it is not the sole criterion in the consideration of the suitability of a student for promotion or graduation. The Faculty reserves the right to require a student to withdraw from the Faculty if that student is considered to be unsuited to proceed with the study or practice of pharmacy. UBC FOPS Academic Regulations: http://www.calendar.ubc.ca/vancouver/index.cfm?tree=12,213,397,392 Once all required course submissions and assessments of student performance are received, the University will determine whether the expected performance on course outcomes was achieved by the student. The final grade for the practicum (i.e. pass/fail) will be determined by the Faculty’s Student Progress Committee. Students must be successful in both 1) the Practice Educator Assessment of the Student and 2) all components of the course to receive a pass (P) grade. The assessment is non-compensatory. This means that the expected level of performance must be met for all criteria listed and as described in the Practice Educator Assessment of Student* to be successful in this course component. A fail (F) grade will be recommended to the Student Progress Committee, if one or more of the following instances occur. The student: PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 22  does not complete required number of practicum hours  does not meet expected level of performance for any element on the Practice Educator Assessment of Student*  does not consistently exhibit professional attributes and skills  does not submit required course submissions (evidence of learning) by the specified deadline  poses any risk to patient safety and is negligent in the provision of patient-centered care *Note: The Practice Educator Assessment of the Student form varies depending on course. The table in Section 2.2 Assessment Processes outlines the OEE Practice Educator Assessment of Student forms used in each course. 2.3a Supplemental Assessments As per Faculty policy (AP-13) on student progress, in general, no supplemental assessments will be granted for practicum courses. A failure in a practicum course normally requires the student to repeat the course at the next suitable opportunity in the following academic year. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 23 2.4 Overview: Inpatient Practicum Course Activities Described below is the continuum of learning activities for the direct patient care practicums occurring in the inpatient practice setting in the E2P PharmD program. This table is intended to provide a high-level overview of each course, including minimum activity requirements, however further detail for each activity category and the associated expectations can be found in the applicable course handbook sections. Please note: In circumstances where the minimum requirements of an activity cannot be met do limited opportunities at the practicum site given the setting and/or patient population, the activity may be substituted with an alternative activity at the discretion of the practice educator and/or designated pharmacist if need. IPPE APPE Broad Activity Category PHRM 272 (2 weeks, 80 hours) Minimum Required PHRM 472 (8 weeks, 320 hours) Minimum Required E*Value Learning Modules Coursework: First 72-Hour Requirements UBC Pharmacy Student Health and Safety Orientation 1 (uploaded to Connect) 1 (uploaded to Canvas) 72-hour Checklist 1 1 E*Value Learning Modules Coursework: Practicum Activities Student Introduction Resume 1 1 Learning Contract 1 1 Orientation to Inpatient Pharmacy Medication Distribution System 1 n/a Orientation to the Clinical Pharmacist’s Role 1 n/a Orientation to the Patient Medical Record 1 n/a Inpatient Pharmacy Practice Reflection 1 n/a Medication Reconciliation 1 As required Counseling 1 As required Interprofessional Collaboration 1 2 Drug Information Response 1 2 Provision of Pharmaceutical Care 1 16 Presentation n/a 2 Service Optional Up to 30 % of practicum time. Student Evaluation of Practice Educator and Practice Site 1 1 E*Value Learning Modules Coursework: Clinical Reasoning Reflection Clinical Reasoning Reflection n/a 3 E*Value Learning Modules Coursework: Self-Assessment Self-Assessment n/a 4 E*Value Learning Modules Coursework: Student Evaluation of OEE Course Student Evaluation of Office of Experiential Education Course 1 1 Practice Educator Assessment of the Student Practice Educator Assessment of the Student 1 1 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 24 2.5 Course Schedule The following are suggested scheduling guides to help plan out the required activities during PHRM 272 and PHRM 472. These schedules include all required practicum activities for each course. The timing of activities may vary due to site and practice educator-specific circumstances. Once set by the practice educator, students must adhere to the daily schedule, daily activities, and practicum hours as required in the Entry-to-Practice PharmD Program Practicum Policies, Procedures, and Guidelines. For all practicum activities, students must review all recommendations and documentation with the practice educator/designated pharmacist prior to interacting or discussing with the patient/caregiver, physician or other health care providers. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 25 2.5.a PHRM 272 Course Schedule Week 1 Monday Tuesday Wednesday Thursday Friday ☐ UBC Pharmacy Learner Health and Safety Orientation form ☐ Orientation to pharmacy, staff & services ☐ Review completed Student Introduction Resume and 72-hour Checklist with practice educator ☐ Establish schedule of activities, expectations and mechanism for reporting to and receiving feedback with practice educator ☐ Orientation to DIR Resources and DIR Activity ☐ Orientation to the Patient Medical Record Activity ☐ Document and update completed activities on E*value Learning Modules Coursework as needed ☐ Review completed Learning Contract with practice educator ☐ Inpatient Pharmacy Medication Distribution System Activity ☐ Document and update completion of activities on E*value Learning Modules Coursework as needed ☐ Orientation to the Clinical Pharmacist’s Role Activity ☐ Attend rounds ☐ Document and update completed activities on E*value Learning Modules Coursework as needed ☐ Reflect on activities completed this week ☐ Work on DIR assignment ☐ Counselling Activity ☐ Document and update completed activities on E*value Learning Modules Coursework as needed Week 2 Monday Tuesday Wednesday Thursday Friday ☐ Provision of Pharmaceutical Care Activity (patient 1) ☐ Document and update completed activities on E*value Learning Modules Coursework as needed ☐ Provision of Pharmaceutical Care Activity continued (patient 1) ☐ Work on DIR assignment ☐ Document and update completed activities on E*value Learning Modules Coursework as needed ☐ Medication Reconciliation Activity (patient 2) ☐ Interprofessional Collaboration:Shadow another healthcare professional ☐ Document and update completed activities on E*value Learning Modules Coursework as needed ☐ Engage in service activities (optional) ☐ Complete DIR and reflection assignment and prepare for debrief & discussion sessions ☐ Update and complete activity entries on E*Value Learning Modules Coursework in preparation for assessment ☐ DIR and Reflection discussion/debrief ☐ Revisit Learning Contract ☐ ASSESSMENT ☐ Complete Student Feedback Evaluation Surveys on E*Value ☐ Document and update completed activities on E*value Learning Modules Coursework ☐ Ensure all required course submissions (i.e. E*Value Learning Modules Coursework entries) and all other required course components are received by the OEE by specified deadline PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 26 2.5.b PHRM 472 Course Schedule Week 1 Monday Tuesday Wednesday Thursday Friday ☐ Orientation to site, pharmacy, and staff ☐ Orientation to practicum specific ward & nursing unit ☐ Review updated Student Introduction Resume with practice educator/facilitator ☐ Review completed Plan section of the Learning Contract with practice educator by the first 72 hours ☐ Complete and submit the UBC Pharmacy Learner Health and Safety form by the first 72 hours ☐ Complete 72-Hour checklist with practice educator/facilitator ☐ Shadow practice educator in interactions with patients and healthcare providers ☐ Identify two patients to work up and review patients with practice educator ☐ Discuss presentation options with practice educator and develop plan for identifying presentation topics and scheduling details (date, time, audience and topic) ☐ Discuss professional service activity opportunities with practice educator ☐ Reflect on activities completed this week ☐ Document and update completed activities on E*value Learning Modules Coursework ☐ Plan for Week 2 Week 2 Monday Tuesday Wednesday Thursday Friday ☐ Identify two new patients to work-up and review patients with practice educator ☐ Decide and work on 1 Presentation for a specified audience ☐ Complete 1 written Drug Information Response activity, if the opportunity presents (minimum requirement for practicum: 2) ☐ Provide Service (e.g. medication reconciliation, medication counselling, allergy assessment, etc.) as opportunities present and/or as requested by practice educator ☐ Complete Self- Assessment Week 2 ☐ Complete Clinical Reasoning Reflection-Week 2 ☐ Reflect on activities completed this week ☐ Document and update completed activities on E*value Learning Modules Coursework ☐ Plan for Week 3 Week 3 Monday Tuesday Wednesday Thursday Friday ☐ Identify two new patients to work up and review patients with practice educator ☐ Work on and/or present 1 Presentation for a specified audience ☐ Complete 1 written Drug Information Response activity, if the opportunity presents (minimum requirement for practicum: 2) ☐ Provide Service (e.g., medication reconciliation, medication counselling, allergy assessment, etc.) as opportunities present and/or as requested by practice educator ☐ Reflect on activities completed this week ☐ Document and update completed activities on E*value Learning Modules Coursework ☐ Plan for Week 4 Week 4 Monday Tuesday Wednesday Thursday Friday ☐ Identify two new patients to work-up and review patients with practice educator ☐ Identify and work on 2nd Presentation for a specified audience ☐ Complete 1 written Drug Information Response activity, if the opportunity presents (minimum requirement for practicum: 2) ☐ Provide Service (e.g., medication reconciliation, medication counselling, allergy assessment, etc.) as opportunities present and/or as requested by practice educator ☐ Complete Self- Assessment-Week 4 ☐ Complete Clinical Reasoning Reflection-Week 4 ☐ MIDPOINT ASSESSMENT ☐ Reflect on activities completed this week ☐ Document and update completed activities on E*value Learning Modules Coursework ☐ Plan for Week 5 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 27 Week 5 Monday Tuesday Wednesday Thursday Friday ☐ Identify two new patients to work up and review patients with practice educator ☐ Work on and/or present 2nd Presentation for a specified audience ☐ Complete 1 written Drug Information Response activity, if the opportunity presents (minimum requirement for practicum: 2) ☐ Provide Service (e.g., medication reconciliation, medication counselling, allergy assessment, etc.) as opportunities present and/or as requested by practice educator ☐ Reflect on activities completed this week ☐ Document and update completed activities on E*value Learning Modules Coursework ☐ Plan for Week 6 Week 6 Monday Tuesday Wednesday Thursday Friday ☐ Identify two new patients to work up and review patients with practice educator ☐ Work on and/or present 2nd Presentation for a specified audience ☐ Complete 1 written Drug Information Response activity, if the opportunity presents (minimum requirement for practicum: 2) ☐ Complete Service (e.g., medication reconciliation, medication counselling, allergy assessment, etc.) as opportunities present and/or as requested by practice educator ☐ Complete Self- Assessment- Week 6 ☐ Complete Clinical Reasoning Reflection- Week 6 ☐ Reflect on activities completed this week ☐ Document and update completed activities on E*value Learning Modules Coursework ☐ Plan for Week 7 Week 7 Monday Tuesday Wednesday Thursday Friday ☐ Identify two new patients to work up and review patients with practice educator ☐ Work on and/or present 2nd Presentation for a specified audience ☐ Complete 1 written Drug Information Response activity, if the opportunity presents (minimum requirement for practicum: 2) ☐ Complete Service (e.g., medication reconciliation, medication counselling, allergy assessment, etc.) as opportunities present and/or as requested by practice educator ☐ Reflect on activities completed this week ☐ Document and update completed activities on E*value Learning Modules Coursework ☐ Plan for Week 8 Week 8 (Final Week) Monday Tuesday Wednesday Thursday Friday ☐ Identify two new patients to work up (at minimum) ☐ Complete 1 written Drug Information Response activity, if the opportunity presents (minimum requirement for practicum: 2) ☐ Complete Service (e.g., medication reconciliation, medication counselling, allergy assessment, etc.) as opportunities present and/or as requested by practice educator ☐ ☐ Complete Learning Contract – Act and Reflect section and review with practice educator ☐ Complete Self- Assessment- Week 8 ☐ Complete Student Evaluation of Practice Educator form and review with practice educator ☐ Document and update completed activities E*value Learning Modules Coursework ☐ Ensure E*value Learning Modules Coursework entries are fully completed ☐ FINAL ASSESSMENT PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 28 SECTION 3 – REQUIRED COURSE ACTIVITIES 3.1 Handbook Instructions The following section describes the course activities, intended learning objectives and required evidence of learning to confirm the student’s safe and satisfactory completion of these activities. All practicum activities must be completed under the supervision of a practice educator and/or a designated pharmacist. The presentation of information in this handbook will follow the following format: *STUDENTS ARE EXPECTED TO REVIEW AND UNDERSTAND ALL ACTIVITY REQUIREMENTS SECTIONS APPLICABLE TO THEIR PRACTICUM COURSES Section Heading Definition In Practice Connection of learning activity to practice Description General context and concepts related to the activity is presented Learning Objectives Describes what the student will be able to do as a result of engaging in the learning activity Minimum Activity Requirements Breakdown of minimum activity requirements that students must complete Process How the student and the practice educator will engage in the activity and steps involved Required Forms/ Checklists Checklists and documentation forms that are required to complete the specific course activity. Please see Appendix 1 and 2 Accessory Resources Templates, guiding documents, and other resources available to support activity completion. Please see Connect/Canvas Practice Educator Verification of Activity Completion How the practice educator will verify safe and successful completion of the activity by the student PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 29 3.2 E*Value Learning Modules Coursework: Process E*Value Learning Modules Coursework is an online tool utilized to track student completion of all required practicum activities. Students are expected to participate in each course activity and use this documentation tool to indicate completion. Practice educators are required to verify the completion of these activities by the last day of practicum. Students are expected to be familiar with the use of E*Value prior to the start of their practicums. Detailed instructions on E*Value use will be posted on Connect/Canvas for students and on the OEE Practice Educator Resource Center for practice educators. There are five types of forms students that are applicable to the inpatient practicums on the E*Value Learning Modules Coursework site, each with requirements for the student and/or the practice educator: E*Value Learning Module Coursework Form Name Student Submission Deadline Student Role Practice Educator Role First 72-Hours Requirements 72 hours after beginning the practicum Complete form Not applicable – OEE to review Practicum Activities By 11:59 pm on the last OEE scheduled block date of the practicum Complete form Verification required Clinical Reasoning Reflection (PHRM 472 only) At the end of weeks 2, 4, and 6 of the practicum. All 3 submissions must be completed by 11:59 pm on the Sunday of week 6. Complete form Verification required Self-Assessment (PHRM 472 only) Every two weeks during the practicum, last self-assessment due by 11:59 pm on the last OEE scheduled block date of the practicum Complete form Verification required Student Evaluation of the OEE Course By 11:59 pm on the last OEE scheduled block date of the practicum Complete form Not applicable – OEE to review The following describes how each of these forms will be used during the practicum: 1) First 72-Hours Requirements Form Following the completion of the UBC Pharmacy Learner Health and Safety Orientation and the 72 Hour Checklist, the student is to login to E*Value, acknowledge the completion of both of PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 30 these activities, listed under the First 72-Hour Requirements form of the E*Value Learning Modules Coursework site, and submit the completed form. This must be completed within the first 72 hours of the practicum beginning. The completed UBC Pharmacy Learner Health and Safety Orientation form must also be uploaded to Connect/Canvas. 2) Practicum Activities Following completion of ALL minimum requirements for each practicum activity for the specific practicum course as described in this course handbook, the student is to login to E*Value and acknowledge the completion of each respective activity, listed under the Practicum Activities form of the E*Value Learning Modules Coursework site. The student must submit the completed form for verification by the practice educator. This must be completed before the deadline for submission, which is 11:59pm on the last scheduled OEE block date of the practicum. For some activities, the student will be required to complete specific documentation (e.g. completed learning contract form, patient care plans, follow-up evaluations, written correspondence with health care providers, etc.), as described under each specific course activity. It is the student’s responsibility to ensure all documentation completed is shared with their practice educator. Students are responsible for tracking these documents, which may be requested by the practice educator(s) on site and/or OEE for review at any time. Students must ensure the confidentiality of all patient information in their documentation. For PHRM 272: Practice educators will be using the E*Value Learning Modules Coursework submissions and the completed and signed requirements checklists associated with specific activities to verify safe and satisfactory completion of activities when conducting the final assessment for PHRM 272 practicums. As stated above, students are responsible for keeping any additional documentation associated with activity completion, which may be requested, by the practice educator and/or the OEE at any time. 3) Clinical Reasoning Reflection (PHRM 472 only) At two-week intervals (i.e. week 2, 4, and 6), the student will reflect and document about a clinical decision that they have made during their practicum in the two weeks prior. To complete the Clinical Reasoning Reflection, the student must login to E*Value to submit a Clinical Reasoning Reflection form on their E*Value Learning Modules Coursework site, for verification by the practice educator. One form must be completed by the end of weeks 2, 4, and 6. The final deadline for all three submissions will be 11:59pm on the Sunday of week 6. 4) Self-Assessment (PHRM 472 only) At two-week intervals, the student will complete a self-assessment of their progress on practicum, as detailed in Section 3.17. To complete the self-assessment documentation, the PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 31 student must login to E*Value to submit a Self-Assessment form on their E*Value Learning Modules Coursework site, for their specific practicum course, for verification by the practice educator. This must be completed every two weeks, and for the last self-assessment completed, this must be submitted before the deadline for submission which is 11:59pm on the last scheduled OEE block date of the practicum. 5) Student Evaluation of OEE Course Following completion of the Student Evaluation of the OEE Course survey on E*Value, the student will acknowledge completion of this survey on the Student Evaluation of the OEE Course form and submit this form on the E*Value Learning Modules Coursework site. This must be completed before the deadline for submission, which is 11:59pm on the last scheduled OEE block date of the practicum. Required Forms/Checklists  UBC Pharmacy Learner Health and Safety Orientation form (see Appendix 1 or Connect/Canvas)  72-Hour Checklist (see Appendix 1 or Connect/Canvas) Accessory Resources  E*Value Learning Modules Coursework instructions (see Connect/Canvas) Practice Educator Verification of Activity Completion PHRM 272 Prior to/on the last day of the practicum, practice educator to verify the student has completed the minimum requirements for all activities through verification of student’s E*Value Learning Modules Coursework entries. PHRM 472 Prior to/on the last day of the practicum, practice educator to verify the student has completed the minimum requirements for all activities through verification of student’s E*Value Learning Modules Coursework entries. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 32 3.3 Student Introduction Resume In Practice A resume is a documentation tool used to present personal academic achievements, work experiences, special skills, awards, and further roles and accomplishments in a structured and formal way. Pharmacists may share their resume with colleagues, organizations and employers to provide insight into who they are, in the context of their experiences. It also provides an avenue of demonstrating impact, in practice, within communities, and in other ways. Description of Activity Constructing, organizing, and maintaining a strong resume is an important skill for pharmacists. For this activity, students will develop and maintain a comprehensive resume prior to each of their practicum experiences. Students will use their resume as an opportunity to demonstrate their accomplishments, (e.g. academic achievements, awards), experiences (e.g. work experience, practicums, volunteering, teaching), community involvement (e.g. volunteer activities), and special skills, in order to provide practice educators with an understanding of the student prior to the start of the practicum. In discussing their resume with their practice educator, students will have the opportunity to practice sharing their skills and experiences, in an informal manner, as part of their practice site orientation. Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Develop a current resume which accurately and comprehensively identifies their work experiences, academic acheivements, special skills, and key attributes and accomplishments  Communicate, both in writing and verbally, experiences and skills which identify and differentiate the student as an individual in a concise and structured manner Minimum Activity Requirements PHRM 272 Within the first 72 hours of the practicum, student to review updated Resume with practice educator and/or designated pharmacist. PHRM 472 Within the first 72 hours of the practicum, student to review updated Resume with practice educator and/or designated pharmacist. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 33 Process 1) One week prior to the start of the practicum, the student will develop and/or update their resume using the OEE Resume Template and upload their resume in PDF format onto their E*Value account for viewing by the practice educator. 2) During the final pre-practicum communication with the practice educator, which occurs one week prior to the practicum start date, the student must notify the practice educator that the resume has been uploaded and is available for viewing. 3) Within the first 72 hours of the practicum, the student and practice educator should review the student’s resume to gain an understanding of the student’s skills and experiences. 4) Student to acknowledge the completion of this activity under the Practicum Activities section of their E*Value Learning Modules Coursework and submit form for practice educator verification. Required Forms/Checklists  OEE Resume Template (see Appendix 1 or Connect/Canvas) Accessory Resources  E*Value Student Introduction Resume instructions (see Connect/Canvas) Practice Educator Verification of Activity Completion PHRM 272 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Module Coursework entry. PHRM 472 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Module Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 34 3.4 Learning Contract4,6 In Practice Practicing pharmacists must engage in self-directed learning to remain updated and current; the continued expansion of the scope of practice both encourages and warrants this type of growth. A learning contract is one method of implementing the concept of self-directed learning. 5 Description of Activity A Learning Contract is a written document that is developed by the student to identify learning goals and assess his/her progress towards attaining these goals throughout the practicum. Students are expected to create a learning contract for each practicum. This activity allows the student to plan and undertake learning activities to support the maintenance of competence and professional development required of a health care professional in the fieldwork setting.1 The Learning Contract should enhance and guide the student’s learning process throughout their required on-site activities.5 Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Identify and document their own learning goals  Develop an action plan to assess their progress toward obtaining these learning goals  Complete appropriate activities to achieve identified learning goals  Conduct personal reflection and self-evaluation  Reinforce their understanding of the role of self-directed and life-long learning in pharmacy practice Minimum Activity Requirements PHRM 272 Student to complete and review one Learning Contract for this practicum experience with their practice educator and/or designated pharmacist. PHRM 472 Student to complete and review one Learning Contract for this practicum experience with their practice educator and/or designated pharmacist. Process 1) During the first 72 hours of the practicum, the student must identify, at minimum, three* personal site-specific learning goals, and document these goals in the “PLAN” section of the Learning Contract form. a) The learning goals must be realistic and attainable and take into consideration the context of the site, available resources, and time frame. They can be knowledge or skill PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 35 based in nature; knowledge-related learning goals are generally centered on certain therapeutic topics while skill-related learning goals pertain to learning “how” to complete a task. b) Students may consider any constructive feedback provided to them by a practice educator(s) from past practicum, either verbally or as a part of a final assessment; or, students may consider other learning experiences (e.g. integration activities, seminars courses, etc.) they may have undertaken and received feedback on. *Please note: PHRM 272 students are to identify a minimum of one personal site-specific learning goal. 2) By the end of the first 72-hours on practicum student to review the “PLAN” section of their Learning Contract form with their practice educator and/or designated pharmacist. a) The practice educator may help to clarify and articulate these learning goals, as well as assist in identifying activities or resources to support the attainment of these proposed learning goals. b) The practice educator may also suggest or make modifications to the learning goals to ensure they are appropriate and attainable by the completion of the practicum. 3) At the mid-point of the practicum, student to re-assess status of the Learning Contract with practice educator to determine which learning goals have been met, and which ones still need to be met. 4) During the last week of the practicum, the student must complete the “ACT” and “REFLECT” components of the Learning Contract. Following which, the student will review and discuss with the practice educator the progress in achieving the stated learning goals. The Learning Contract is intended to be useful for students in maintaining continuity in learning needs as they transition to the next practicum or into practice. 5) Student to document completion and review of all three components, PLAN-ACT-REFLECT, of the Learning Contract with their practice educator and/or designated pharmacist on the Practicum Activities section of their E*Value Learning Modules Coursework. Submit this form for practice educator verification. Required Forms/Checklists  Learning Contract Form (See Appendix 1) Accessory Resources – None PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 36 Practice Educator Verification of Activity Completion PHRM 272 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Modules Coursework entry. PHRM 472 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Modules Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 37 3.5 Orientation to Inpatient Pharmacy Medication Distribution System7 – PHRM 272 In Practice There are a wide range of responsibilities and challenges a pharmacist experiences on a daily basis in the dispensary setting. Pharmacists must have a good understanding of the medication distribution systems and processes used in their practice setting in order to efficiently and effectively provide care to patients. Description of Activity This activity provides students with an opportunity to explore the processes involved in drug distribution and medication order review in the inpatient practice setting by participation in shadow activities and discussions with pharmacy staff. Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Appreciate how inpatient medication distribution systems function  Describe the roles of the different pharmacy team members, including but not limited to pharmacists, regulated technicians, and pharmacy assistants, in the drug distribution process  Describe how drug preparations and products, including compounded specialty items, are produced and distributed in the inpatient setting  Systematically review and assess prescriber orders written in the inpatient setting  Describe the pharmacist’s contribution to the care of the patients in the inpatient setting, including factors required for safe and effective medication distribution and administration (e.g. medication safety protocols, ISMP, Tall Man lettering, approved abbreviations) and how medication errors can be prevented, particularly from the dispensary point of view Minimum Activity Requirements PHRM 272 Student to complete one Orientation to the Inpatient Pharmacy Medication Distribution System with the practice educator. Process 1) Prior to the introduction and tour of the medication distribution system at the practicum site, student to review the suggested Inpatient Medication Distribution Discussion Questions/Topics below and all the resources listed in the Accessory Resources section of this activity. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 38 2) Students to complete a guided tour, as a group or in pairs, of the dispensary and observe various aspects of the drug distribution process. This includes but is not limited to the observation of the work completed in the following areas: a) Dispensary – order entry, preparation/filling, and verification etc. b) Distribution – wardstock/Omnicell/narcotics/crash carts etc. c) Compounding – IV’s (antibiotics, narcotic infusions, chemotherapy, TPN, home IV etc.) d) Satellites – dispensaries (long term care, chemo, etc.) 3) While on tour students to discuss the importance of each area, how it contributes to the overall distribution of medications to patients, and how each of the different pharmacy team members are responsible for the safe and effective distribution of medications in this setting. 4) Students to become familiar with the formulary and related formulary procedures and policies specific to the practice site. If time permits, and at the discretion of the practice educator, students are also to work through site-specific prescriber orders while completing the dispensary orientation and discuss the concept of “troubleshooting” orders. 5) Once guided tours have been completed, students are to discuss the various aspects of the inpatient medication distribution system and process as a group and with the practice educator and/or designated pharmacist using the suggested Inpatient Medication Distribution Discussion Questions/Topics below. Inpatient Medication Distribution Discussion Questions/Topics a) What pharmacy team members work in the various areas related to the drug distribution process? Discuss each one and their specific role. b) Consider the medication order process:  How and when is a medication order brought to the pharmacy?  How are medications delivered to the floors/units? What about narcotics and/or controlled drugs?  What are the steps in the medication order process (from the time the order is written to the time the patient receives the medication)?  Who can write the medication order? i.e. who has prescribing authority? Who can take a verbal order? Do pharmacists at the practicum site have prescribing authority?  Who reviews, enters, fills, prepares, and then checks the order? Who determines if the prescription is safe and appropriate for the patient?  What is the general turnaround time from the time the order is written to when the patient receives their medication? c) How are questions/issues with medication orders clarified (i.e. troubleshooting)? PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 39  Describe the different types of issues identified e.g. errors in medication reconciliation orders, use patient’s own medications, missing information, allergies etc.  Discuss the various resources used to resolve the issues identified e.g. hospital formulary, therapeutic interchange policies, Health Canada Drug Product Database, parenteral drug manuals etc.  Describe what approaches could be taken to try to resolve the issues identified (e.g. page the physician to discuss if the order was intentional, write a prescription interpretation for the order, obtain a new verbal order from the physician for a new dose, frequency, route, duration, etc.) and if these would be applicable in real life practice.  For any medication errors identified, what would the impact have been on the patient if the errors had not been caught or if the orders had not been clarified? d) What are some examples of prescribing policies that are unique to the inpatient setting that you observed at the practicum site (e.g. dispensing patient’s own medications, procurement and dispensing of a non-formulary drug, pre-printed order sets, pass medications, automatic stop orders, automatic/therapeutic substitutions, methadone etc.)? e) Describe some of the medication distribution systems used in the inpatient setting (e.g. Omnicell, Pyxis, etc.) and specifically at the practicum site. f) What are the hours of the hospital dispensary at the site? Is it a 24-hour site or is the dispensary only open during the day/early evening? If the dispensary closes overnight, how are medication orders filled? Do pharmacists at the practicum site need to be on call? What does that entail? g) What types of products require aseptic technique to be used in their manufacturing process? h) List some examples of medication safety processes/ procedures/ policies you encountered while completing your guided tour (e.g. where is concentrated KCL found/are abbreviations acceptable when writing orders/is TALLMAN lettering used in labelling medications/ does medication reconciliation occur on admission, transfer, and/or discharge on a regular basis at your site etc.) 6) Student to document completion of this activity on the Practicum Activities section of their E*Value Learning Modules Coursework and submit this form for practice educator verification. Required Forms/Checklists - None PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 40 Accessory Resources  Assessment of Prescriber Orders – A Student Guide Practice Educator Verification of Activity Completion PHRM 272 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Modules Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 41 3.6 Orientation to the Clinical Pharmacist’s Role – PHRM 272 In Practice In the inpatient setting, clinical pharmacists provide pharmaceutical care to their patients on a daily basis (optimizing medications, medication reconciliation, medication counselling), as well as providing services to the physicians/nursing units/institution (such as nursing in-services, drug use evaluation, adverse drug reaction (ADR) reporting, answering drug information requests, etc.). Description of Activity This activity will introduce students to the role of a clinical pharmacist in the inpatient setting and the various patient care and service activities clinical pharmacists provide to their patients and their practice site through various discussions. Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Describe the roles of the different pharmacists (Grade I, Grade II, CPS etc.) that work in the inpatient setting  Identify the skills and/or specific training needed to practice in this setting  Describe what a clinical pharmacist in the inpatient setting does in a typical day  Explain the difference between patient care and service activities in the inpatient setting  Discuss the role of other health care team members that clinical pharmacists may interact with on a daily basis [e.g. nurses (RN, LPN, CRN), nursing students, physicians (hospitalists, attending, residents, medical students), physiotherapists, occupational therapists, dieticians, etc.] Minimum Activity Requirements PHRM 272 Student to complete one Orientation to the Clinical Pharmacist’s Role session with the practice educator, including attending a minimum of one patient care rounds session. Process 1) As part of the orientation to the site (as a group or in pairs), student to complete an introductory session on inpatient clinical pharmacy practice with the practice educator and discuss the following topics:  What are the different roles pharmacists have in the inpatient setting?  What kind of training do pharmacists require to practice in this setting? PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 42  What is a clinical pharmacist’s scope of practice in the inpatient setting? How does it differ from a community pharmacist’s scope of practice in BC?  What does a clinical pharmacist do and what does a typical day look like?  What are some examples of patient care and service activities that a clinical pharmacist may perform on a day-to-day basis?  How would you describe the role that a clinical pharmacist plays in the interprofessional health care team? What are the roles of other health care team members that a clinical pharmacist may interact with when providing direct patient care? 2) During the practicum, students to complete a minimum of one shadow experience where a clinical pharmacist performing patient care and service activities is directly observed. Observe their clinical activities closely and be an active participant when called upon. Students will be assigned and scheduled for these experiences by the practice educator at the practice site. a) Discuss with the practice educator when these sessions will occur b) Ensure the steps above have completed prior to the session c) Activities to observe can include but are not limited to the following:  Patient assessments and interviews, identification and resolution of DTPs, care plan development, follow up and monitoring, counseling, medication reconciliation, physical assessment, pharmacokinetic adjustments, adjustments for renal function, antibiotic stewardship reviews, IV to PO step down etc. d) Consider the following questions while completing the shadow experience:  When interviewing a patient where would you stand? Would you sit on the bed? Would you take notes?  If a DTP is identified and an alternative/recommendation is selected how would you decide to follow through with your recommendations i.e. when would you write a note vs. discussing with the team vs. paging or calling the physician etc.?  How would you respond to questions from the patient and/or other health care team members to which you do not know the answers?  How often would you follow up on your patients in hospital?  Where would a pharmacist document his or her interactions and findings in the patient medical record at your practicum site?  Are hospital pharmacists involved in health promotion activities? How does a clinical pharmacist in the inpatient setting integrate disease prevention, risk factor reduction and/or harm minimization into his or her patient care and service type activities? What are some examples that you observed? 3) With the help of the practice educator, students to identify at least one patient care rounds session to attend as part this activity’s shadow experience. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 43 a) Prior to and while attending patient care rounds, students to reflect on the following questions and then discuss them further with their practice educator:  How would you describe the role of the clinical pharmacist on the interprofessional health care team? How do they contribute to the team and to patient care rounds? What impact do they have on the patient care provided by the team as a whole?  What types of interprofessional collaboration did you observe while attending patient care rounds? 4) If possible, students are encouraged to complete all the steps in this activity prior to working on any assignments involving direct patient care (e.g. medication reconciliation, counselling, provision of pharmaceutical care etc.) 5) Student to document completion of this activity on the Practicum Activities section of their E*Value Learning Modules Coursework and submit this form for practice educator verification. Student to include the date the activity was completed and the name of the practice educator that facilitated the activity. Required Forms/Checklists – None Accessory Resources – None Practice Educator Verification of Activity Completion PHRM 272 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Modules Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 44 3.7 Orientation to the Patient Medical Record7 – PHRM 272 In Practice An integral part of the pharmaceutical care process is assessing your patient. Pharmacists in the inpatient setting need to be able to effectively navigate the patient’s medical record in order to assess their patient’s appropriately and in a comprehensive way. Description Of Activity This activity introduces students to the patient medical record (i.e. chart) at their practicum site and provides students with an opportunity to discuss various aspects of the patient medical record and how the information is used by pharmacists in the provision of pharmaceutical care and service, in a real-life setting. Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Locate and describe the basic layout of the patient medical record specific to the site  Describe how pharmacists, when providing patient care, use the patient medical record  Identify the steps and resources needed to complete a chart review and patient workup in the inpatient setting Minimum Activity Requirements PHRM 272 Student to complete one Orientation to the Patient Medical Record session with the practice educator. Process 1) As part of the orientation to the site, as a group or in pairs, students to complete a brief tour of a ward/nursing unit with the practice educator. 2) During this orientation student to also complete an introductory session on the patient medical record/chart/information system specific to the practicum site. Some of the questions and/or topics to cover and consider during this session include: a) What kind of patient medical record/chart is used at the site? b) Where are the patient medical records/charts kept at the site? c) Discuss the purpose of the patient medical chart. How does it impact the provision of care to patients by the health care team? PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 45 d) What kind of information can be found in a patient’s chart? Discuss the different sections/components of the chart and where you would find the specific information about a patient including but not limited to:  Laboratory data  Vital signs  Diagnostic Reports (Chest X-Rays, EKG, Echo etc.)  Dietary Intake  Blood sugar readings  Daily nursing notes  MAR  Previous admission information e) Who writes in the chart and where do they document their findings in the chart? f) Who has prescribing authority at the practicum site? Who can write orders in the chart? g) Where can pharmacists document their findings and interactions? Is there a specific documentation format that pharmacists at the practicum site must follow? h) Discuss how a pharmacist can use the patient medical record in the provision of patient care and specifically how it can be used as part of the patient assessment process. i) What happens to the patient medical chart once the patient is discharged from the site? 3) To complete this activity student to become familiar with the steps and resources needed to complete a chart review and patient work up in the inpatient setting, including how to report your patient by reviewing the Accessory Resources listed for this activity. The resources provided serve as a general guide for use but the practice educator may amend this at any time to better suit their practice environment and patient population. As approaches and resources may vary, students should always discuss their approach with the practice educator on site prior to completing these types of activities for the first time while on practicum. 4) Student to document completion of this activity on the Practicum Activities section of their E*Value Learning Modules Coursework and submit this form for practice educator verification. Student to include the date the activity was completed and the name of the practice educator that facilitated the activity. Required Forms/Checklists- None Accessory Resources  Working Up A Patient in the Inpatient Setting – A Student Guide  Inpatient Patient Work Up Form  Allergy Assessment – A Student Guide  Requirements Checklist for Inpatient Presentation to Practice Educator (see Appendix 2) PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 46 Practice Educator Verification of Activity Completion PHRM 272 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Modules Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 47 3.8 Inpatient Pharmacy Practice Reflection – PHRM 272 In Practice Pharmacists must engage in self-directed learning to remain updated and current. Fostering reflective skills is an essential part of self-directed, lifelong learning and is key to enhancing overall professional growth and development.8 Description of Activity This activity will allow students to reflect upon their introductory inpatient pharmacy practice experience. Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Articulate and document how the learning from this experience has impacted them and their understanding of clinical pharmacy practice in the inpatient setting Minimum Activity Requirements PHRM 272 Student to complete the Inpatient Pharmacy Practice Reflection activity with the practice educator and complete a minimum of one written reflection prior to the end of the practicum experience. Process 1) Prior to commencing the practicum, student to review this activity description in full and the PHRM 272 Required Reflection Questions outlined below: PHRM 272 Required Reflection Questions a) What is the primary role of a clinical pharmacist in the inpatient setting? Provide one or two examples of patient care and/or service activities you observed a clinical pharmacist provide to patients while on your 2-week practicum. b) How would you describe the role that a clinical pharmacist plays in the interprofessional health care team? c) How did interacting with a clinical pharmacist while in hospital impact patients? Provide one example of this that was the most memorable for you and explain why. d) What did you discover about clinical pharmacy in the inpatient setting that you were not aware of before this experience? e) How has this experience impacted you as a student pharmacist, your understanding of pharmacy practice in this setting and your future learning? PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 48 2) Over the course of the 2-week practicum student to discuss the PHRM 272 Required Reflection Questions outlined above with the practice educator and/or other hospital pharmacy staff members met on practicum. 3) Prior to the end of the practicum student to complete a written reflection based on all the questions discussed. The completed reflection assignment should be a maximum of 750 words, typed, with a minimum size font of 11. 4) At the end/on the last day of the practicum, as a group and/or in pairs, students are to present and discuss the reflection with their practice educator for assessment and feedback and then document completion of activity on Practicum Activities section of E*Value Learning Modules Coursework. Student to include the date the activity was completed and the name of the practice educator that facilitated the activity. Required Forms/Checklists – None Accessory Resources – None Practice Educator Verification of Activity Completion PHRM 272 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Modules Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 49 3.9 Medication Reconciliation – PHRM 272 In Practice The provision of pharmaceutical care is a primary responsibility of the pharmacist although it is shared with physicians and other health care providers. Pharmacists may provide this service directly to patients or their caregivers.9 Medication reconciliation is part of providing comprehensive pharmaceutical care and pharmacists are uniquely positioned and trained to provide this service as their patients transition through various care settings. 10 Having pharmacy students participate in the verification of medication histories has also been shown to improve the accuracy of patient medication records in the inpatient setting.11 Description of Activity This activity allows students to perform medication reconciliation in the inpatient setting as patients transition through care (e.g. on admission to a hospital and/or on discharge from a hospital). Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Identify and perform the various steps involved in the medication reconciliation process, under the supervision and guidance of their practice educator such as:  Gathering information from a patient’s medical record and other secondary sources to be able to prepare a Best Possible Medication History (BPMH) and/or Best Possible Medication Discharge Plan (BPMDP)  Clarifying and completing a patient’s BPMH by interviewing the patient  Reconciling medication records to ensure continuity of care and prevention of medication errors  Communicating the BPMDP to the patient and/or caregiver through a discharge counselling session  Communicating and documenting the BPMH and/or BPMDP and reconciliation activities according to the requirements and guidelines of the practicum site Minimum Activity Requirements PHRM 272 Student to perform medication reconciliation on admission OR on discharge for a minimum of one patient. Note: the patient chosen for this activity must be different then the patient chosen for the provision of pharmaceutical care activity that is required for PHRM 272. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 50 Process12, 13 1) Student to review the Required Forms/Checklists and Accessory Resources noted within this activity description prior to engaging in any medication reconciliation activities. As approaches and resources may vary, student to discuss process/approach to medication reconciliation with the practice educator on site prior to completing this type of activity for the first time while on practicum. 2) Under the guidance and supervision of the practice educator student to perform medication reconciliation on admission OR discharge for a minimum of one patient as directed and assigned: For Medication Reconciliation on Admission a) Review the Medication Reconciliation in the Inpatient Setting – A Guide, focusing on medication reconciliation on admission, and the Requirements Checklist for BPMH Interview. b) Using the guide and forms provided, or site-specific forms if available, create a BPMH by gathering the patient’s medication information and interviewing the patient and/caregiver. c) Prior to conducting the interview present the patient and the information gathered above to the practice educator, using the Requirements Checklist for Inpatient Presentation to Practice Educator as a guide if needed, and specifically discuss the areas you want to focus on and/or clarify with the patient during the interview. d) Under the practice educator’s guidance and supervision conduct a detailed BPMH medication reconciliation interview. e) Have the practice educator observe, assess, and provide feedback on the interview skills/process using the Requirements Checklist for BPMH Interview and document findings. f) Following the patient interview identify and discrepancies that need to be clarified. g) Discuss with the practice educator any discrepancies identified and the process for resolving any discrepancies identified/reconciling the medication orders. h) Observe and/or work with the practice educator to communicate and resolve any discrepancies identified with the most responsible prescriber. i) Under the guidance and supervision of the practice educator, draft a note to document patient’s BPMH and the interaction as per the site’s requirements and/or observe their practice educator document the patient’s BPMH and the reconciliation activities performed (i.e. discrepancies, drug therapy problems, and recommendations). j) If deemed appropriate, under the guidance and supervision of the practice educator, relay any medication changes to the patient. For Medication Reconciliation on Discharge PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 51 a) Review the Medication Reconciliation in the Inpatient Setting – A Guide, focusing on medication reconciliation on discharge and the Requirements Checklist for BPMDP Counseling. b) Using the guide and forms provided, or site-specific forms if available, create a BPMDP by gathering the patient’s medication information, assessing all the medications and identifying all discrepancies. c) Discuss with the practice educator any discrepancies identified and the process for resolving any discrepancies identified/reconciling the medication orders and work with and/or observe the practice educator resolve any discrepancies identified with the most responsible prescriber, writing new prescriptions if needed. d) Draft a note to document the BPMDP as per the site’s requirements, under the guidance and supervision of the practice educator, and/or observe the practice educator document the patient’s BPMDP. e) Prepare to conduct the discharge counseling session and then present the patient and the information gathered above to the practice educator, using the Requirements Checklist for Inpatient Presentation to Practice Educator as a guide if needed, and specifically discuss the areas you want to focus on with the patient during the discharge counseling session. f) Under the guidance and supervision of the practice educator communicate the BPMDP to the patient and/or caregiver by conducting a BPMDP counseling session. g) Have the practice educator observe, assess, and provide feedback on the discharge counseling skills/process using the Requirements Checklist for BPMDP Counseling and document findings. h) Work with and/observe the practice educator communicate the BPMDP to the appropriate healthcare providers within the patient’s circle of care (e.g. community pharmacy, primary care physician, etc.) as applicable and document the above activities as per the site’s requirements 3) Student to document completion of this activity on the Practicum Activities section of their E*Value Learning Modules Coursework. Submit this form for practice educator verification. Student to include the date the activity was completed and the name of the practice educator that facilitated the activity. Note: To meet the expected level of performance on this activity students must achieve an overall satisfactory assessment on the Requirements Checklist for BPMH Interview or Requirements Checklist for BPMDP Counseling, which must be completed and signed by the practice educator that facilitated and assessed the activity. Students must retain all supporting documentation for this activity for their records, including the completed and signed Requirements Checklist, which will be requested by the practice educator when conducting the final assessment of the student at the end of the practicum. These documents may also be requested by the OEE at any time. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 52 Required Forms/Checklists  For medication reconciliation on admission: Requirements Checklist for BPMH Interview (see Appendix 2)  For medication reconciliation on discharge: Requirements Checklist for BPMDP Counseling (see Appendix 2) Accessory Resources  Inpatient Patient Work Up form  Requirements Checklist for Inpatient Presentation to Practice Educator (see Appendix 2)  Medication Reconciliation in the Inpatient Setting – A Student Guide Practice Educator Verification of Activity Completion PHRM 272  Prior to/on the last day of the practicum, practice educator to verify that the student has safely and satisfactorily completed the minimum requirements for this activity through verification of student’s E*Value Learning Modules Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 53 3.10 Counseling – PHRM 272 In Practice As care providers and scholars, pharmacists have a professional and legal responsibility to provide accurate information to the patient regarding medication therapies, including potential adverse effects, monitoring parameters for effectiveness and safety, and outcomes of therapy, amongst others. As communicators, pharmacists need to present in an effective manner accurate, concise, and relevant information to patients, caregivers, and other health professionals. Documentation of patient care activities should include information provided, findings, follow-ups, recommendations, and patient outcomes to promote continuity of care.1, 9 Description of Activity This activity will allow students to prepare for and provide medication counseling to patients and/or caregivers in an inpatient setting. Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Provide patient education and medication counseling, to patients and/or caregivers in the inpatient setting, including what medication they are taking, why they are taking it, how to optimally take it, any potential adverse effects, relevant and measurable monitoring parameters for effectiveness and safety, and outcomes of therapy, amongst others  Communicate relevant, accurate, and concise information in an effective and organized manner, tailored to the specific audience  Share information with patients in a respectful manner and in such a way that is understandable, encourages discussion, and enhances participation in decision-making14  Document patient care activities in a timely, retrievable, and usable manner in compliance with all professional and legal requirements1 Minimum Activity Requirements PHRM 272 Student must counsel a minimum of one patient and/or caregiver on their medication therapy. Note: If the opportunity arises and time permits students are encouraged to exceed the minimum. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 54 Process 1) Student to review the General Medication Counseling Guide and the Requirements Checklist for Counseling in preparation for this activity. 2) Based on the medications to be counseled on and the resources listed above, student to prepare information to be provided to the patient during the counseling session and review with the practice educator. 3) Under the direct supervision of the practice educator student to counsel patient. 4) Student to draft a note to document the interaction as per the site’s requirements and/or observe the practice educator document the interaction. Note: The format of the documentation notes may be adapted from the SOAP note format to conform to the practice educator and/or site’s requirements. 5) Student to document completion of this activity on the Practicum Activities section of their E*Value Learning Modules Coursework and submit this form for practice educator verification. Student to include the date the activity was completed and the name of the practice educator that facilitated the activity. Note: To meet the expected level of performance on this activity students must achieve an overall satisfactory assessment on the Requirements Checklist for Counseling, which must be completed and signed by the practice educator that facilitated, observed, and assessed the activity. Students must retain all supporting documentation for this activity for their records, including the completed and signed Requirements Checklist, which will be requested by the practice educator conducting the final assessment of the student at the end of the practicum. These documents may also be requested by the OEE at any time. Required Forms/Checklists  Requirements Checklist for Counseling (see Appendix 2) Accessory Resources  General Medication Counseling - A Student Guide Practice Educator Verification of Activity Completion PHRM 272  Prior to/on the last day of the practicum, practice educator to verify that the student has safely and satisfactorily completed the minimum requirements for this activity through verification of student’s E*Value Learning Modules Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 55 3.11 Interprofessional Collaboration In Practice Interprofessional collaboration is the process of developing and maintaining effective interprofessional working relationships with learners, practitioners, patients/clients/ families and communities to enable optimal health outcomes. Elements of collaboration include respect, trust, shared decision-making, and partnerships.15 Interprofessional collaboration is an integral part of providing comprehensive care to patients and in experiential education interprofessional education (IPE) occurs when students, healthcare workers, or health professionals from two or more disciplines work collaboratively to “learn about, from and with each other to enable effective collaboration and improve patient health outcomes”.16 Description of Activity This activity will introduce students to the healthcare team in the inpatient setting. Through discussions and shadow experiences students will be able to observe and reflect upon the importance and challenges of interprofessional collaboration in the provision of patient-centered care. Learning Objectives4 By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Recognize the diversity and the roles of other health care providers in the inpatient setting, their responsibilities and competencies  Demonstrate their own role, responsibilities, values and scope of practice to others  Reflect on the interprofessional opportunities that exist for clinical pharmacists in an inpatient setting Minimum Activity Requirements PHRM 272 Student to complete one Interprofessional Collaboration session (i.e. shadow experience) as directed and scheduled by the practice educator and/or designated pharmacist. PHRM 472 Student to complete two Interprofessional Collaboration sessions (i.e. shadow experience) as directed and scheduled by the practice educator and/or designated pharmacist. Process 1) With the help of the practice educator student to identify at least one (PHRM 272) or two (PHRM 472) health care team member(s) to complete a shadow experience with during the practicum. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 56 a) As part of the shadow experience, student to discuss and reflect on the following questions with the practice educator after completing each shadow experience:  What is the health care professional’s role on the health care team in the inpatient setting?  What actual or potential opportunities do they have or have had to work in collaboration with clinical pharmacists on the health care team? 2) Student to document completion of this activity on the Practicum Activities section of their E*Value Learning Modules Coursework and submit this form for practice educator verification. Student to include the date the activity was completed and the name of the practice educator that facilitated the activity. Required Forms/Checklists – None Accessory Resources – None Practice Educator Verification of Activity Completion PHRM 272 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Modules Coursework entry. PHRM 472 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Modules Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 57 3.12 Drug Information Response 4 In Practice Providing drug information is intrinsic to the effective provision of direct patient care. Pharmacists are required to integrate and apply knowledge of pharmacotherapeutics, pharmacology, pathophysiology and other pharmaceutical sciences to the drug-related aspects of patient care, and to communicate that knowledge to other healthcare professionals and directly to patients. Description of Activity This activity allows students to answer drug information questions that pharmacists encounter on a daily basis. Learning Objectives 1 By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Identify and describe available drug information resources  Gather patient-specific information and background information relating to the drug information request, if applicable  Develop a systematic process, including identifying appropriate resources, to search for evidence relating to drug information requests  Critically appraise information in the context of specific drug information requests and provide evidence-based responses  Document the drug information response using scientific writing skills and communicate information appropriately, with practice educator support, to requestor  Recognize the role of pharmacists in enhancing patient care, and advancing the health and wellbeing of others, through the provision of drug information. Minimum Activity Requirements Please note: Students are expected to engage in responding (verbally and/or in writing) to any drug information questions presented to them while on site. PHRM 272 Student to complete the Drug Information Response activity with the practice educator and/or designated pharmacist, which includes completing a minimum of one Drug Information Response as outlined in this activity and presenting and discussing it with the practice educator for assessment and feedback. PHRM 472 Student to complete a minimum of 2 Drug Information Responses as outlined in this activity and present and discuss each response with their practice educator for assessment and feedback. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 58 Process Note: PHRM 272 students are to complete the drug information request and response Orientation and Discussion section detailed below and then move onto the Process as outlined to complete the DIR assignment. PHRM 272 Only – Orientation and Discussion 1) Complete a tour and/or orientation of the drug information resources available at the site and become familiar with the contents and focus of each. 2) As a group and/or in pairs, discuss hospital-specific drug information resources with the practice educator using the following questions as a guide: a) What are some drug information resources available to pharmacists at the practicum site? b) Each student to identify and discuss at least 2 different drug information resources:  What are the names of the resources?  What are the strengths and weaknesses of each?  When would one be used over the other? 3) Review and become familiar with all the resources for this activity as listed under the Required Forms and the Accessory Resources sections prior to completing any assigned drug information requests. PHRM 272 and 472 – Process Continued 1) Identify with practice educator and/or designated pharmacist, drug information requests that are routine for the practice site. Requests may come from patients, physicians, other pharmacists, or other health practitioners. 2) Complete drug information responses, as they arise in day-to-day practice at the site and are assigned by the practice educator and/or designated pharmacist. For each assigned drug information request: a) Define the question: Clearly define the specific question being asked and when the response is due. Use the Drug Information Request and Response form or an appropriate site-specific documentation tool to gather background information relating to the request. Use additional support documents, such as the Inpatient Work Up Form to assist in gathering pertinent patient information if the DIR is patient specific. b) Background information: Provide the general context from which the question arises. This general context is necessary when formulating the real question that needs to be PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 59 answered and to ensure the information provided will be applicable and appropriate for the recipient of the drug information response. c) Complete a pharmacotherapy work-up17, in order to capture all relevant patient information, such as age, gender, medical history, etc. if the drug information request is patient specific. d) Literature search and critical-appraisal:  Review “How to Perform a Literature Search”18 video on Connect/Canvas  Perform a search of the resources, references, and evidence to respond to the question. Consider the type/nature of the question (e.g. dosing, drug-interaction, adverse effects, etc.) to help guide the use of appropriate resources, including primary resources, where possible  Critically appraise and evaluate the information gathered in the context of the question e) Response: Compose an evidence-based written response to the drug information request, using appropriate referencing and scientific-writing skills.  Clearly answer the question that has been asked so that it is easy for the reader to understand or interpret; use separate headings (e.g. recommendation, rationale, etc.) to outline applicable sections. f) Indicate all references used to procure the answer. Where primary resources are used, they must be cited using Vancouver Style. g) Review the Requirements Checklist for Drug Information Responses to ensure you have captured all requirements for this activity. h) Present and review response to each drug information question with DIR with your practice educator and/or designated pharmacist on site in a timely manner. i) Have the practice educator and/or designated pharmacist provide feedback on the DIR response using the Requirements Checklist for Drug Information Responses. 3) If possible or if the opportunity arises, under the direct supervision of your practice educator, provide the DIR response to the person requesting the drug information either verbally and/or in writing, as the situation requires. 4) If new information arises that changes your drug information response, follow-up as required. 5) Student to document completion of this activity on the Practicum Activities section of their E*Value Learning Modules Coursework and submit this form for practice educator verification. Student to include the date the activity was completed and the name of the practice educator that facilitated the activity. For PHRM 272 student to include the dates the associated activities were completed and the name of the practice educator and or designated pharmacist that facilitated, observed, and assessed the activity. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 60 PHRM 272: To meet the expected level of performance on this activity students must achieve an overall satisfactory assessment on the Requirements Checklist for Drug Information Response, which must be completed and signed by the practice educator that facilitated, observed and assessed the activity. Students must retain all supporting documentation for this activity for their records, including the completed and signed Requirements Checklist, which will be requested by the practice educator conducting the final assessment of the student at the end of the practicum and may be requested by OEE at any time. Required Forms/Checklists  Requirements Checklist for Drug Information Responses (see Appendix 2) – required for PHRM 272 and accessory resource for PHRM 472 Accessory Resources  Drug Information Request and Response Form  Inpatient Work Up Form  How to Perform a Literature Search Video Practice Educator Verification of Activity Completion PHRM 272 Prior to/on the last day of the practicum, practice educator to verify that the student has safely and satisfactorily completed the minimum requirements for this activity through verification of student’s E*Value Learning Module Coursework entry. PHRM 472 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Module Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 61 3.13 Provision of Pharmaceutical Care In Practice The provision of pharmaceutical care is the primary responsibility of the pharmacist, although shared with physicians and other health care providers. Pharmacists may provide this service directly to patients and/or their caregivers; or they may manage/supervise or teach/train others to provide this care. Thus, the ‘patient’ may vary depending on the specific responsibility pharmacists have in this role.6 Description of Activity Pharmaceutical care is the fundamental focus of all direct patient care practicum activities. Students are expected to take responsibility for and participate in the role of a pharmaceutical care practitioner through the integration of both cognitive (pharmacotherapy workup) and physical work (implementation of patient care process through collaboration with the patient, caregivers, and interdisciplinary team).17 Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to9:  Assess the patient’s health status and needs  Develop a care plan with the patient that includes opportunities to adopt healthy behaviors, establishes and addresses determinants of health affecting the patient and access to health services and resources, and incorporates disease prevention, health promotion, and health surveillance  Support the patient to implement the care plan  Collaborate and communicate effectively with members of the health care team, including patients, pharmacy colleagues and individuals from other professionals  Support and monitor the patient’s progress with the care plan  Document findings, follow-ups, recommendations, information provided and patient outcomes Minimum Requirements PHRM 272 Students are expected to work up and develop one care plan for a minimum of one patient (i.e. full patient work up and development of one care plan for one of the patient’s medical conditions) and present to the practice educator for assessment and feedback. This patient must be different from the patient chosen for the Medication Reconciliation activity. Note: Given the short duration of this practicum, following-up on patients is not required, however it is highly encouraged if possible and time permits. PHRM 472 Students to provide safe and effective Provision of Pharmaceutical Care (work up and care plan) to a minimum of 16 patients and present and discuss each patient work-up and care plan with their practice educator for assessment and feedback. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 62 Process 4 1) Under the guidance and supervision of their practice educator and/or designated pharmacist, students are expected to provide pharmaceutical care for every patient to whom they are assigned to work up*. This includes: a) Conducting patient assessments (including, but not limited to, gathering patient specific information, conducting patient interviews and allergy assessments etc.) to identify and prioritize drug therapy problems, b) Developing and implementing care plans that address the desired patient specific outcomes, and c) Completing follow-up evaluations, where feasible *Please note: For PHRM 272 please refer to the minimum requirements as described above. 2) The following considerations should be taken into account when completing this activity: a) Format: plans may be simple or detailed, verbal or documented, and will vary depending on the individual patient’s requirements. While the specific format for care plans may vary by site, it should be consistent with the principles of pharmaceutical care outlined in Cipolle RJ, Strand LM, Morley PC Pharmaceutical Care Practice: The Patient Centered Approach to Medication Management, McGraw Hill, 2012. Students are also encouraged to look back on materials from preceding courses in the program curriculum to support their understanding of the patient care thought process. b) Confidentiality: Patient confidentiality must be maintained at all times when completing these activities. This includes ensuring that all patient information (e.g. labs, charts, written documentation) does not leave the practice site. c) Therapeutic Diversity: Care should be provided for a wide range of therapeutic scenarios. Students are expected, if possible, to care for patients with acute and chronic illnesses, and in various life stages, by the end of the practicum. d) Complexity: Care can be provided for patients with simple drug therapy problems or those with more complex problems. Regardless of the patient scenario, all components of the pharmaceutical care process are to be completed. Please refer to Section 2.1 Direct Patient Care Practicum Goals and Learning Objectives for further details on level of complexity for patient care activities for each course. e) Interprofessional Collaboration: Students will be expected to work closely with relevant members of the healthcare team to provide collaborative care, in a manner that encourages respectful dialogue and collaborative decision-making. This may include regular communication to share and document their assessment of the patient’s mediation-related needs and recommendations to address those needs. f) Documentation: Documentation of care on paper or electronic files and charts must be completed to the standards applicable in the given site. Practice requirements and level of independence in documentation should be discussed early in the practicum. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 63 3) Students must review all recommendations and documentation associated with these activities with the practice educator and/or designated pharmacist prior to discussing it with the patient/caregiver, physician, or other health care providers. 4) Student to acknowledge the completion of this activity under the Practicum Activities form on the E*Value Learning Modules Coursework site and submit form for practice educator verification. PHRM 272 Note: To meet the expected level of performance on this activity students must achieve an overall satisfactory assessment on the Requirements Checklist for Inpatient Presentation to Practice Educator, which must be completed and signed by the practice educator that facilitated and assessed the activity. Students must retain all supporting documentation for this activity for their records, including the completed and signed Requirements Checklist, which will be requested by the practice educator when conducting the final assessment of the student at the end of the practicum and may be requested by OEE at any time. Required Forms/Checklists  Requirements Checklist for Inpatient Presentation to Practice Educator - requirement for PHRM 272 but accessory only for PHRM 472 (see Appendix 2) Accessory Resources  Inpatient Patient Work-Up Form  Allergy Assessment – A Student Guide  Working Up a Patient in the Inpatient Setting – A Student Guide  Medication Reconciliation Activity (see activity description in course handbook)  Counseling Activity (see activity description in course handbook)  Requirements Checklist for Inpatient Presentation to Practice Educator (see Appendix 2) – accessory for PHRM 472 but required for PHRM 272 Practice Educator Verification of Activity Completion PHRM 272 Prior to/on the last day of the practicum, practice educator to verify that the student has safely and satisfactorily completed the minimum requirements for this activity through verification of student’s E*Value Learning Module Coursework entry. PHRM 472 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Module Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 64 3.14 Clinical Reasoning Reflection19 – PHRM 472 In Practice Clinical reasoning and therapeutic decision making are key components of the pharmaceutical care process and are skills used by pharmacists in clinical practice on a daily basis.9 Description of Activity In this activity, students will reflect upon their clinical reasoning and decision-making process using real-life examples encountered during their PHRM 472 inpatient practicum experience. Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Identify situations where therapeutic decision making and clinical reasoning skills are required in practice  Identify the clinical concepts in which critical thinking must be used and clinical evidence applied in order to properly assess a patient’s drug related needs and make appropriate recommendations  Characterize critical thinking in terms of the specific details that must be questioned and explored by the pharmacist in the given situation  Describe the necessary skills required to make sound therapeutic decisions  Reflect on the therapeutic decision making and clinical reasoning process and document how learning from these experiences will be integrated into their future practice Minimum Activity Requirements PHRM 472 Student to complete and submit one Clinical Reasoning Reflection at the end of weeks 2, 4, and 6 on E*Value Learning Modules Coursework for practice educator assessment and feedback (total: three submissions/8-week practicum). Process17,19 At weeks 2, 4 and 6, students will: 1) Choose at least one example of a recommendation/therapeutic decision made in the two weeks prior during which they demonstrated clinical reasoning skills. Note that the submission must be based on a decision made in the two weeks prior. a) Examples of recommendations that would require clinical reasoning include, but are not limited to:  Optimizing drug therapy (i.e., choosing a different drug, changing a dose or changing the route of administration, starting/stopping a drug) PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 65  Implementing a monitoring plan (e.g., laboratory, diagnostics, or other)  Recommending how to proceed with drug therapy after an allergy assessment  Assessing a drug level and the rationale for changing or not changing the drug dosage 2) Log on to E*Value Learning Modules Coursework. Document and reflect on the recommendation/therapeutic decision that was made using the questions outlined in the Clinical Reasoning Reflection form as a guide. Students must ensure patient confidentiality and patient identifiers are all removed from all submissions. 3) Review the Assessment Guide for Clinical Reasoning Reflection in Appendix 1 to ensure that the submission meets the outlined satisfactory submission requirements. 4) Submit the Clinical Reasoning Reflection form ideally by the Sunday of that week (e.g. Sunday of week 2, week 4, etc.) for review and approval by practice educator. Note:  All three reflections must be completed prior to week 7 of the practicum in order to allow for the practice educator to assess and verify the submissions.  In order to meet the requirements of this activity, students must meet the Satisfactory Submissions requirements outlined in the Assessment Guide for Clinical Reasoning Reflection for all 3 submissions.  If the requirements are not meet, the practice educator can ask the student to make revisions and resubmit their work directly to the practice educator (i.e. students will not be required to resubmit their revisions on E*value). Required Forms/Checklists  Clinical Reasoning Reflection Week 2, 4, 6 (see E*Value Learning Modules Coursework and Appendix 1)  Assessment Guide for Clinical Reasoning Reflection (see E*Value Learning Modules Coursework and Appendix 1) Accessory Resources  Clinical Reasoning Examples Practice Educator Verification of Activity Completion PHRM 472 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity and has met the Satisfactory Submission requirements for 3 of their submissions through verification of the student’s E*Value Learning Module Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 66 3.15 Presentation20 – PHRM 472 In Practice Health care professionals commonly utilize presentations to consolidate their learning, share therapeutic knowledge and build on communication skills. Pharmacists must communicate effectively and demonstrate fundamental knowledge with diverse audiences, including patients, peers, and other health care professionals, in daily practice. Description of Activity Presentations enable students to develop their skills as scholars and communicators1. Students are provided with the opportunity to prepare and deliver presentations designed to meet the learning needs of a specific audience. Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Identify and understand the learning needs of an audience  Select pertinent research/information to address the learning needs of the audience  Use an evidence-based approach to evaluate research/information gathered, where applicable  Organize and display information in a coherent and comprehensive format for delivery  Demonstrate knowledge in the specified topic area  Adopt verbal, non-verbal and written communication techniques to facilitate and deliver effective presentations  Facilitate and/or respond to discussions on a topic  Identify areas of strength and areas for improvement for future presentations Minimum Activity Requirements PHRM 472 Student to complete at minimum two presentations during their 8-week practicum.  Note: One of the two presentations may be prepared and/or presented in collaboration with another student/learner on site as determined by the practice educator. Process For each presentation, under the direct supervision of the practice educator and/or designated pharmacist, the student must: 1) Plan: With the practice educator, select the specific topic for a presentation. The presentation may be: PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 67 a) Education, practice, or research-related b) In any format (e.g. formal case presentation, journal club, in-service, research/project presentation, etc.) c) Presented to any audience (e.g. health practitioners, patients, care provides, students), as determined by the practice educator(s) d) Presented with another student and/or learner on site (maximum 1 of 2 presentations) 2) Prepare: Prepare for presentation on their own time outside of the onsite practicum hours. When preparing their presentation, students should remember to: a) Structure presentation for allotted time and tailor content to learning needs of the intended audience b) Prepare their presentation in advance to allow time for review and feedback by the practice educator and incorporation of the suggested edits as required c) Develop clear and effective visual aids or presentation tools as required. Prepare handouts in advance of the presentation if applicable. All such materials must be reviewed by the practice educator and/or designated pharmacist before distribution. d) Practice to ensure an organized and well-paced presentation e) Anticipate and prepare for questions the audience may have in advance f) Provide their practice educator with a Presentation Evaluation form 3) Deliver: Conduct the presentation with clear delivery, tailored to the audience. a) Keep track of time and pacing of the presentation b) Use appropriate verbal communication for the intended audience to articulate information with correct terminology c) Use appropriate non-verbal communication to show confidence, enhance interest and audience comprehension d) Listen carefully and effectively respond to audience questions; do not guess at an answer 4) Assessment and feedback: Following completion of each presentation, the student should request to receive feedback and comments from the practice educator and/or designated pharmacist, in order to implement any required changes prior to the next presentation. 5) Student to document completion of activity on Practicum Activities section of E*Value Learning Modules Coursework. Required Forms/Checklists  Presentation Evaluation Form (see Appendix 1) PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 68 Accessory Resources  Presentation Resources folder Practice Educator Verification of Activity Completion PHRM 472 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Module Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 69 3.16 Service In Practice Pharmacists are often conducting service activities which are an essential part of the day-to-day operations of inpatient practice settings. Some of these may be in the context of conducting medication reviews, clarifying prescriber orders, applying for Special Authority Requests, submitting reports and/or arranging medication access on discharge. These services are often done in collaboration with an interdisciplinary team to ensure that patients receive the necessary care and services. Description of Activity This activity will allow pharmacy students to participate in the provision of service in the inpatient setting. Learning Objectives By the end of the practicum experience, within the level of complexity commensurate with year level, the student will have demonstrated the ability to:  Prioritize and manage their time to balance workflow, patient care, and practice requirements  Communicate with patients, the pharmacy team, and other health care professionals to provide health-related services for their patients, their practice site, and as outlined in the pharmacist’s expanded scope Minimum Activity Requirements PHRM 272 No minimum requirement; if time permits and the opportunity arises students are encouraged to participate in service activities as requested and/or suggested by their practice educators. PHRM 472 No minimum requirement; students are expected to seize the opportunity to partake in service activities as requested and/or suggested by their practice educators. Students may spend up to 30% of their practicum duration providing Service based activities in addition to their other activities. Process 1) During the first week of the practicum, the student will clarify and review with the practice educator, the site-specific policies and procedures required in order to engage in service activities. Students are encouraged to observe and ask questions to clarify the process for each service activity as needed. Service activities may include but are not limited to: a) Conducting medication reconciliation on admission, transfer, or discharge b) Providing medication counseling c) Clarifying prescriber orders PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 70 d) Reporting adverse drug reactions e) Conducting drug usage evaluations f) Conducting chart reviews g) Performing allergy assessments h) Performing Patient Safety and Learning System (PSLS) reporting 2) Throughout the practicum, under the guidance and supervision of the practice educator and/or designated pharmacist, the student will participate in various workflow and service activities as they arise in daily practice. Students are encouraged to refer to the appendices in this handbook and resources on Connect/Canvas for guidance as needed Required Forms/Checklists – None Accessory Resources  See activity descriptions and appendices in this handbook and the Accessory Resources folder on Connect/Canvas for guiding documents specific to various service activities. Practice Educator Verification of Activity Completion – None PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 71 3.17 Self-Assessment – PHRM 472 In Practice Practicing pharmacists must engage in self-directed assessment and learning to remain up to date and current; the continued expansion of the scope of practice both encourages and warrants this type of growth. Self-assessment and development of action plans are some methods of implementing the concept of self-directed learning. Description of Activity Students will be asked to self-assess their knowledge, skills, and professional attributes every two weeks while on practicum. Students will reflect on progress made as well as develop actionable steps going forward for improvement. This activity will create an opportunity for continual self-development, which is an important skill required of all pharmacists. Learning Objectives By the end of the practicum experience, the student will have:  Reflected on their knowledge, skills, and professional attributes  Developed and adapted an action plan to help in obtaining outcomes  Completed appropriate activities to achieve identified action plan  Reinforced their understanding of the role of self-directed and life-long learning in pharmacy practice Minimum Activity Requirements PHRM 472 Student to complete one Self-Assessment form and review with practice educator every two weeks (i.e. week 2, 4, 6, 8 for a total of four). Process At two-week intervals (i.e. at the end of weeks two, four, six), the student will: 1) Review the DPC Practice Educator Assessment of Student form and ensure understanding of the expected level of performance and level of patient complexity for their practicum course. 2) Reflect on their performance over the previous two weeks of practicum and how it compares to the expected performance criteria described on the assessment rubric. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 72 3) Log on to the E*Value Learning Modules Coursework site. Document and reflect on their performance using the questions on the respective week’s Self-Assessment form and submit the form for practice educator verification. 4) Review their Self-Assessment form for that week with their practice educator and/or designated pharmacist for guidance and input and make revisions to the action plan, if necessary, based on their discussion. Note:  If the practice educator is in agreement with the self-assessment and action plan, the practice educator will indicate so on the Self-Assessment form on the E*Value Learning Modules Coursework site.  If the practice educator is not in agreement with the student’s self-assessment and/or action plan, and this cannot be resolved through discussion between the student and practice educator, the practice educator will indicate so on the Self-Assessment form on the E*Value Learning Modules Coursework site. In this instance, the student must notify the Office of Experiential Education at phar.oee@ubc.ca immediately such that appropriate support can be provided. Additional Note:  As these are learning practicums, students are not expected to reach the expected level of performance in all areas of the assessment at the onset of their practicum (except for professionalism, of which student must consistently exhibit at all times).  Lower than expected level of performance and/or a discrepancy with the practice educator’s assessment create opportunities for gaps to be identified and corrected. The action plan is intended to help address any deficiencies noted in the knowledge and/or skills of the student.  However, the intention is for the student to reach the appropriate level of performance by the end of the practicum in order to be successful in the course. Required Forms/Checklists  Self-Assessment Week 2, 4, 6, 8 (see E*Value Learning Modules Coursework and Appendix 1) Accessory Resources – None Practice Educator Verification of Activity Completion PHRM 472 Prior to/on the last day of the practicum, practice educator to verify that the student has completed the minimum requirements for this activity through verification of student’s E*Value Learning Module Coursework entry. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 73 REFERENCES 1. AFPC Educational Outcomes for First Professional Degree Programs in Pharmacy in Canada 2017. Available at: http://www.afpc.info/system/files/public/AFPC-Educational%20Outcomes%202017_final%20Jun2017.pdf 2. NAPRA Professional Competencies for Canadian Pharmacists at Entry to Practice. Available at: http://napra.ca/sites/default/files/2017-08/Comp_for_Cdn_PHARMACISTS_at_EntrytoPractice_March2014_b.pdf 3. Lester, S. Novice to Expert: the Dreyfus model of skill acquisition. Stan Lester Developments 2005. Available from: http://www.sld.demon.co.uk/dreyfus.pdf 4. Adapted with permission from: 2011-2012 Structured Practical Experience Program, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario. 5. Adapted with permission: Faculty of Medicine 2003 University of Manitoba, Winnipeg, Manitoba. 6. Adapted with Permission: College of Pharmacists BC, Professional Development and Assessment Program 2012. 7. Adapted with permission from the College of Pharmacy, Faculty of Health Professions, Dalhousie University Jan 2017. 8. Wald, HS et al. (2012). Fostering and Evaluating Reflective Capacity in Medical Education: Developing the REFLECT Rubric for Assessing Reflective Writing. Academic Medicine: 87(1): 41-50. 9. Adapted with permission: College of Pharmacists of British Columbia – Framework of Professional Practice: 2006. 10. Fernandes, OA. (2009). Medication Reconciliation. Pharmacy Practice; 24-32. 11. Mersfedler TL, Bickel RJ. Inpatient medication history verifications by pharmacy students. Am J Health-Syst Pharm. 2008; 65: 2273-5. 12. Canadian Patient Safety Institute and ISMP Canada (2017). Medication Reconciliation in Acute Care Getting Started Kit, version 4. Retrieved March 15, 2017 from: https://www.ismp-canada.org/medrec/ 13. ISMP Canada (2015). Hosptial To Home – Facilitating Medication Safety at Transitions: A Toolkit for Healthcare Providers. 14. Adapted from: Canadian Interprofessional Health Collaborative – A National Interprofessional Competency Framework 2010 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 74 15. A National Interprofessional Competency Framework, Canadian Interprofessional Health Collaborative, February 2010 16. World Health Organization 2010. http://www.who.int/hrh/resources/framework_action/en/ 17. Cipolle RJ, Strand L, Morely PR. Pharmaceutical Care Practice: The Patient Centered Approach To Medication Management, McGrawHill, 2012. 18. Pelletier, Tila. How to Perform a Literature Search [Internet]. Vancouver, BC. 2017 [cited 27 February 2018]. Video: 31mins. 19. Adapted with permission from the Experiential Education Program, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 2016. 20. Adapted with permission from the University of Toronto, Leslie Dan Faculty of Pharmacy, for use in the academic pharmacy program at the University of British Columbia. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 75 SECTION 4 – APPENDIX 1: REQUIRED FORMS 4.1 UBC Pharmacy Student Health and Safety Orientation PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 76 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 77 4.2 72 Hour Checklist2 The practice educator or designated pharmacist should complete this checklist with the student within the first 72-Hours of the practicum. Student Introduction Review with the practice educator or designated pharmacist:  Student Introduction Resume  Learning Contract  College of Pharmacists of BC Confidentiality Agreement (must be kept on site for CPBC inspection)  UBC Pharmacy Learner Health and Safety Orientation Site Introduction & Contact Information  Introduction to pharmacy staff/ front store/ other health care providers  Introduction to practicum site and/or ward  Overview of site workflow  Pharmacy phone number: ________________________  Pharmacy fax number (if applicable): ___________________________  Practice educator(s) contact information: _______________________________  Facilitator contact information (if applicable): _______________________________  Other important numbers student should know: _______________________________ Tour of Practice Site  Fridge for food  Coat and bag storage/locker (if available)  Personal area to work on assignments, store books, and other materials  Private area for patient counseling and discussions  Computers/workspace suitable for use on site/ward  Lunch/staff room, microwave for food, or cafeteria location  Washrooms  Pharmacy department layout/ Pharmacy workflow  Academic resources and references  Site specific orientation program (if applicable) Practicum Scheduling and Planning  Pharmacy operation and/or pharmacist service hours  Determine with practice educator if any access permitted beyond shift hours or not  Daily schedule reviewed (i.e. student schedule including lunch break, practice educator shift, suitable times to review assignments with practice educator)  Tentative 4-week or 8-week plan for the practicum  Time management strategies and assignment deadlines 2 *Adapted with permission: Pharmacy 4080 Manual. College of Pharmacy, Dalhousie University: 2013 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 78  Tentative date for mid-point assessment: _____________  Tentative date for the final review and verification of completion of activities on Practicum Activities Log with practice educator (note: this must be done prior to/on the last day of the practicum) ________  Tentative date for final assessment: _____________  Expectations for meeting deadlines and preparedness for patient activities (i.e. for patient interviews, organizing a clinic, assignments and projects etc.)  Discuss expectations for documentation, including available tools, resources/forms, and site-specific policies (which forms/documentation methods are required to be used by student on site per site policies)  Verify practice educator requirement for online copy or hardcopy/printed patient care activity assignments  Upcoming CE events or other education related events (if applicable) Technology  Software used for patient health information, prescription processing etc.  PharmaNet Access  Computers student can use for looking up patient information (in the pharmacy/clinical room/ward), checking references, working on documents, etc.  Student password access and login  Other relevant technologies onsite (i.e. Scriptpro, Omnicell etc.) Site Policies and Procedures  Patient Confidentiality  Site-specific policies, procedures, and guidelines (e.g. hand washing, etc.)  Appropriate phone/fax/photocopier use  Appropriate use of hand held electronic devices (e.g. smartphones, tablets, etc.)  Procedure to follow for sharps injury (contact OEE - UBC incident form to be completed)  Procedure to follow if sick or student has a personal emergency  Procedure to follow if the student will be late arriving to the site  Procedure to follow in the event of a pharmacy robbery (if applicable)  Emergency evacuation plan/designated safe area to meet  Dress code (including footwear)  Lab Coat requirement  Fragrance policy (i.e. perfume and cologne)  “UBC Student Pharmacist” nametag to be worn at all times (CPBC Bylaw)  Site ID badge (if applicable)  Other (as determined by the practice educator) PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 79 Patient Safety  Describe site-specific policies/procedures for preventing medication errors (e.g. scanning drug products)  Describe pharmacy department’s/site medication incident documentation procedures and reporting system  Review practice educator expectations and level of practice educator supervision required for patient care activities  Review process for student to follow if the student is asked a question and is unsure of the advice to provide to the patient or other health care provider  Other (as determined by the practice educator) Student Learning and Safety  Parking  Public transit locations  Neighborhood safety e.g. walking in pairs if late shift  Any other information that may impact student learning that the practice educator should be aware of Outpatient Practice (including Non-Direct Patient Care) Specifics  Patient care services (i.e. methadone dispensing, delivery services, blister-packing, long term care services, specialty compounding etc.)  Patient products (i.e. ostomy supplies, wound care, assistive devices, home and healthcare products etc.)  Certified personnel on-site (i.e. Certified Diabetes Educator, travel medicine, immunizations)  Inter-professional and intra-professional collaboration  Specific physician approved protocols (i.e. warfarin dosing, pain management etc.)  Other (as determined by the practice educator) Inpatient/ Health Authority Clinic Practice (including Non-Direct Patient Care) Specifics  Patient care services (i.e. obtaining special authority approval, medication/device counselling, etc.)  Patient products (i.e. ostomy supplies, wound care, assistive devices, home healthcare products etc.) if applicable  Inter- and intra- professional collaboration  Hospital overhead paging codes (i.e. code blue, code yellow etc.)  Other (as determined by the practice educator) PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 80 4.3 OEE Resume Template PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 81 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 82 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 83 4.4 Learning Contract Form3,4 Student Name: ____________ Student ID: ____________ PLAN  What are my learning goals and why did I choose this?  What is my primary motivation in choosing these learning goals?  What is my action plan? Consider the learning activities and resources available to help you meet your goals. 1) 2) 3) 3 Adapted with Permission: College of Pharmacists of BC, Professional Development and Assessment Program 2012. 4 Ambrose SA, Bridges MW, Lovett MC, DiPietro M, Norman MK. How learning works: 7 research-based principles for smart teaching. San Francisco, CA: Jossey-Bass; 2010. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 84 ACT  What were some learning activities that I completed to meet my learning goal(s)?  What resources were available that assisted me in achieving these goals? (i.e. lectures, patient care rounds, seminars, online programs, health-related journals) 1) 2) 3) REFLECT  What did I learn in relation to my goal(s)?  Have I used this learning? How will I use this learning in the future?  What future learning goal(s) did this activity trigger, if any?  Will this document be useful for maintaining continuity in learning needs as I transition to the next practicum or out into practice? 1) 2) 3) PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 85 4.5 PHRM 472 E*Value Learning Modules Coursework – Clinical Reasoning PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 86 4.6 PHRM 472 Assessment Guide for Clinical Reasoning Reflection5,6,7 Requires Resubmission (if the criteria outlined in any of the following 4 categories below are met) Satisfactory Submission 1) Summary of Patient Encounter A short summary of encounter and the clinical issue/drug therapy problem that required clinical reasoning skills. Summary does not clearly establish reason for encounter and need for clinical reasoning and/or does not provide an adequate recap of the recommendation provided. Summary is complete and provides description of the reason for encounter and need for clinical reasoning. May be lacking some minor details. The recommendation is clearly stated. 2) Analysis of Patient Assessment a) What information was required and explored to assess the necessary, effectiveness, safety, adherence, and patient specific factors of your decision? b) What clinical evidence or lab data was used to make the assessment and how was it retrieved? (if applicable) c) What questions were asked of the patient/caregivers and/or other healthcare professionals? Analysis of Patient Assessment section omits greater than one of the following points or does not thoroughly represent and effectively communicate:  Information required and/or explored to assess the necessary, effectiveness, safety, adherence, and patient specific factors of the decision  Clinical evidence or lab data used to make the assessment (if applicable) and how it was retrieved  Questions asked of the patient/caregivers and/or other healthcare professionals Analysis of Patient Assessment section clearly addresses the following points:  Information required and/or explored to assess the necessary, effectiveness, safety, adherence, and patient specific factors of the decision  Clinical evidence or lab data used to make the assessment (if applicable) and how it was retrieved. Acknowledgment of non-retrievable data made  Questions asked of the patient/caregivers and/or other healthcare professionals page 1 of 2 5 Adapted with permission: College of Pharmacists of British Columbia – Framework of Professional Practice: 2006. 6 Adapted with permission from the Experiential Education Program, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 2016. 7 Adapted with permission from: 2009 Copyright Medication Management Canada and 2003-2005 Peters Institute of Pharmaceutical Care, Cipolle RJ, Strand LM Morely PC Pharmaceutical Care Practice: The Clinician’s Guide, McGraw Hill, 2004. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 87 3) Patient Outcomes a) What was your recommendation? b) How was your recommendation and rationale documented at your practice site? (if applicable) c) Did the physician and/or team accept it? Why or why not? d) What was the outcome for the patient? Patient Outcomes section omits greater than one of the following points or does not thoroughly represent and effectively communicate:  What recommendation was provided  How the recommendation was implemented and how it was documented at the practice site (if applicable)  Acceptance/rejection of recommendation by health care team and reason why  Patient outcomes Patient Outcomes section clearly addresses the following points:  What recommendation was provided  How the recommendation was implemented and how it was documented at the practice site (if applicable)  Acceptance/rejection of recommendation by health care team and reason why  Patient outcome 4) Reflection a) What specific skills (e.g. communication, problem solving, pharmacokinetics, physical assessment, therapeutic thought process, collaboration, documentation, cultural/health literacy sensitivity, health promotions, etc.) were required for this process? Which were most useful? Which were most challenging? b) How will you use your learning from this experience in your practice moving forward? Reflection omits greater than one of the following points or does not thoroughly represent and effectively communicate:  Skills applied in clinical decision-making process  Reaction to what was observed and/or learned  Impact the experience has had on the student’s future (career decisions, attitude, etc.) Reflection clearly addresses the following points:  Skills applied in clinical decision-making process  Reaction to what was observed and/or learned  Impact the experience has had on the student’s future (career decisions, attitude, etc.) page 2of 2 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 88 4.7 PHRM 472 Presentation Evaluation Form Student Name __________________________________________________ Date: _____________________________________________ Presentation Title ____________________________________________________________________________________________________________ Communication Needs Improvement Meets Expectation Exceeds Expectation N/A Developed presentation at an appropriate level for audience. Used appropriate terminology and is articulate. Used appropriate non-verbal communication to demonstrate confidence and enhance the interest and comprehension of audience. Used clear, legible and effective slides and handouts. Presented information in a logical sequence and effectively communicated the key messages. Spoke in a strong voice and at an appropriate pace throughout the presentation. Actively engaged the audience in the learning activity. Organization and Content Needs Improvement Meets Expectation Exceeds Expectation N/A Developed measurable learning objectives. Summarized relevant literature. Effectively appraised and critiqued the important strengths and weaknesses of the evidence presented and the impact and applicability. Presented clear and appropriate personal interpretation of outcomes of the evidence versus investigators conclusions. Presented a clear final summation and recommendation based on the topic of the presentation. Effectively responded to questions, demonstrating appropriate understanding and reasoning. Able to justify recommendations appropriately. What was the most positive aspect of the student's presentation: What areas need of improvement: 4.8 PHRM 472 E*Value Learning Modules Coursework – Self Assessment Example of form to be completed online on E*Value. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 90 4.9 Student Evaluation of Practice Educator and Practice Site PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 91 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 92 4.10 Student Evaluation of OEE Course PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 93 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 94 4.11 PHRM 272 Practice Educator Assessment of Student PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 95 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 96 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 97 4.12 Direct Patient Care Practice Educator Assessment of Student (PHRM 472) PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 98 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 99 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 100 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 101 PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 102 SECTION 5 – APPENDIX 2: REQUIREMENTS CHECKLISTS 5.1 Requirements Checklist for Best Possible Medication History (BPMH) Interview8 Note: Student expectations for this activity to commensurate with expected year level performance characteristics NA = Not Applicable; U = Unsatisfactory; S = Satisfactory Student Name: 8 Adapted from the University of British Columbia Faculty of Pharmaceutical Sciences Integrations Activity Team. © The University of British Columbia, Faculty of Pharmaceutical Sciences, 2016. All rights reserved. INTRODUCTION: NA U S    Determines identity of patient/patient’s caregiver    Introduces self, practice educator, purpose and duration of interview    Asks permission to ask questions/proceed    Indicates information will be kept confidential and establishes privacy INFORMATION GATHERING: NA U S    Obtains all contact and demographic info (name, address, phone, physician, specialist)    Obtains reason for encounter/hospital admission    Obtains all medication experience info (expectations, concerns, compliance aids, etc.)    Obtains immunization status (childhood & adult)    Obtains all social drug use info (tobacco, caffeine, alcohol, recreational drugs)    Obtains allergy, ADR & alerts/preferences/special needs info    Obtains all current and past medical history    Obtains medication list or pill bottles (vials)    Obtains all current and past medication information  Prescriptions  OTCs  Vitamins/Minerals/Supplements  Complementary alternative medications  Doctor samples  Dosage forms other than oral (i.e. patches/inhalers/creams/injectables etc.):  Asked if there has been any antibiotics used in the past 3 months    Asks detailed questions about indication, dose, duration, route and frequency for each drug    Asks if there’s been any medications recently stopped or changed and the reason    Obtains the name and location of patient’s regular community pharmacy and asks for permission to contact them, if needed PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 103 9 For PHRM 272 -To achieve an overall satisfactory assessment all criteria listed in all sections of this Requirements Checklist must be “satisfactory”, if applicable. CLOSING: NA U S    Briefly summarizes/clarifies information obtained    Offers to answer questions    Says “Thank you”, “Goodbye” (or similar closing) COMMUNICATION SKILLS: NA U S    Sounds professional, assertive, respectful    Well organized, speaks clearly, confidently    Shows genuine interest, engaged not distracted    Uses appropriate questioning (open-ended, one question at a time, no interrupting)    Asks personal questions sensitively; uses preamble or lead-in statements    Uses appropriate language, correct terms/pronunciation, no misinformation    Listens, responds with appropriate empathy    Non-verbal communication appropriate (posture, eye contact, body language, gestures) COMMENTS: OVERALL ASSESSMENT9:  Unsatisfactory  Satisfactory PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 104 5.2 Requirements Checklist for Best Possible Medication Discharge Plan (BPMDP) Counseling10,11,12 Note: Student expectations for this activity to commensurate with expected year level performance characteristics NA = Not Applicable; U = Unsatisfactory; S = Satisfactory Student Name: INTRODUCTION: NA U S    Determines identity of patient/patient’s caregiver    Introduces self, practice educator, purpose and duration of session    Asks permission to proceed    Indicates information will be kept confidential and establishes privacy DISCHARGE COUNSELLING SESSION: NA U S    Provides the patient with an accurate and comprehensive medication schedule    Reviews and counsels on all discharge medications +/- devices and assesses patient’s understanding of each i.e. the purpose of each medication, how it works, dose, timing, potential side effects (with emphasis on any new medications intended duration) and potential interactions etc.    For each medication identifies and communicates the following if applicable:  Medications that have CHANGED while in hospital  Medications that are NO LONGER REQUIRED on discharge  Medications that are TO CONTINUE on discharge  Medications that are NEW and the patient is to take on discharge    Counsels patient on when to seek medical care    Ensure counselling on all other miscellaneous points have been completed (e.g. non-drug measures)    Identify any barriers to non-adherence and offer solutions, e.g. discuss blister packages/dosettes with patient and if this is something they want, document this on prescriptions that are being sent to community pharmacy; assess if special authority applications are in place/required    Ensures outpatient lab requisition is prepared and forwarded to patient (if applicable and not already done by others)    Discusses future steps patient must take (e.g. follow-up with physician in a timely manner, which tests will be needed, etc.)    Ask patient to return all discontinued medications to his/her own pharmacy to minimize any risk of confusion CLOSING: NA U S    Asks the patient and/or caregiver to summarize the discharge medication instructions 10 Adapted with permission from the LMPS (SPH, SMH, VGH) EEF’s Mutually Beneficial Activity Checklists (with contributions from Dr. M. Leung and her directed studies students March 2016). 11 Adapted with permission: Canadian Patient Safety Institute and ISMP Canada (2017). Medication Reconciliation in Acute Care Getting Started Kit, version 4. Retrieved March 15, 2017 from: https://www.ismp-canada.org/medrec/ 12 ISMP Canada (2015). Hospital To Home – Facilitating Medication Safety at Transitions: A Toolkit for Healthcare Providers. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 105    Summarizes main points and offers to answer questions    Advise patient/caregiver to keep the medication list on him/her at all times and share with his/her family physician, specialist(s) or dentist at every appointment    Ask the patient about his/her preferred pharmacy and have the discharge prescription faxed there.  Advise patient to use ONE community pharmacy to fill all prescriptions    Says “Thank you”, “Goodbye” (or similar closing) COMMUNICATION SKILLS: NA U S    Sounds professional, assertive, respectful    Well organized, speaks clearly, confidently    Shows genuine interest, engaged not distracted    Uses appropriate questioning (open-ended, one question at a time, no interrupting)    Asks personal questions sensitively; uses preamble or lead-in statements    Uses appropriate language, correct terms/pronunciation, no misinformation    Listens, responds with appropriate empathy    Non-verbal communication appropriate (posture, eye contact, body language, gestures) PATIENT SAFETY NA U S    Information provided is accurate i.e. no misinformation given to the patient COMMENTS: OVERALL ASSESSMENT13:  Unsatisfactory  Satisfactory 13 For PHRM 272 -To achieve an overall satisfactory assessment all criteria listed in all sections of this Requirements Checklist must be “satisfactory”, if applicable. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 106 5.3 Requirements Checklist for Counseling14,15 Note: Student expectations for this activity to commensurate with expected year level performance characteristics NA = Not Applicable; U = Unsatisfactory; S = Satisfactory Student Name: INTRODUCTION: NA U S    Identifies self and practice educator, offers to counsel, and confirms patient identity (name + at least one identifier)    Explains purpose of counselling session    States approximate time needed    Establishes privacy and confidentiality    Asks other relevant questions (e.g. symptoms, other Rx, or non-Rx meds, allergies, lab etc.) and/or confirms information found in the chart if necessary INFORMATION GATHERING AND DRUG INFORMATION: NA U S    Gives name of medication(s) prescribed (brand and generic)    Asks what the patient knows about the medication    Explains what it is being used for and describes how it works    Indicates directions, frequency and route of administration    Explains any special directions and/or device instructions if applicable. Able to demonstrate proper technique if needed    Explains what the patient should do if they miss any doses    States how long to use the medication SIDE EFFECTS: NA U S    Identifies important and common side effects    Explains how to manage side effects and expected time frame (e.g. will fade with time)    Explains what to do if side effects don’t go away or are intolerable INTERACTIONS: NA U S    Identifies important drug, food, and/or natural health product interactions    Explains interactions and how to manage them; states “no interactions present” if applicable    Advises patient to always check with his/her doctor and/or pharmacist before starting a new or over the counter product LABORATORY MONITORING: 14 Adapted from the University of British Columbia Faculty of Pharmaceutical Sciences Integrations Activity Team. © The University of British Columbia, Faculty of Pharmaceutical Sciences, 2016. All rights reserved. 15 Adapted with permission from the LMPS (SPH, SMH, VGH) EEF’s counselling checklists (with contributions from Dr. M. Leung and her directed studies students March 2016) © The University of British Columbia, Faculty of Pharmaceutical Sciences, 2016. All rights reserved. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 107 NA U S    Explains the need for lab work if applicable including what the lab test is, how often the patient requires testing, and what target values are expected STORAGE: NA U S    Explains storage requirements, shelf life CLOSING: NA U S    Summarizes the main points    Explains what to expect, when to expect it, and how to monitor the response of therapy    Explains what the patient should do if no relief obtained    Offers suggestions to improve medication adherence    Checks for patient’s understanding    Explains what to do if questions or concerns arise; differentiating before and/or after discharge, and when to seek medical attention    Provides written information if available/applicable    Says “Thank you”, “Goodbye” (or similar closing) COMMUNICATION SKILLS (VERBAL / NON-VERBAL): NA U S    Is professional, assertive, respectful    Well organized, speaks clearly, confidently    Shows genuine interest, engaged not distracted    Uses appropriate questioning (open-ended, one question at a time, no interrupting)    Asks personal questions sensitively; uses preamble or lead-in statements    Uses appropriate language, correct terms/pronunciation, no misinformation    Information provided is accurate i.e. no misinformation given to the patient    Listens, responds with appropriate empathy    Non-verbal communication appropriate (posture, eye contact, body language, gestures) PATIENT SAFETY: NA U S    Information provided is accurate i.e. no misinformation given to the patient FEEDBACK COMMENTS: OVERALL ASSESSMENT16:  Unsatisfactory  Satisfactory 16 FOR PHRM 272 ONLY - To achieve an overall satisfactory assessment all criteria listed in all sections of this Requirements Checklist must be “satisfactory”, if applicable. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 108 5.4 Requirements Checklist for Drug Information Responses (DIR)17 Note: Student expectations for this activity to commensurate with expected year level performance characteristics NA = Not Applicable; U = Unsatisfactory; S = Satisfactory Student Name: QUESTION: NA U S    Clearly documents and articulates the drug information question BACKGROUND INFORMATION AND PATIENT ASSESSMENT: NA U S    Provides the general context from which the question arises and provides the background information necessary to understand the question being asked.    Provides the background information necessary to understand the patient, as appropriate:  Pertinent patient information (e.g. age, gender, weight, allergy assessment, body mass index, current diet and exercise, etc.)  Subjective and objective data, including relevant laboratory values, physical signs and symptoms  Family and social history  Patient’s beliefs/concerns and goals for health and wellness  Lists complete past and current medical condition/associated conditions  Lists complete past and current medication therapies (prescription, non-prescription), including generic name, indication, doses, frequency and duration etc.    Uses supporting evidence (laboratory data, physical signs and symptoms, test results, etc.) to support assessment of patient RESEARCH AND RESPONSE: NA U S    Provides a comprehensive, organized, timely response to the DIR [usual length is two to four pages (not including references list), depending on complexity of the question].    Presents information in an organized and logical manner. Answer is concise and does not unnecessarily repeat information.    Describes the search strategy (primary or tertiary literature, databases used, search terms used, etc.) and resources (online tertiary references, guidelines, etc.) used to find information to answer the question.    Answers the specific question and fully discusses the thought process (N,E,S,A) relevant to the drug(s) and medical condition involved (e.g. Necessary – include pathophysiology, signs/symptoms, causes, drug and nondrug risk factors etc.) unless otherwise directed    Conducts critical appraisal and evaluation of the evidence.  Accesses and evaluates the full publication of any evidence if possible (does not use only the abstract to draw conclusions)  Considers the purpose, intervention, methodology of any clinical trials used to answer the question  Clearly represents the results of any evidence found  Considers the strengths and weaknesses of the trial / evidence 17 Adapted with permission: Drug Information Form, BC Drug and Poison Information Centre, Vancouver British Columbia 2012. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 109  Applies the clinical literature to the patient; identifies limitations of applicability    Provides clear and detailed recommendation(s) and rationale for decision-making. Final recommendations include:  Concise dosing recommendations (drug, dose, route of administration, regimen, frequency, and duration) that are patient specific and supported) with appropriate references  Pharmacokinetic dosing and drug monitoring, where appropriate. Incorporate renal dosage adjustment into the therapeutic plan for patient, where appropriate  Tapering/titration schedules, where applicable, that are clearly articulated  Rationale and evidence for ALL recommendations (drug and non-drug)  Patient preferences/values (e.g. once daily versus twice daily dosing)  Non-drug measures that are relevant and patient specific  Adverse drug reaction (ADR) profile of drug option(s) and medication administration  Viable therapeutic alternatives are discussed and rationale for choice is provided. Provide reasoning (compare and contrast Efficacy, Safety and Adherence) for alternatives for your specific patient.  Address patient’s unmet needs.    Summarizes the finding and recommendation(s) into a clear final conclusion or summary paragraph MONITORING PLAN AND OUTCOME: NA U S    States relevant monitoring endpoints, including Effectiveness and Safety endpoints, appropriate frequency, duration, expected change, date, and who is responsible for monitoring and follow up.    Monitoring plan is patient-specific.    States patient’s response to recommendations provided REFERENCES: NA U S    Provides complete citation list using Vancouver style for written submissions.    Uses primary literature and other resources appropriately to address the question. FEEDBACK COMMENTS: OVERALL ASSESSMENT18:  Unsatisfactory  Satisfactory 18 FOR PHRM 272 ONLY - To achieve an overall satisfactory assessment all criteria listed in all sections of this Requirements Checklist must be “satisfactory”, if applicable. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 110 5.5 Requirements Checklist for Inpatient Presentation to Practice Educator19,20 Note: Student expectations for this activity to commensurate with expected year level performance characteristics NA = Not Applicable; U = Unsatisfactory; S = Satisfactory Student Name: INFORMATION GATHERING: NA U S    Pertinent patient information is given (e.g. age, gender, weight, allergy assessment, body mass index, current diet and exercise, etc.)    Provides the reason for encounter (chief complaint) and background information necessary to understand the concern (e.g. history of present illness)    Subjective and objective data is given, including review of systems/physical exam and relevant laboratory values. Able to interpret vital signs, findings of physical assessments and uncomplicated lab values (i.e. INR, serum creatinine, lipids, liver function, etc.)    Family and social history is provided    Patient’s beliefs/concerns and goals for health and wellness are considered    Lists complete past and current medical condition(s)    Lists complete past and current medication therapies (prescription and non-prescription), including generic name, indication, doses, frequency, duration, etc. Provide detail for PRN dosing, adherence, and other relevant information PHARMACEUTICAL CARE PLAN20 NA U S    Identification and prioritization of appropriate Medical Issues/Problems    Justification for prioritization of medical Issues/problems provided For each medical issue:    Reports signs and symptoms    States appropriate goals of therapy    Goals of therapy are patient centered and realistic    Goals of therapy are specific, measurable and the timeframe set is realistic    Identification of all Drug Therapy Problem(s) (DTPs) associated with the medical condition being presented, prioritized appropriately (may use NESA to help with this)    All therapeutic alternatives are assessed appropriately for the patient    Rationale included in assessment of therapeutic alternatives    Chooses the best option, provides justification and makes reasonable medication recommendations    Pharmacological interventions include: dose, route, frequency, and duration    Patient preferences have been taken into account    Both pharmacological and non-pharmacological options are explored    Provides an appropriate monitoring plan with efficacy and safety endpoints    Each parameter for monitoring is clear: frequency, expected change, timeframe, who is to monitor COMMUNICATION SKILLS (VERBAL / NON-VERBAL): 19 Adapted from the University of British Columbia Faculty of Pharmaceutical Sciences Hospital Transition Modules. © The University of British Columbia, Faculty of Pharmaceutical Sciences, 2016. All rights reserved. 20 FOR PHRM 272 ONLY: Students are expected to complete a minimum of 1 patient work up and develop a care plan for a minimum of 1 of that patient’s medical conditions. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 111 NA U S    Speaks clearly with appropriate tone and pace    Uses appropriate eye contact, body language, and posture    Confident and relaxed when reporting    Information is delivered effectively and efficiently (i.e. not excessively wordy)    Information is well-organized and flowed smoothly    Uses appropriate professional language PATIENT SAFETY: NA U S    Information provided is accurate i.e. no misinformation given FEEDBACK COMMENTS: OVERALL ASSESSMENT21:  Unsatisfactory  Satisfactory 21 FOR PHRM 272- Students are expected to complete a minimum of 1 patient work up and develop a care plan for a minimum of 1 of that patient’s medical conditions and present the patient and care plan to the practice educator for assessment using this Requirements Checklist. To achieve an overall satisfactory assessment all criteria listed in all sections of this Requirements Checklist must be “satisfactory”, if applicable. PHRM Inpatient Practicums Handbook Copyright © 2018 UBC Faculty of Pharmaceutical Sciences, Office of Experiential Education. All Rights Reserved. 112 5.6 Requirements Checklist for Allergy Assessment22 Note: Student expectations for this activity to commensurate with expected year level performance characteristics NA = Not Applicable; U = Unsatisfactory; S = Satisfactory Student Name: ALLERGY ASSESSMENT: NA U S    Information gathering is thorough and relevant. All questions from the Allergy Assessment Form are asked and documented appropriately (in the patient’s medical chart, the institution’s pharmacy records, and PharmaNet if needed).    Student interprets the information provided by the patient appropriately in completing the “Drug Allergy Assessment” step. Student is able to differentiate a true drug allergy versus adverse drug reaction/intolerance.    Student appropriately identifies recommended “Pharmacist Action,” where applicable.    Student follows up on allergy recommendations (e.g. Epipen counselling) where applicable.    Student identifies any non-drug allergy(s).    Student documents non-drug allergy(s) appropriately. COMMUNICATION SKILLS (VERBAL / NON-VERBAL): NA U S    Speaks clearly with appropriate tone and pace    Uses appropriate eye contact, body language, and posture    Confident and relaxed when reporting    Information is delivered effectively and efficiently (i.e. not excessively wordy)    Information is well-organized and flowed smoothly    Uses appropriate professional language PATIENT SAFETY: NA U S    Information provided is accurate (i.e. no misinformation given to the patient) FEEDBACK COMMENTS: OVERALL ASSESSMENT:  Unsatisfactory  Satisfactory 22 Adapted from the University of British Columbia Faculty of Pharmaceutical Sciences Integrations Activity Team. © The University of British Columbia, Faculty of Pharmaceutical Sciences, 2016. All rights reserved.
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Inpatient Practicums Handbook for Students and Practice Educators : Introductory and Advanced Pharmacy Practice Experiences (IPPE, APPE) – Inpatient
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