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INTRODUCTORY PHARMACY PRACTICE EXPERIENCES
(IPPE-I COMMUNITY)
PHAR 4139
Fall 2014
August 18 – December 2, 2014
Instructor:
Matthew Zak, Pharm.D., BCPS
Assistant Director of Experiential Education
Office: Room 332
Phone: (585) 385-7379
Fax: (585) 385-5295
Office Hours – Friday 12:30 – 2:30
Email: [email protected]
St. John Fisher College Wegmans School of Pharmacy
IPPE-I (Introduction to Community Pharmacy)
Welcome to the Introductory Pharmacy Practice Experiences (IPPE) I. This introductory
rotation is the first of four introductory rotations offered at the Wegmans School of Pharmacy
(WSOP). The focus of this rotation will be to introduce the student to the practice of
pharmacy in the community setting.
Please review the course description, homework, tasks and other learning activities in this
manual. The student will spend a minimum of eight hours per week at a site to observe and
participate (as allowed by law and preceptor) in the daily operations of a pharmacy in New
York State. Weekly homework and tasks have been developed to help the student benefit
from these early experiences. In addition, weekly classroom sessions will allow for lively
student discussion, reflection and critical thinking. Classroom discussions will review the
student activities that occurred on rotation.
A special THANK YOU goes to the Outpatient Preceptor Advisory Committee (OPAC)
members who volunteer their time to make this manual a tool for excellence in pharmacy
student education.
Accessory
The student will create and maintain a MyFolio virtual portfolio in E*Value to maintain and
update various professional documents; resume/CV, intern permit, HIPAA training forms,
immunization documentation. The students are encouraged to share such documentation
with their preceptor as necessary in order to enhance their learning experience and to allow
the preceptor to customize the experience for the student. In addition, students will upload
completed assignments, homework, forms etc. that the student has completed during this
rotation in E*Value (Coursework). The student will also complete a pre-rotation selfevaluation form.
Confidentiality
Patient information is private and we are entrusted with it. The patients trust us because we
are health care professionals.
Therefore, confidentiality is the foundation for the
establishment of trust between patients and health care providers. The students are
expected to not discuss any patient information that they have encountered at their rotation
sites outside of their learning environment. Any infraction will result in immediate dismissal
from the site and a failing grade will be given for the rotation. The student will be reported to
the Student Progress Committee.
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Letter to the Preceptor
Thank you very much for contributing your time and effort in our educational endeavor. We are
preparing a generation of professionals who will lead our profession into the future. Preceptorship is
an opportunity to shape the future of pharmacy.
PHAR 4139 is a 15 week rotation in which each student will complete a total of 120 hours in the form
of one, eight hour day each week over the Fall semester. The student will spend the majority of time
assisting in the operational aspects of the pharmacy - the process for getting the medication to the
patient in an accurate and timely fashion. The student will also complete homework and tasks which
will enhance the learning experience. The homework and tasks must be approved by the preceptor
and if not acceptable will be repeated until completed to the preceptor’s satisfaction. Finally, the
student will keep a reflection journal that will be reviewed and discussed with their preceptor.
The students will upload all documents to E*Value Coursework (Learning Modules) for review by the
preceptor. Preceptors should review the student’s documents in E*Value and discuss their growth
and educational plans in regards to the pharmacy profession. The preceptors will also verify
completion of homework assignments and tasks and assess student performance in E*Value.
Preceptors will be notified electronically when their student has submitted assignments/tasks and
when formative and final assessments are due.
Expectations of Preceptor:
1. Explain your expectations to student: start times, HIPAA requirements, etc.
2. Introduce student to site/staff and review rotation schedule (total 15 days).
3. Attend development presentations at school as the preferred method of preceptor training. In lieu
of
attending
presentations,
review
materials
on
our
website
available
at:
http://www.sjfc.edu/academics/pharmacy/preceptors/. For groups, an on-site presentation
can be scheduled by contacting the Experiential Education Office (585) 385-7249.
4. Set dates when students will complete activities.
5. Set dates and time for the a formative assessment (week 7), final assessment (week 14), and
Preceptor Summary Grading Sheet (week 14).
6. Coach and mentor students to achieve mastery of “task list” starting with week two.
7. Coach and mentor student regarding homework – give practical examples to reinforce learning.
8. Review student’s homework and provide feedback to the student.
9. Identify and resolve student difficulties early. For serious issues such as repetitive tardiness or
unexcused absences, document the issue and notify the Experiential Education Office as
soon as possible. A feature in E*Value is the Student Concern Card, a feature which sends our
office a message regarding any student issues you would like us to be aware of. You can access
a concern card by clicking on Evaluations/On-The-Fly.
10. Discuss career options with the student (locally at current site and other sites in general).
11. Motivate, motivate, motivate, and motivate the student some more. Share your pharmacy
practice challenges and how you handle these difficult situations.
Should you have any questions, please contact:
Andrea DiGiorgio
Experiential Education Coordinator
Wegmans School of Pharmacy
St. John Fisher College
3690 East Avenue
Rochester, NY 14618
Ph: (585) 385-7249
Fax: (585) 385-5295
[email protected]
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IPPE-I Overview
1. PRE-ROTATION STUDENT SELF-ASSESSMENT: The student will complete
this form approximately 30 days prior to the start of rotation. The purpose of this
assessment is to give the preceptor an idea of how much experience and knowledge the
student has pertaining to the assigned rotation. This will help the preceptor in her/his
teaching methods especially in the beginning of the rotation.
2. HOMEWORK: Student and preceptor are to discuss homework one week ahead
of the due date. For example, homework listed under week two should be
discussed during week one, and uploaded to Coursework for the preceptor to
review on week two. The preceptor will then discuss the homework with the
student, point out its strengths and weaknesses, and comment. If the homework
is acceptable, the preceptor will mark it as such in Coursework. If not
acceptable, the student must re-do the paper. A copy of the homework should
also be brought to class to share during classroom discussion.
3. ACTIVITIES/TASKS: The student must complete and have their preceptor verify
(in E*Value) as acceptable all required activities/tasks in order for the student to
pass the rotation. For each task the student will check off the number of the
completed task, document the date of completion and a description of what
occurred, if requested by the preceptor. The activity may be repeated until the
student masters the activity.
4. PATIENT COUNSELING: The student must complete a patient counseling
session regarding significant medication use issues with empathy and at a level
the patient can comprehend. The preceptor will evaluate the student using the
patient counseling evaluation rubric and if not acceptable, the preceptor may
require the student to complete the task until acceptable.– (use appropriate
evaluation form in the manual)
5. JOURNAL REFLECTION: The student will document practical knowledge and
error prevention strategies learned on rotation through weekly journal reflection
(see example later in manual). This document will be uploaded to Coursework
by the student for preceptor review. If not acceptable, the preceptor will provide
guidance and the student will repeat the exercise.
6. TIME VERIFICATION FORM: Once completed and signed by the preceptor, the
student should scan and upload the signed form into E*Value (Coursework).
7. FORMATIVE ASSESSMENT (week 7): Student and preceptor should complete
forms independently on-line in E*Value on week seven. These forms should be
printed. Student and preceptor should compare the student’s self-assessment
with the preceptor’s assessment and discuss the differences and similarities. A
strategy for enhancing the student’s learning for the remainder of the rotation
should be discussed. For students at risk for failure during a formative
assessment, a written plan of action for improvement, should be composed
by the preceptor and student, signed by the student and preceptor and a
copy sent to the Assistant Director of Experiential Education and uploaded
into the Action Plan folder in MyFolio.
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8. FINAL PRECEPTOR and STUDENT ASSESSMENTS:
Must be completed and submitted online in E*Value by Thursday of week 14.
a. Student must complete their final self-assessment and final assessment of
preceptor and site during week 14.
b. Preceptor should complete their final assessment of the student during week
14.
c. Preceptor should discuss their final assessment of the student with the
student and make any final suggestions and/or comments to the student
during week 14 or 15.
NOTE: Documents should be verified by preceptor and maintained by the
student in Coursework. Student is responsible to make sure preceptor
completes all required documents.
Rotation Policies & Regulations
The student must share and discuss the rotation manual with his/her preceptor
during the first day of rotation. The student is responsible for reading the content of the
rotation manual and is expected to follow the policies and regulations as stated. The
student will also comply with the following: (1) all the rules, policies, and procedures of the
site; and (2) established standards of pharmacy practice and applicable federal and state
statutes and regulations. Any infringements may lead to automatic dismissal from the site
and failure of the rotation.
I.
Pre-requisite
Possession of a valid New York State intern permit (which requires completion of the
first professional year of pharmacy school in good standing), HIPAA training certificate
and the necessary medical records as required by the site.
II.
Health records
Students should have all site required health records up to date (physical examination,
immunization, PPD and/or CXR) before starting rotation. These requirements will vary
by site. Copies of these records should be physically kept in your possession, uploaded
in MyFolio, (SJFC WSOP Health History Folder) and a hard copy given to the Wellness
Center. Failure to adhere to this policy may result in the delay of your rotation.
III.
Professional insurance
St. John Fisher College arranges liability insurance for students at school assigned sites
each year.
IV.
Site Selection
a. A site assignment is tentative and does NOT guarantee that a student will attend that
site.
b. Student is responsible for ALL expenses associated with attending site.
c. Students may NOT have a first degree relative as a preceptor.
d. Students may NOT receive academic credit for working at a site where they are
currently employed.
e. Students will NOT accept any remuneration from the site while on rotation.
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f.
For IPPE-I, APPE Institutional, or APPE Community, students may NOT select a
rotation site at which they are currently employed.
g. The Assistant Director of Experiential Education or assigned preceptor can refuse a
student assignment if she/he feels there may be a conflict of interest.
h. For IPPE I and APPE Community Pharmacy a student may not select a site where
they have been employed in the past.
i. For IPPE-III, IPPE-IV, APPE Ambulatory Care, APPE Inpatient/Acute Care General
Medicine or APPE Electives, a student may NOT select a site where their potential
preceptor would have a dual role as a preceptor and a “boss” or ”job reviewer”. If
the assigned preceptor does not have such a role, then the student can perform a
rotation in an institution where they are currently employed.
j. Students who feel that they may not meet the above guidelines should contact the
Assistant Director of Experiential Education and the prospective preceptor before
selecting the site
V.
E*Value and Coursework Portfolio
The student is responsible for maintaining and uploading all required documents to
E*Value and Coursework. This system will be used for verifying compliance and
assessing student performance.
VI.
Grading
Grading will be Satisfactory (Pass) or Unsatisfactory (Fail). Failure of either portion of
the course (rotation or didactic lecture) will mandate repeating the entire course.
VII.
Evaluations
The preceptor will evaluate the student throughout the rotation. Formal and informal
feedback is encouraged. Preceptor evaluations of the student (both professionalism and
learning outcomes) should be used to encourage student improvement in specific areas
where the student is not performing well. The student must evaluate the preceptor,
rotation site and assignment process during week 14 of the rotation. Failure to adhere to
this policy may result in an incomplete grade or failure. Failure may result if required
documents are not completed and received by the Experiential Education Office by their
due date.
VIII.
Weather conditions
All students should follow the weather advisory from SJFC regarding cancellation or
delay of classes on campus. However, the students who cannot travel to their sites due
to hazardous weather conditions should immediately notify their preceptors and the
Experiential Education Office at (585) 385-7249. Attendance policy still applies
regarding make up days and missing days.
IX.
Dismissal from sites
All students are representing Wegmans School of Pharmacy and the Pharmacy
profession during their presence at the rotation site. Therefore, professionalism and the
highest standards are expected from students during their training at the sites. The
Department of Pharmacy Practice and the site reserve the right to dismiss any student
who does not uphold a professional attitude during the rotation time. Any student caught
under the influence of any substance of abuse/addiction, or caught stealing from the site
will be dismissed automatically and fail the rotation. The student will then be reported to
the Student Progress Committee and if necessary, the WSOP Student Honor
Committee.
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X.
Academic Honesty & Plagiarism
St. John Fisher College has a firm policy concerning academic dishonesty that includes,
but is not limited to, cheating, plagiarism, or any other action that misrepresents
academic work as being one’s own. Students are expected to demonstrate academic
honesty in all coursework, whether completed in-class or not, individually, or as part of a
group project. All students are expected to be familiar with the details of the Policy on
Academic Honesty, which are found in the current Student Handbook.
XI.
Professionalism
Consistent with the expectations of a professional and practice environment,
professional behavior and attitudes are expected for all students enrolled in this course.
Examples of professional behavior include, but are not limited to, appropriate demeanor,
grooming, punctuality, and civility.
XII.
Personal Appearance
As a representative of the School of Pharmacy, a student’s personal appearance is an
extension of the School and will, to some degree, determine how customers, patients,
and colleagues view the student, the program, and the profession of pharmacy.
Conservatism and discretion are key determinants of professional attire. Business
casual is the minimum requirement for appropriate attire for students during the three
didactic years of the Pharmacy program. The following guidelines for attire are provided
to assist the Pharmacy Doctoral Candidate to what is deemed as acceptable. The WSoP
Dress Code shall be in effect from 8:00 AM until 5:00 PM Monday through Friday and
covers the WSoP building and atrium. Students are also expected to adhere to the code
when serving as a representative of the program.
a. Hair: Hair should be clean and neatly groomed. Hair may not be dyed any
unnatural hair colors. Males shall have short hair (above the shoulders) and it
shall be neatly combed. At times and at the discretion of the course instructor,
(lab, etc), it may be necessary for females with longer hair to have it pulled back.
Hair ornaments shall be moderate and in good taste.
b. Nails: Nails must be neatly manicured (not chipped) and kept at a length that will
not interfere with the duties of a pharmacist (e.g., dispensing prescription,
compounding in lab, making IVs). If polish is used, it must be conservative in
color.
c. Skin: No body piercings (other than earrings) or tattoos are allowed to be visible.
d. Permissible Jewelry: Females and males are allowed no more than two
earrings per ear. Earrings should be of a conservative nature (not large, no
gauges or stretchers, etc).
e. Shirts: Revealing clothing (e.g., tank tops, spaghetti straps, halter tops, midriffs,
tube tops, swim tops) is not permitted, and proper undergarments shall be worn.
For men sweaters are acceptable. If shirts are worn they should have a collar
and should be tucked in. For women, blouses should not be low cut or tight
fitting. Hoodies and sweatshirts may not be worn in the building during the hours
that the dress code is in effect.
f. Skirts/Dresses: Skirt length shall be no shorter than one inch above the knee
(when standing) and may not be tight fitting. Split skirts are permitted, provided
they are not tight fitting and fall within the skirt guidelines.
g. Pants/Slacks: Pants shall not be tight fitting. Denim of any color, spandex,
leggings, athletic wear, and sweat suits are not permitted. Pants must be worn
properly at the hips. Any pants that contain rivets are not considered business
casual. No shorts of any kind are allowed in the building during the hours that the
IPPE I Manual
7
dress code is in force. No student shall dress in a way that his/her underwear is
partially or totally exposed and proper undergarments shall be worn.
h. Shoes: Shoes must be clean and in good condition. Non-dress open toe casual
sandals (flip flops, Birkenstocks, etc) shall not be worn. No athletic shoes or
sneakers are permitted.
i. Head Gear: Hats, caps, and other head gear may not be worn in the building
during the hours that the Dress Code is in effect. Only headgear worn for bona
fide religious purposes is permissible.
Should the student be cold in class this
code shall not prohibit a student from wearing a jacket during class.
A faculty member who sees a student in violation of the student policy and
procedures will counsel that student. Continued infractions of the student policy and
procedures will result in sanctions appropriate to the policy (such as being sent home for
repeated violations of dress code).
XIII.
Confidentiality & HIPAA
Patient information is private and we are entrusted with it. The patients trust us because
we are health care professionals. Therefore, confidentiality is the foundation for the
establishment of trust between patients and health care providers. The students are
expected to not discuss any patient information that they have encountered at their
rotation sites outside of their learning environment. The student will also complete and
abide by any site specific HIPAA requirements. Any infraction will result in immediate
dismissal from the site and a failing grade will be given for the rotation.
XIV.
Sexual Harassment
Sexual harassment is strictly prohibited. Below is the legal definition of sexual
harassment, any allegation of sexual harassment by preceptor or student MUST be
reported immediately to the Assistant Director of Experiential Education and the Director
of Human resources. Sexual harassment, by law, is defined as unwelcome sexual
advances, requests for sexual favors, or other verbal or physical conduct of a sexual
nature when 1) submission to such conduct is made an explicit or implicit term or
condition of employment, 2) submission to or rejection of such conduct is used as a
basis for employment decisions, or 3) such conduct has the purpose or effect of
unreasonably interfering with an individual’s work performance, or educational
experience, or creates an intimidating, hostile, or abusive work or educational
environment. Sexually harassing conduct may include, but is not limited to, sexually
charged or sexually suggestive comments or jokes, sexual advances, requests for
sexual favors, sexually suggestive pictures, drawings or emails, or similar conduct of a
sexual nature.
XV.
Student Complaint Process
If the student feels they are being asked to perform an activity that is considered
unprofessional conduct, puts patients or the student at risk for harm, or is contrary to the
law, policies and/or regulations of the institution, site or college, the student should
immediately discuss the concern with their preceptor. If the student is not satisfied with
their preceptor’s response the student should immediately contact the Experiential
Education Office at (585) 385-7249. The Assistant Director of Experiential Education will
then talk with the student and preceptor to discuss possible options.
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Preceptor (P) and Student (S) Rotation Reminders:
Week 1
1. Preceptor to review manual with student. (P and S)
2. Schedule date and time for formative (week 7) and final assessment (week 1415) with student. (P and S)
3. Review student’s homework and activity due week two with student. (P and S)
4. Complete Time Form. (P)
5. Complete Journal Reflection. (S)
Week 2-14
1. Review homework and journal reflection due the next week with student. (P and
S)
a. Review, comment, and verify (if acceptable) last week’s completed
homework with student. (P and S)
2. Complete weekly homework within 24 hours of rotation. (S)
3. Complete on average one task a week observed by preceptor. (S)
4. Complete Time Form. (P)
5. Complete Journal Reflection on day of rotation. (S)
a. Review, comment, and verify last week’s journal writings. (P)
6. Upload all completed/acceptable assignments (homework, journal writing) into
E*Value (Coursework) in a timely manner. (S)
7. Complete formative assessment of student at week 7. (P)
8. Complete formative self-assessment at week 7. (S)
9. Preceptor and student to compare formative assessments and discuss
similarities and differences at week 7. (P and S)
10. Complete preceptor and site final assessments at week 14. (S)
11. Complete final student self-assessment at week 14. (S)
12. Complete final assessment of student and Summary Grading Sheet week 14.
(P)
Week 15
1. Compare & discuss preceptor’s final assessment of student with student’s final
self-assessment during week 14 or 15. (P and S)
2. Complete Time Form and sign. (P)
3. Complete Journal Reflection. (S)
4. Upload Time Form completed by preceptor into E*Value. (S)
5. Upload Homework Verification Form verified by preceptor into E*Value. (S)
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FORMS
Preceptor required to complete:
Time Form
Patient Counseling Rubric
Formative/Final Preceptor Assessment of Student (Professionalism and Learning
Outcomes) at weeks 7 and 14
Preceptor Summary Grading Sheet
Student required to complete:
Journal Reflection
Student Pre-Rotation Self Evaluation
Student Self-Assessment (Professionalism and Learning Outcomes) at weeks 7 and
14 (use the same form as above)
Final Student Assessment of Preceptor*
Final Student Assessment of Rotation Site*
Professionalism Pledge
Sample Action Plan
Absence Request Form - if needed
Optional Challenge Assignments
*
Because your feedback is critical in the process used to improve courses in the WSoP
curriculum, the faculty has adopted a policy requiring all students to participate in the
evaluation process in order to optimize the data we receive. To achieve this, participation in
the process is now a requirement for passing all WSoP courses. Students failing to
complete the evaluations will receive an “incomplete” in all courses not evaluated. The
incomplete can only be removed by completing the evaluations.
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Time Form
Student Name:
Rotation Site:
Date:
Preceptor Name:
It is the student’s responsibility to have this form completed by the preceptor.
Hours
Preceptor’s
Preceptor’s comments
signature
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Week 7
Week 8
Week 9
Week 10
Week 11
Week 12
Week 13
Week 14
Week 15
Total hours
(Should be ≥
120 hours)
This is a form that must be maintained by the student and once completed, students
will scan and upload into E*Value for review by the Assistant Director of Experiential
Education to verify completion.
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Homework Assignments
Please upload your homework as a single page, typed, double spaced paper to Coursework
for preceptor review, discussion, and comments. The report is due the week of the
assignment date. For example the topic listed with week two is due week two, therefore, the
student should have reviewed this question and discussed it with her/his preceptor during
week 1 of the rotation. Your preceptor will then designate it as acceptable or unacceptable.
If the assignment is deemed unacceptable by the preceptor, the student must resubmit the
assignment until it is acceptable. Homework should be completed at home unless allowed
specifically by the preceptor to be done at site.
Date
Week 1
Week 2
Week 3
Week 4
Topic
Orientation to site and introduction to site’s team. Discuss importance of
completing requirements on time, review evaluation criteria, schedule
assessment dates/times for weeks 5, 10, and 15. Write an overview of the
profession of pharmacy, why you (student and preceptor) chose pharmacy and
discuss how you feel about current pharmacy issues of importance i.e. Direct to
Consumer Advertising (DTCA), Medicare D, etc
Describe what your preceptor believes is the importance of pharmacists
to society. List what your preceptor believes are important traits of
being a professional in pharmacy. What do you believe is the role of
pharmacist in society? List the items required to be on a non-controlled
substance prescription.
- http://www.op.nysed.gov/title8/part29.htm
§ 29.7 Special provisions for the profession of pharmacy. (a) 1
List the activities unlicensed persons can perform in a pharmacy.
- http://www.op.nysed.gov/title8/part29.htm
§ 29.7 Special provisions for the profession of pharmacy. (a) 21
Write the mission statement of the organization or pharmacy. If unknown,
create one based on your preceptor’s professional activities at the site. What is
the purpose of a mission statement and how does it impact the activities of the
pharmacy?
Discuss what the preceptor feels is a commonly used drug that is most likely to
cause an Adverse Drug Reaction (ADR).
Discuss what the preceptor feels is a commonly used drug that is most likely to
be involved in a significant (clinically important) drug interaction.
Week 5
IPPE I Manual
Describe the responsibilities of team members (pharmacist, student, tech,
clerk, others) in the pharmacy. Use of a grid or table may help. Consider the
following:
1. Order entry
2. Inventory management
3. Offer to counsel patients
4. Counseling patients
5. Billing/payment issues
6. Scheduling of pharmacists/technicians
7. Customer/Patient relations
8. Error management
12
List the clinical services the preceptor would like to provide.
Observe and describe an OTC clinical service given by your preceptor.
Mention the following:
Week 6
1. Disease state pathophysiology
2. Medication name (B & G), dose, frequency, duration, counseling
3. Pharmacology, absorption, distribution, metabolism, excretion, adverse
effects, drug interactions
4. Contraindications to use of the medication
5. Alternative OTC medications available
6. Why the product was chosen over alternatives
List the most frequent class of medications the pharmacy dispenses and
compare to the least frequently used class of medications. Why the usage
difference?
Week 7
What is the newest medication to be put on the shelf? What is it used for?
How does the preceptor feel about bad handwriting? What problems can it
cause?
Week 8
Week 9
Week 10
Describe the medication organization on the shelves. Is it organized by brand
name, generic name, class of medications, or other? What are the advantages
and disadvantages of the method of organizing the medications? How can the
current organization minimize medication errors? How could this be improved?
Describe the two most effective error prevention techniques used at your site
and how they improve patient safety. Consider the following:
1. NDC checks
2. Error reporting
3. Double checks
Why are they the most effective? How could they be improved?
Which health care professional should take the lead in preventing medication
errors? Why?
Describe how the drug interactions software handles drug interactions. Explain
the various levels of severity-what do they mean? Give an example of a typical
drug interaction identified by the computer system, its level of severity and how
you would handle that situation. In other words would you call the provider, just
refuse to dispense the medication and tear up the prescription, dispense the
prescription with verbal counseling…?
Describe your site’s automated dispensing equipment - if any. What is the
advantage to using this equipment? Is there a potential danger to using the
system? Explain.
Week 11
IPPE I Manual
Outline the process for filling a prescription at your site. Start with the patient
presenting a prescription to the pharmacist (or intern) and end with the patient
paying for the prescription. Be sure to include patient history and counseling.
Describe how technology is used to prevent errors and increase efficiency at
your site?
13
Week 12
State the drug information reference your preceptor prefers and why. Describe
the pharmacology and counseling points for the following: Commit® [OTC];
NicoDerm CQ® [OTC]; Nicorette® [OTC]; Nicotrol Inhaler® [OTC]; Nicotrol NS®
[OTC];
Describe a continuous quality improvement process used by the site or your
preceptor.
Week 13
In NY State when should a patient be offered counseling? Under what
circumstances can an unlicensed person or an intern make an offer to counsel a
patient?
http://www.op.nysed.gov/prof/pharm/part63.htm
§63.6 Registration and operation of New York establishments.
Week 14
According to NY State law list the items required to be in a patient’s medication
profile. Before a prescription is dispensed a prospective drug regimen review
should be conducted such as screening for drug-drug interactions. List the
other required screening elements.
http://www.op.nysed.gov/prof/pharm/part63.htm
§63.6 Registration and operation of New York establishments.
Week 15
IPPE I Manual
Final assessment, grading and future advice.
14
Tasks
The tasks below must be successfully completed by the student and verified by the preceptor. The
date should be documented where indicated. The preceptor may ask you to write a brief description
of the completed task at their discretion. A task may be repeated until the student masters it.
Starting with week two of the rotation, at least one task should be completed on a weekly basis. All
tasks should be completed by week thirteen. Successful completion of the course requires the
student to successfully perform all tasks.
1. Interview patients to obtain appropriate information needed to properly fill
prescriptions such as:
- demographic information
- medication history
- allergies
- insurance information
2. Fill prescriptions in an accurate and timely fashion
enter prescription information into computer
print label
select medication
fill medication bottle
label
- complete safety checking
-
3. Counsel a patient where you have to say “I don’t know the answer to that
question, but I will research it and get back to you”
-
student will not default to preceptor for answer
- student arranges mutually agreeable time to discuss researched answer with patient
- student will perform necessary steps to obtain answer independently and contact
patient for follow-up counsel
4. Provide drug information to patients/other healthcare personnel
- use medication safety guides from site or the web at:
http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm
- use drug information sources at the site such as USPDI or Facts and Comparisons
5. Counsel patients regarding significant medication use issues with empathy and
at a level the patient can comprehend – (use appropriate evaluation form in
the manual)
- observe preceptor counsel
- perform a practice counseling session with pharmacy personnel and have your
preceptor critique you
- perform a counseling session under your preceptor’s supervision following the “Patient
Counseling Evaluation Form” in the manual
6. Accept a verbal prescription from a health care provider under the supervision of
a preceptor:
- may be taken from a recording or simulated by your preceptor
- repeat order back to provider as an error prevention technique
7. Appropriately interact with other members of the pharmacy team and understand
the importance of technicians and other support personnel
- student can describe the functions of the pharmacy technician
- student performs the major functions of a technician
IPPE I Manual
15
8. Identify adherence (compliance) issues in patients with chronic diseases
(hypertension/diabetes) via refill records and take action in a non-judgmental
fashion to discuss the reasons for the non-adherence - if possible create a plan
or strategy to improve adherence
- student will identify non-adherence of a chronic medication by reviewing refill records
- student will counsel the non-adherent patient and identify why this occurs and work
with the patient to overcome this issue
9. Re-order medications to keep inventory at optimal levels
- student will participate in the process to keep medication at ideal levels for the site
- student will explain how the pharmacy determines the optimal quantity for a given
medication
10. Bill third party carriers for prescription coverage
- student will perform on-line adjudication of prescriptions
- student will resolve simple problems associated with the rejection of a claim
11. Perform the calculations and compound a combination product
- student will perform the required calculations and prepare a compound prescription
under the supervision of a preceptor. If the pharmacy doesn’t receive an order for a
compound, the RPh can assign the student to make a 1% cream of the drug of their
choice.
IPPE I Manual
16
Patient Counseling Evaluation Form
Did Not
Complete
Partially
Completed
Completed
Not
Applicable
Comments
Appropriate professional
introductions:
Identify self, professional title,
identify patient (full name)
Explains the purpose and
importance of the session
Didnotmeet
minimums
Gets patient’s consent to proceed
Didnot
complete
MedicationReconciliation: Full
credit must include a listing of ALL
medications (name, dose,
frequency) patient counseled on.
Didnotmeet
minimum
requirements
Patientspecificprofile
informationreview
Allergies and type of reactions are
reviewed
ScreenedforETOH,tobacco,
caffeineandherbal/OTC use.
(for full credit you must cover all
these elements)
Usedopenendedquestions:
“What” did your doctor tell you?
“How” did he tell you to take it?
“What” concerns do you have?
Didnotmeet
minimum
requirements
Allergiesreviewed
butreactiontype
notdiscussed
Didnotmeet
minimum
requirements
Partiallymet
requirements
Inconsistentuse
ofopenended
questionsor
ignoredpt
specific
feedback
Didnotask
probing
questionto
assesspatient
understanding
Doesnot
identifypatient
concernor
counselis
inappropriate
Someopenended
questions/didn’t
useptspecific
feedback
Didn’tconsistently
askprobing
questionstoassess
understanding.
Allcompletedina
natural,comfortable
andappropriate
manner.
Consistentlyused
openended
questionsand
providedfollow‐up
orcommenttopt
response
Consistentlyasked
probingquestions
toassessknowledge
andunderstanding.
Identifiespatient
concernbutdoes
notprovide
appropriatecounsel
Identifiespatient
concernand
provides
appropriatecounsel
Information
providedwas
unorganized,
conversation
wasstiltedor
unnatural.
Someinfowas
presentedoutofa
naturalsequence/
conversationwith
thepatientwasless
thannatural.
Allinformation
providedwas
logical,succinctand
tothepointand
wellcommunicated.
Inaccurateinfo
provided,but
wouldnotresult
inpatientharm.
Mostinfoaccurate
withlessaccurate
elementswouldn’t
resultinptharm.
Allinformation
providedwas
accurate
Discussionlevel
toohighfor
patient
comprehension.
Didn’tseept
cuestoIDlack
ofunderstand
Elementswere
notperformed
Discussionwasat
appropriatelevel
withsometechnical
termsused.Ptlikely
understood.
Allinformation
providedwasatan
appropriatelevel
withpatient
understandingand
comfortevident.
Someperformed
Allperformedand
achieved
Usedbutdidnot
verify
Usedappropriately
withfeedback
Assessedpatient’scurrent
understandingofeach
medicationand/ordiseaseas
appropriate.
Identifiesconcerns/problems
ofimportanceperthepatient.
Informationwasprovidedin
anorganized&logicalmanner
Succinct and to the point
Conversation smooth without
hesitation Maintain ctrl and direction of the
session
Informationprovidedwas
accurate
*** Any inaccurate information
provided that could result in
patient harm or injury will result
in failure of the exercise and need
to redo ***
Effectivelycommunicated
verballywithterms
understandabletolaypublic
andnon‐verballywithgoodeye
contactandcomfortablebody
languageorgestures.
Summarizedkeypointsand
providedopportunityfor
follow‐up.
Usedteachbacktoverify
patientunderstanding
IPPE I Manual
Didnot
complete
Didnotuse
Allelements
completedina
clear,poised,
confidentmanner
Allelements
completedina
clear,poised,
confidentmanner
Completed
Consent+appxtime
required
Allelements
completedina
clear,poised,
confidentmanner
Allallergiesand
reactionsdiscussed
andverified
17
Week 7 and 14 Formative and Final Preceptor Assessment of Student and
Student Self-Assessment – Communication and Professionalism
(Complete online in E*Value)
These formative and final assessments (professionalism and learning outcomes) will help the student
to recognize her/his strengths and also any weaknesses which require changes and improvements.
An honest assessment will help the student in her/his learning endeavor. This student selfassessment will allow the student to formally compare his/her perceived performance with that of the
preceptor. Any differences should be discussed honestly and openly with the preceptor and a plan
created so that the student can achieve the desired outcome. Assessments must be completed at
week 7 and 14 however it can be used more frequently if needed. The preceptor and student should
discuss and compare the student’s self-assessment and the preceptor’s assessment of the student.
It is the student’s responsibility to have this evaluation form completed by the preceptor in a timely
manner.
Verbal
Language
PROFESSIONALISM AND COMMUNICATION ASSESSMENT
-1Needs Attention
Negative attributes
Include these
examples
-2Meets Standards
Positive attributes include
most of these examples
-3Exemplary
Positive attributes
include all these
examples plus “meets
standards”

Inappropriate
vocabulary used
for audience
Grammar
impedes
understanding
 Vocabulary is
appropriate for audience
(peer, faculty, patient,
doctor)
 Makes significant
contributions to the
conversation
 Vocabulary always
appropriate for the
audience (peer,
faculty, patient,
doctor, etc…)
May be inaudible,
demanding tone,
disrespectful
tone,
inappropriate
volume for
situation
(example: too
loud for
confidentiality)
Verbal
presentations (if
any) suggests
lack of
preparation
 Demonstrates confident
tone without arrogance
 Respectful
 Verbal presentations (if
any) flow fairly smoothly
– suggesting good
preparation
 Demonstrates empathy
 Adjusts style and
tone for specific
situation and/or
audience
 Verbal presentations
(if any) are smooth
and rehearsed

Delivery & Tone
Verbal

IPPE I Manual

18
Non-Verbal
Body Language





Listening



Appears
distracted
Inappropriate use
of technology
(uses phone at
inappropriate
times)
Closed posture,
staring
Inappropriate
distance
 Usually shows active
engagement (examples:
nodding, leaning in,
appropriate eye contact,
posture)
 Demonstrates empathy
 Always
demonstrates active
engagement in
conversation
(examples: nodding,
leaning in,
appropriate eye
contact, posture,
etc…)
Instructions need
to be repeated
Interrupts
inappropriately
Does not ask
appropriate
questions
Struggles
comprehending
verbal
instructions
 Responds to verbal
instructions
 Demonstrates
understanding of
information heard
 Demonstrates
engagement by asking
appropriate questions.
 Verifies
understanding of
information heard.
 Makes significant
contributions to
conversation
 Demonstrates
engagement by
asking in-depth
questions
Written
Email

Errors in spelling,
grammar, etc…
 Inappropriate for
audience- ex:
demanding

Lack appropriate
level of formality
ex: excessive
abbreviations.
 Text-style writing
IPPE I Manual
Not addressing
legal
requirements
 Lacks clarity or is
not concise
 Plagiarism and/or
inaccuracy
 Documentation
does not suggest
content knowledge
 Writing is illegible

Appearance
Professionalis
m
Charting/
Recording/
Documentation



Inconsistency in
following dress
code
Sloppy, unkempt
appearance
Lack of CLEAN
lab coat




Emails are timely
Respectful tone
Few if any spelling or
grammatical errors
Appropriate formality












Addresses all legal
requirements
Usually clear, concise
Includes proper citations
Good content knowledge
shown
Accurate
Dress is consistent with
Student Dress Code
Dress is always situation
appropriate (ex: CLEAN
lab coat)





Timely & proactive
emails
Respectful tone
No spelling errors
No grammatical
errors
Adjust level of
formality for
audience
Addresses ALL legal
requirements
Always clear,
concise
Includes proper
citations
Documentation
suggests high level
of content
knowledge
N/A
19

Punctuality/
Attendance/
Accountability




Attitude

Character

IPPE I Manual




Often late for
class, meetings,
rotations,
appointments
Often late with
assignments
Acts irresponsible
or immature at
events/meetings/r
otation sites
Does not carry fair
share of group
work
Makes excuses
Exhibiting any of
these behaviors:
negative attitude,
cocky, defensive,
aggressive,
arrogant,
indifferent,
blaming of others
Lacking good work
ethic
Dishonest
Culturally
insensitive
Illegal or immoral
actions
Does not accept
responsibility






Consistently on time for
class, meetings, rotation,
etc…
Assignments
consistently on time
Diligent
Consistently acts
responsible with groups,
a meetings and/or at site
Always prepared for
group work
Accepts group’s
decisions












Generally positive and
appropriately confident
attitude
Accepts feedback openly
Good work ethic
Willing to help others if
asked
Trustworthy
Appreciates diversity
Exhibits empathy &
compassion





Always punctual
and often early for
appointments
and/or
assignments.
Always acts
responsible and
appropriate with all
groups
/events/meetings
Ability to work
independently
Can lead group
work
Works toward
common goals
Always positive and
projecting
appropriate
confidence
Accepts and acts on
feedback
Good work ethic
Proactively helps
others
Fair & just with
customers,
preceptors,
colleagues
Models cultural
sensitivity, empathy,
compassion
20
Week 7 and 14 Formative and Final Preceptor Assessment of Student and
Student Self-Assessment - Learning Outcomes
(Complete online in E*Value)
Please answer statements in E*Value with the following scale:
1
2
3
Needs Attention
Meets Standards
Exemplary
The student requires
significant guidance and
reminders to meet basic
criteria, may need
additional training outside
this rotation.
The student requires moderate
prompting to meet MOST complex
criteria and minimal guidance to meet
basic criteria. The student meets all
basic criteria.
The student requires limited
prompting to meet MOST
complex criteria. The student
meets ALL basic criteria.
Learning Outcomes
OBTAINS accurate patient information when filling or refilling prescriptions.
FILLS prescriptions in an accurate and timely manner using the sites computer system.
FORMULATES complete, accurate, and thoughtful responses to drug information questions from
patients or other healthcare providers.
EFFECTIVELY utilizes pharmacy reference materials to find needed information.
RESPECTS patient confidentiality, uses discretion when discussing patients or handling records.
DISTINGUISHES between record keeping requirements of CIIs, CIII-Vs and non-controls.
CAN STATE procedures for and limitations of generic substitution.
CAN STATE procedures for processing refill authorizations and transferring prescriptions.
ACCURATELY TRANSCRIBES verbal prescriptions.
ACCURATELY prepares medication for dispensing and ensures that label is correct.
ENSURES that prescription information is accurate and complete.
PROMOTES error prevention by identifying critical points in the dispensing process where errors may
occur.
CAN COUNSEL patients taking simple medication regimes (i.e., 3 medications or less)
CAN APPLY basic pharmacy law principles when filling prescriptions.
EFFECTIVELY use the pharmacy’s management principles to maintain inventory at goal levels.
PROMOTE patient health by non-judgmentally encouraging adherence (compliance) and/or lifestyle
modification (e.g., diet and exercise).
UNDERSTANDS common sig abbreviations; accurately interprets written prescriptions.
IPPE I Manual
21
PRECEPTOR SUMMARY GRADING SHEET
(Complete online in E*Value by the end of week 14)
1. Student completed a minimum of 120 rotation hours with no unexcused absences.
Satisfactory = Student Completed
Unsatisfactory = Student did NOT complete
2. Student completed assigned homework to preceptor’s satisfaction.
Satisfactory = Student Completed
Unsatisfactory= Student did NOT complete
3. Student completed ALL tasks with a status of “Achieved”.
Satisfactory = Student Completed
Unsatisfactory = Student did NOT complete
4. Preceptor reviewed and approved student’s Journal Reflection Forms (Total of 14 for
weeks 1 – 14).
Satisfactory = Student Completed
Unsatisfactory= Student did NOT complete
5. Student compared her/his Formative self-assessment with preceptor at weeks 7 with the
preceptor’s Formative assessment of the student. Student compared her/his Final selfassessment with the preceptor’s Final assessment of the student during week 14 or 15.
Satisfactory = Student Completed
Unsatisfactory= Student did NOT complete
6. Student’s average on the Preceptor’s final assessment of the student on Communication
and Professionalism and Learning Outcomes was:
Satisfactory = ≥ 2.0
Unsatisfactory = < 2.0
7. Student reviewed experiential portfolio (including the IPPE-I Manual) with preceptor on
first day of rotation.
Satisfactory = Student Completed
Unsatisfactory= Student did NOT complete
To pass the ROTATION portion of PHAR 4139, the student MUST receive a
Satisfactory from her/his preceptor for ALL of the criteria listed above.
IPPE I Manual
22
Journal Reflection
Pharmacy professionals are committed to lifelong learning, often this is called
independent learning. This is a skill that should be nurtured in the students early
years of college and will help the student tremendously throughout their career. One
tool to assist the student is keeping a journal. The result is students holding
themselves accountable and taking responsibility for their own learning.
Immediately at the end of each rotation day, the student will create a journal
reflection document and list at least two new error prevention strategies. This
reflection will be uploaded to Coursework for preceptor review. The following is an
example:
Journal Reflection:
Date:
New knowledge gained:
Error prevention strategies:
1.____________________________________________________________
2.____________________________________________________________
Reflections:
The student will then reflect (think) about how they might use these concepts/tasks
to benefit patient care and prevent errors in the future. Reflections do not have to be
long; in fact it should be concise so it will be easy to review later. The preceptor will
discuss the reflection with the student then review and approve the journal reflection
in Coursework. In addition, these journal reflections may be discussed during class.
The course coordinator will review these on a regular basis so students will upload
completed entries into E*Value (Coursework) once approved.
IPPE I Manual
23
Final Student Evaluation of Preceptor
(Complete in E*Value Week 14)
Please answer the following statements:
Criteria
The evaluation methods and criteria were clarified with me early in the rotation
My preceptor exemplifies the characteristics of a professional
My preceptor gave me adequate feedback on a regular basis
My preceptor’s feedback helped me improve
My preceptor (or designee) was readily available
My preceptor asked questions that caused me to explore issues and answer questions
My preceptor answered my questions clearly
My preceptor prompted me to work independently as needed
My preceptor displayed dedication to teaching/education
Overall my preceptor is an effective educator, coach or mentor
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
What did the preceptor do that was most effective in supporting your learning needs?
___________________________________________________________________
___________________________________________________________________
______________________
What would you suggest for changes?
___________________________________________________________________
___________________________________________________________________
______________________
Additional Comments: (not mandatory)
___________________________________________________________________
___________________________________________________________________
______________________
IPPE I Manual
24
Final Student Evaluation of Experiential Site
(Complete in E*Value Week 14)
Please answer the following statements:
Criteria
Exposure to the practice of pharmacy at the site meet your expectations
The site provides an environment conducive to your learning
Y/N
Y/N
Strengths of the site:
___________________________________________________________________
___________________________________________________________________
______________________
Weaknesses of the site:
___________________________________________________________________
___________________________________________________________________
______________________
Suggestions for improvement:
___________________________________________________________________
___________________________________________________________________
______________________
IPPE I Manual
25
Sample Action Plan
IPPE-I Action Plan for: STUDENT NAME
Date:
Student X received an overall average of 2.5 for the formative
preceptor assessment of student at week 5. Student X and I
discussed the problem of repetitively showing up late for rotation
(9:30AM instead of 9AM as expected). The student stated that child
care was the issue but now realizes the importance of showing up on
time and will make alternate child care arrangements. The student
has agreed to be on time for the remainder of the rotation. I
reminded the student that any future violations of rotation policies and
regulations will result in failure of the rotation.
Student Signature
Preceptor Signature
cc: Assistant Director of Experiential Education
IPPE I Manual
26
EXPERIENTIAL EDUCATION ABSENCE REQUEST FORM
St. John Fisher College
3690 East Avenue
Rochester, NY 14618
Phone: 585-385-7249
Fax: 585-385-5295
Except for emergency, this form MUST be submitted to the Experiential Education Office
10 days prior to your requested days.
Student name
Date
Rotation type and dates
Site name and address
Preceptor name and phone number
Date requested off for current rotation
Total Hours requested off for current rotation
Total days requested off to date
(include all IPPE and APPE rotations)
Reason for requested days off - be specific (for example: illness, funeral, etc. - days to be made up
in future). Any excused/unexcused non-emergency absence NOT documented on this form may
result in failure of the rotation.
C:\Documents and Settings\robrocta\My Documents\Manuals\2006\SJFC\IPPE-EE\EE com.
and inst..doc
(continue on back)
Preceptor approved makeup dates and times (NOTE: Make up time must be in a minimum of
4 hour blocks):
Date
Start Time
End Time
Total Hours
Date
Start Time
End Time
Total Hours
Preceptor’s signature
Date
Assistant Director of Experiential Education _________________________Date_______
IPPE I Manual
27
IPPE I Optional Challenge Assignments
The following are suggested optional assignments designed to further challenge the
advanced student. All tasks must be completed before the preceptor assigns their
student an optional challenge. It is up to the preceptor’s discretion to decide if the student
has enough experience and has demonstrated mastery of the assigned tasks. Upon
completion and preceptor approval of any challenge assignments, the student will complete
an “on-the-fly” optional challenge assignment form in E*Value (Coursework).
The number of challenge assignments the student may complete while on this rotation is
determined between the student and preceptor. The following is a list of potential
assignments; however, the preceptor may decide to assign the student an assignment of
their own design that is not included on the list below.
1. Complete a reference sheet for the pharmacist identifying critical counseling points for
the drugs and/or devices used to treat any of the disease states listed below. The
reference sheet could include items such as mechanism of action, dosing, timing of
administration, side effects, drug interactions, warnings, and precautions.
a. Hypertension
b. Diabetes
c. Asthma
d. Coronary artery disease
e. Congestive heart failure
f. Head lice
g. Athlete’s foot
h. Hypercholesterolemia
i. Osteoporosis
j. Hypothyroidism
k. Peptic ulcer disease
l. Acne
m. Influenza
2.
Assign the student a drug information question commensurate with their level of
education with a focus on the selection and use of resources to answer the question.
3.
4.
Complete a complex compounding assignment.
Outline the process at your site for a drug product recall.
a. Store level only
b. Patient level
5.
Outline a plan for inventory management at your rotation site.
6.
Outline the process for ordering pharmacy inventory at your site. (from
wholesaler or other supplier)
7.
Create staffing schedule for your pharmacy (include man hours for
pharmacists, technicians, etc) for a 2-week period during rotation. Include
assessment of workload to justify staffing.
8.
Create counseling sheets/cards for 10 of the top 200 drugs.
9.
Create counseling sheets/cards for the top 5 OTC items at your rotation site.
10.
Organize program to dispose of expired patient medications.
11.
Create a comparison chart highlighting differences/similarities between blood
glucose monitors.
IPPE I Manual
28
12.
Outline process for proper disposal of expired stock medications (legend vs.
control) including hazardous substances.
13.
Describe the process of reporting a medication error at your rotation site.
14.
Reflect on the aspects of your rotation site’s physical layout that either
impedes or supports efficient delivery of patient care. Include diagram with
layout of important features or changes you would suggest.
15.
Identify five (5) medications used at your rotation site that are not stored at
room temperature and five (5) systemic medications administered by a non-oral
route of administration (identify route and common indication).
16.
Outline and discuss the differences in responsibilities/liabilities between
pharmacists and technicians in the processing of a prescription. What
attitudes/behaviors may contribute to unsafe dispensing practices?
17.
Identify 5 patients at your site who are on more than six (6) chronic
medications. Identify any potential duplication in therapy or potential drug-drug
interactions. Complete an assessment of compliance of these patients’
maintenance/chronic medications.
18.
Review your sites OTC aisle. Identify product duplications among the
cough/cold, headache relief, allergy, and generalized pain selections. Make a list
of your recommended picks for each category. Include dose, frequency and
duration of treatment and justification for the products you choose.
19.
Review your sites VITAMIN supplements. Identify a minimum of two (2)
recommendations for each of the following (include dosage form, and dose if
appropriate):
a.
Calcium supplements
b.
Iron supplements
c.
MVI
d.
MVI w/Fe
e.
Therapeutic MVI w/minerals
f.
Pediatric Multiple vitamin
20.
Review your sites Natural Products/Herbal/Dietary Supplements selections.
Identify the top five (5) products sold at your site. Create a chart identifying the
product, indication or marketed use, dose, side effects, potential interactions with
prescription and/or other drug products. Discuss with your preceptor and other
pharmacy staff why you would or would not recommend these to your patient(s).
21.
Review your site’s Weight Loss/Sleep Aids selections. Identify two (2)
products you would recommend for each. Discuss recommendations for the use
of each selection (include dosage form, dose, duration, etc) as well as any nonpharmacologic interventions that you think may be beneficial.
22.
Create a plan for or coordinate a “Healthy Living” day at your site to highlight
healthy lifestyle choices. Highlights to include home diagnostics aides (blood
glucose machines, blood pressure monitors), nutritional supplements, diet aids.
Also, include any resources or databases for patients to utilize for healthy living
IPPE I Manual
29
info such as nutritional info, exercise, etc. (include local references/resources
where appropriate).
23.
Compile a list of your rotation site’s top five (5) third party plans. Include
common exclusions to coverage, days’ supply allowed, and tier system (if
appropriate).
24.
Select a recent news article concerning a health care issue. Outline and
discuss the impact this issue may have on the profession of pharmacy or how
this article may affect the healthcare of your patients.
25.
Discuss with your preceptor an ethical dilemma (observed or theoretical) and
what procedure or resources your site would utilize to resolve it.
26.
Describe the daily process of opening and closing the pharmacy at your site.
Outline the process in chronological order.
27.
Practice dialogue with your preceptor regarding how to handle a patient who
is unable to pay for their medications.
28.
Practice dialogue with your preceptor regarding how to handle an angry
patient or physician or complaints about drug prices.
29.
Discuss with preceptor your site’s plan to resolve the issue of a colleague
intentionally NOT filling a prescription (e.g. Birth control, emergency
contraception, etc.)
IPPE I Manual
30