My involvement in the Community Pharmacy Clinical Clerkship
rotations.
For several years I have worked with three pharmacist in
the Gainesville area to provide structured clinical pharmacy experiences
for pharmacy students in the community pharmacy setting. The significant
barrier to providing this type of experience is the lack of time available
to the community pharmacist to provide these clinical services much less
participate in structured learning exercises with their students and supervise
projects. My role has been to help the pharmacist by coordinating the structured
learning and projects for the student who are on the clerkships at these
sites. The following is a typical clerkship syllabus for PharmD student
on one the these rotations.
Community Pharmacy Clinical Clerkship Syllabus
Target Pharmacy
Peggy Owen: Preceptor
Randell Doty: Co-preceptor
Course Philosophy
The importance of the clinical experience cannot be overemphasized
in the profession of pharmacy today. Understanding the principles of proper
patient care is essential if pharmacy is to grow as a profession and maintain
the respect of patients and other health care providers. Pharmacy is in
a state of change as a profession. If pharmacists remain content to exercise
only their technical skills, then they may be left behind in the broader
scope of health care. Since this is the case, this course stresses the
interaction of pharmacist and patient and the pharmacist's responsibility
to those patients.
Particular emphasis will be placed on the careful and
systematic approach to the assessment of the patient's drug therapy to
identify potential and existing drug related problems, evaluate these problems
and work with other health care team members to minimize the risk to the
patient.
Course Description
During the course of the month, the student will be exposed
to the daily clinical activities of the community pharmacy setting, with
the focus placed upon a patient care approach. The student will learn the
goals of clinical intervention and the steps necessary to effectively execute
those interventions. Evaluating and solving drug related problems, patient
interaction, and acting as a primary health care source will be stressed.
Goals, Objectives & Activities
Upon completion of this clerkship the student should have
possess the following via completion of the listed activities.
-
An understanding of the role of the community pharmacist
as a primary care provider who identifies and solves drug related problems
-
Perform triage functions in discussing health related problems
with patients and referring them to appropriate health care providers or
recommending appropriate self-care.
-
Demonstrate the use of selected home health care products.
-
Be able to perform blood pressure and blood glucose determinations
and other self-monitoring and diagnostic procedures.
-
Counsel and teach patients regarding the appropriate use
of prescription medication, OTC medications, and medical supplies using
both oral and written information.
-
Recognition of the most common drug related problems
-
Obtain an accurate medical history of past and present prescription
and OTC drug therapy, illness, and drug therapy problems (e.g., allergies,
etc.)
-
Evaluate a patient's drug regimen in the context of medical
problems, medication compliance, and personal life situations.
-
Detect, report and follow up adverse drug reactions, drug
interactions, noncompliance and other potential drug therapy problems
-
An understanding of the stepwise process used to identify
and solve those problems
-
Collection of the information necessary to discern if the
patient has a drug related problem
-
Identifying these problems
-
Developing therapeutic goals
-
Formulating realistic solutions to the problems
-
Choosing the most appropriate solution
-
Implementing the solution
-
Monitoring the implementation of the solution to achieve
the set goals
-
Construct an organized comprehensive case presentation including
the patient's past history, current history, overview of disease, and various
treatment methods, critically evaluating each component
-
An understanding of the Health Care needs of a community
and the individuals within that community
-
Answer with proper documentation drug related questions from
the public.
-
An understanding of the interaction of the pharmacist with
health care providers regarding drug selection, drug information, and drug
therapy monitoring.
-
Communicate with health care providers verbally and in writing
when necessary by appropriately seeking information, providing drug information
and influencing prescribing behavior in the interest of the patient.
-
Maintain a notebook compiling the answers to drug related
questions answered during the course of the month
-
Recognition of the impact of social, psychological, and economical
factors on drug therapy selection and use.
-
An understanding of the basic logistics behind operating
a clinically active community pharmacy
-
Participate in the community pharmacy management activities
as related to the delivery of patient care services.
-
An understanding of the topics discussed and situations encountered
during the clerkship demonstrated by completing a test at the end of the
month covering those items.
ASSIGNED Activities
-
Participate in community health education or screening project.
-
Present and participate in biweekly topic discussions.
Optional ASSIGNED Activities
Participation may be assigned by the preceptor or chosen
by the student if time and opportunity permit.
-
Involvement with hospice, nursing home or senior center
-
Selection and use of durable medical products equipment and
devices, ostomy supplies, and /or orthopedic appliances
Project Assignment
-
Prepare a project proposal outlining the expansion of clinical
services at the clerkship site. This should include data on need, feasibility,
legalities, expense, profitability, and time to implement. This could be
an expansion of existing services or a new service to be instituted.
-
Prepare and deliver an in-service or newsletter to a group
of local health care professionals concerning a current topic.
-
Prepare a paper on specific topic related to patient oriented
services in a community pharmacy
-
Prepare an analysis of a current clinical service for evaluation
purposes. This could include, patient subjective evaluation, health care
professional subjective evaluation, cost justification, or impact on patient
studies.
-
Participate in expanding the clinical services of the pharmacy
as outlined in a previous clerkship project.
Biweekly discussion topics:
Twice a week the student be prepared to discuss one topic
from the list provided below. These should prepared by the students as
an informal presentation of the topic. The student should be prepared to
answer questions asked by the preceptor. This time should also be used
to discuss the status of the clerkship projects.
-
OTC Diet/Weight control
-
Nutrition/Vitamins
-
OTC Cough, Cold and Allergy
-
Ophthalmic and Contact lens preparations
-
Laxatives
-
Drugs in Pregnancy
-
Diagnostic Testing Products
-
Stomach Upset/Diarrhea
-
Bacterial/Fungal skin infections
-
Acne Medications
-
Dermatitis/Uticaria/Insect Bites
-
OTC Contraception
-
OTC Diabetes Products
-
Poison Prevention
-
Otic Preparations
-
Infant Nutrition
-
OTC Sports Injury Treatment
-
OTC Analgesics
-
Folk Medicine Home Remedies
Presentations of the above topics should contain at least
the following information when applicable:
Introduction
(including any recent products introduced or significant
changes)
Primary Agents
(brief overview of the most common drugs used) Indications
Cautions Adverse Reactions and Toxicity Contrast (be able to discuss differences
in agents)
Recommendations
(which product out of the class discussed would you recommend
in different circumstances if such difference exist
Not all topics will be able to follow this outline
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