University of South Florida | College of Pharmacy Adult Medicine Advanced Pharmacy Practice Experience PHA 7694

The goal of the Adult Medicine Advanced Pharmacy Practice Experience(APPE) is to provide opportunities for students to build on knowledge and skills acquired through didactic education and introductory pharmacy practice experiences and apply them in direct patient care activities in the adult medicine setting. This course takes place in an internal medicine/general medicine unit where patients are managed using a team-based Course approach. Team members may include pharmacists, physicians, nurses, and other Description: healthcare providers. Students may participate in the following types of activities: rounding with a healthcare team, obtaining patient histories, identifying problems requiring therapeutic interventions, solving problems, consulting with physicians, monitoring patient outcomes, and providing educational sessions for the professional staff. Course credit: 6 Credits (40 hours = 1 credit) Students must have successfully completed Introductory Pharmacy Practice Experiences Pre-Requisites: and required didactic courses prior to beginning their Adult Medicine Advanced Pharmacy Practice Experience. Class Meeting Days and Dates/Time: Location: Location:

Preceptor: Primary Preceptor

Office location: Phone: Email: Office hours: Preferred method of contact:

Include any information or documentation that the student must provide (i.e. Pre-Rotation immunization requirements, HIPAA training, etc.) prior to starting rotation and when this Required Materials: information is needed. Note that prerequisite knowledge and skills (recommended review of therapeutic guidelines, etc.) are specified in a subsequent section. Students are encouraged to review primary literature and complete any assigned readings per the preceptor. Most of these resources should be accessible via the Library, and Recommended should not incur any additional expenses beyond photocopying. Materials: Include any additional requirements for the rotation such as a stethoscope, calculator, specific reference, etc. All course materials (audio, visual, print and electronic) are copyrighted by the faculty Notice of member/preceptor. External distribution is prohibited without permission. For additional Permission / Non- information regarding the use of copyrighted materials, please refer to: Permission: http://generalcounsel.usf.edu/policies-and-procedures/pdfs/policy-0-105.pdf. Course Format: Include any information or documentation that the student will be required to participate in as it relates to teaching and assessment, such as:  Journal Clubs

1  Case Presentations  Grand Rounds  Patient Care Rounds  In-services At the conclusion of the Adult Medicine Advanced Pharmacy Practice Experience, students should be able to:

1. Evaluate pathophysiology, clinical presentation, treatment goals, drug therapy, monitoring parameters, outcome measures, prognosis, and long- term management of common medical conditions in the acute care setting. 2. Identify drug-related problems; formulate and implement patient-specific, evidence-based patient care plan, and follow up to determine patient Course progress. Objectives: 3. Provide succinct, clear, and professional oral and written communication including, but not limited to patient care plans, and documentation activities consistent with site specific practices. 4. Provide appropriate patient education/counseling and evaluate patient understanding of provided information about medical conditions, drug therapy, including expected benefits, and risks. 5. Synthesize evidence-based answers to drug information questions posed by patients or health care colleagues. 6. Demonstrate professional conduct and demeanor that is ethical and responsible displaying integrity, compassion, empathy, and respect. Assessment Student performance will be judged on the following: Methods: Include any specific assessments you have for your students in this section. This can include presentations, journal clubs, formal CE presentations, etc. These should be explained in detail as to your expectations.

Examples Listed Below: Include any required activities/assignments: In order to achieve the stated learning objectives, students completing the Adult Medicine Advanced Pharmacy Practice Experience should complete the following activities/assignments:

1. Attend and participate in patient care or interdisciplinary rounds (nursing rounds if physician-led rounds unavailable to students) and prepare one formal SOAP note/progress note each week (total of eight notes) on an assigned patient. 2. Present at least one formal patient case presentation, including analysis and interpretation of the primary medical literature as it applies to the patient case. The audience will be selected by the preceptor. 3. Discuss with the preceptor the treatment, monitoring, and outcomes of the majority of the following common adult medicine patient conditions, with discussions based on actual or simulated patient cases and/or drug therapy problems: a. Chronic Obstructive Pulmonary Disease/Asthma b. Community Acquired and Healthcare Associated Pneumonia c. Congestive Heart Failure d. Coronary Artery Disease e. Myocardial Infarction f. Hypertension, including Hypertensive Crisis and Urgency

2 g. Stroke/Transient Ischemic Attacks h. Anticoagulation and Venous Thromboembolism i. Diabetes j. Renal Failure/End Stage Renal Disease k. Hepatic Disorders l. HIV/Opportunistic Infections m. Skin and Soft Tissue Infections 4. Participate in therapeutic drug monitoring activities, including: a. Application of pharmacokinetic dosing principles to drugs in the following classes, as applicable to the institution: antibiotics, antiepileptics, and/or immunosuppressants for organ transplant rejection; and b. Recommendation of dosing adjustments for renal and hepatic impairment 5. Present at least one journal club presentation, including analysis and interpretation of the primary medical literature. 6. Complete at least 2 written drug information responses using appropriate institutional documentation 7. Present at least one in-service to the pharmacy, nursing, or medical staff.

Student assessments (midpoint and final) will be completed through CORE Elms/RxPreceptor and will be reviewed with the student at both the mid-point and end of the rotation.

Medication Use Systems Management/Practice Management 5% Foundational Knowledge 15% Patient-Centered Pharmaceutical Care 12.5% Monitoring for Endpoints 5% Patient Case Presentations 10% Patient Counseling/Education 5% Drug Information 12.5% Formal Communication Skills (oral and written) 15% Course Grade: Professionalism 20% Total 100.00%

Course grade will be calculated through RxPreceptor.

In order to receive a passing grade, students must earn a grade of at least 70% in the course. A score of less than 70% will result in a failing grade (F). Students who do not receive a passing grade for the course will be required to meet with the Academic Review and Professional Students Affairs Committee (ARPSAC).Students are referred to the Student Handbook for additional information. Examination and/or Major Assignment Include in this section how you will address late assignments. Policies and Procedures: Course Outline, Activities, and Schedule State the hours the student is expected to be on site. If applicable, indicate that the hours may not be firm, and describe situations in which a student may need to stay after hours in order to complete tasks.

State events or meetings inside or outside those hours that a student should attend.

3 When possible, provide typical daily schedule indicating when different activities or breaks may take place. Include time to meet with the student to discuss the student’s performance and make recommendations for improvement.

Consider making a calendar of dates/time to discuss specific topics, have journal club meetings, or have other conferences. Determining in advance what these will be allows student to be prepared.

See APPE Manual for site specific requirements Additional Course Information Student Accessible at: Handbook http://health.usf.edu/cms_author/docs/Templates/pharmacy/docs/COPStudentH andbookOfficial8814.pdf Attendance All students should review the Student Handbook and APPE Manual for COP Policy: expectations.

Attendance is mandatory as the quality of learning experiences is directly related to the time spent in the clinical environment. If sickness or other problems require absence during rotation time, students must arrange to make up lost time with the preceptor. Failure to participate in the assigned number of hours will result in an "Incomplete" grade for the course. All absences should be documented in RxPreceptor and verified by the preceptor.

Excused Absences: each excused absence will be made up at the discretion of the preceptor. Absences may be excused secondary to health or family issues (personal illness, dependent’s illness, doctor appointment, family crisis, etc.), professional issues (interview for position, educational meeting, etc.) or at the discretion of the preceptor for other reasons not listed here. Absences that are planned require notification prior to the day of the absence. A minimum of 1-week notice regarding planned absences is expected.

Unexcused Absences: Unexcused absences will result in grade reductions (see Examination and/or Major Assignment Policies and Procedures). Requests for excused absences should be made directly to the preceptor. Violations of the attendance policy may result in disciplinary action by the ARPSAC.

Each absence must be made up at the convenience of the preceptor. Failure to notify at the time of the absence in the case of unexpected situations will result in an unexcused absence. Failure to notify in advance of planned activities will result in an unexcused absence.

Time missed due to administrative issues (e.g. fees not paid, lack of portfolio requirements) are counted as unexcused absences unless made up at the preceptor’s discretion after the originating offense is corrected.

Tardiness: two unexcused tardiness will be the same as one unexcused absence. The definition of tardy will be left up to the instructor.

Educational meetings are an important part of being a professional. Attendance will be encouraged, but not required. Faculty and instructors will encourage the students to attend meetings.

4 Residency and position interviews likewise are and important for professional advancement but must not be scheduled in time and number to significantly degrade the quality of the ongoing APPEs. This should be taken into consideration when they are scheduled. Days missed due to these events will be made up at the discretion of the preceptor. USF is committed to providing reasonable support for students with disabilities. Students with disabilities are responsible for registering with Students with Disabilities Handling of Services [http://www.sds.usf.edu/index.htm] in order to receive academic Student accommodations. SDS encourages students to notify instructors of accommodation Accommodations needs at least 5 business days prior to needing the accommodation. A letter from SDS must accompany this request. Holidays and USF Policy: http://regulationspolicies.usf.edu/policies-and- Religious Observations: procedures/pdfs/policy-10-045.pdf Professionalism Students and faculty have the right to participate in an academic environment that is Expectations / free from disturbances. Students are required to adhere to the policies and procedures Handling of regarding required professional behavior while on rotations as outlined in the student Academic handbook. As consistent with the expectations of a professional practice environment, Misconduct: professional behavior and attitudes are expected for all students enrolled in this course. Specifically, students:

a. Along with preceptors, should help create a positive learning environment b. Are expected to be on time, quiet, and attentive during class c. Are expected to turn off all cell phones, pagers, etc. (even phones that vibrate may cause a disturbance) d. Are highly encouraged to participate while on rotations in a positive manner by asking/answering questions

Students who find themselves unable to remain attentive while on rotation or rounds should respectfully remove themselves. Students who are disruptive will be respectfully requested to leave the rotation or rounds. Personal work while on rounds (or while participating in activities while on rotations), personal business, checking e- mail, instant messaging, or surfing the internet is not permitted, as this is disrespectful behavior.

It is the goal of the preceptors to have every student successfully complete the course. As a result, students are highly encouraged to consult with the faculty throughout the semester in order to optimize learning and increase success while on rotations.

USF has a zero tolerance policy for drug and alcohol intoxication while on rotation. Please refer to the USF System Alcohol Policy (30-023) http://generalcounsel.usf.edu/policies-and-procedures/pdfs/policy-30-023.pdf

Academic Misconduct Performance on all assignments, practicums, and projects must represent the individual efforts of the student. All students involved in academic misconduct are subject to disciplinary action by the ARPSAC. Suspicions of academic misconduct should be brought to the attention of the preceptor and the Director of Experiential Programs. Students suspected of behaving unprofessionally will be afforded due diligence in accordance with USF policies and procedures.

For additional information please visit the USF Office of Student Rights and

5 Responsibilities: http://www.sa.usf.edu/srr/page.asp?id=69. The University of South Florida has an account with an automated plagiarism detection service (Turnitin®), which allows instructors and students to submit student assignments to be checked for plagiarism. I reserve the right to 1) request that assignments be submitted as electronic files and 2) electronically submit assignments to Turnitin®, or 3) ask students to submit their assignments to Turnitin®, through myUSF. Assignments are compared automatically with a database of journal articles, web articles, and previously submitted papers. The instructor receives a report showing exactly how a student’s paper was plagiarized. For more information about Turnitin®, go to: http://turnit.com/en_us/training/student-training/submitting-a-paper. FERPA Statement For more on plagiarism, go to http://davon.etg.usf.edu/share/plagiarism/story.html. for Courses That Utilize Turnitin: PLEASE REMOVE YOUR NAME FROM THE BODY OF YOUR PAPER AND REPLACE IT WITH YOUR USF ID#. ALSO REMOVE YOUR NAME FROM THE FILE NAME AND REPLACE IT WITH YOUR USF ID# (e.g., “U12345678 Essay 1.docx”) BEFORE SUBMITTING IT TO Turnitin®,. Pursuant to the provisions of the Family Educational Rights and Privacy Act (FERPA), students are requested to maintain confidentiality as a way to keep their personal contact information (i.e. name, address, telephone) from being disclosed to vendors or other outside agencies. By your submission, you are also agreeing to release your original work for review for academic purposes to Turnitin®. In the event of an emergency, it may be necessary for USF to suspend normal Emergency operations. During this time, USF may opt to continue delivery of instruction through Preparedness for methods that include but are not limited to: Blackboard, Elluminate, Skype, and email Academic messaging and/or an alternate schedule. It’s the responsibility of the student to monitor Continuity: Blackboard site for each class for course specific communication, and the main USF, College, and department websites, emails, and MoBull messages for important general information. Syllabus Content All students are expected to read the syllabus, understand its implications, and abide by Change it. Students are encouraged to seek clarification within the first week of the course. Disclaimer: The course coordinator retains the right to make changes to the syllabus as needed. All students are expected to read the syllabus, understand its implications, and abide by it. Students are encouraged to seek clarification within the first week of the course. The Student course coordinator has the right to make changes to the syllabus as needed. Responsibility: Please note there is no guarantee for graduation if APPE hour requirements are not met. Please refer to the APPE Manual for additional information. Course and preceptor evaluations are requirements for the successful completion of this course. These evaluations provide valuable feedback for faculty and allow for input on Teaching and the overall course structure and ways to improve the course. Students are required to Course complete all course and instructor evaluations by the last day of classes. Students who Evaluation: fail to do so may receive an “I” or incomplete grade in the course until this requirement is successfully completed.

6