Course Title: Adult (Replace Adult with Pediatrics If Applicable)Medicineadvanced Pharmacy

Syllabus Template for Preceptors: This template document is intended to assist you in constructing a rotation syllabus to enhance communication with students and meet objectives established by SCCP and our accrediting body, ACPE. Replace or address the highlighted text with the information that is specific to your rotation, then delete this header text and the highlighted instructions for your final syllabus.

Course Title: Adult (Replace “Adult” with “Pediatrics” if applicable)MedicineAdvanced Pharmacy Practice Experience

Site Information:

Site Name

Site Address

Preceptor Information:

Name & Credentials

Phone Number

Email Address

Indicate preferred communication method

Course Purpose: The goal of the Adult (Replace “Adult” with “Pediatrics” if applicable) Medicine Advanced Pharmacy Practice Experience is to provide opportunities for students to build upon knowledge and skills acquired through didactic education and Introductory Pharmacy Practice Experiences and apply them in direct patient care activities in the adult(replace with pediatrics if applicable) medicine inpatient setting. The student will gain experience monitoring drug therapy and will participate in the therapeutic decision making process. Students may participate in the following types of activities: developing a problem list, presenting patients to the preceptor and medical team, developing and implementing a monitoring plan, taking a medication history, responding to drug information requests, and reviewing the policies and procedures of an institution. This course occurs in an internal medicine/general medicine/medicine specialties unit(s) or floor(s) in a hospital setting where patients are managed using a team-based approach. Team members may include pharmacists, physicians, physician assistants, nurse practitioners, nurses, and other healthcare providers. This experience will be directed and evaluated by one or more preceptors.

Patient Population(s) Exposed To:

Specify patient populations students exposed to regularly (i.e. diverse population of adults aged 18 +)

Hours Credit: Four

Pre-Rotation Requirements for Student:

Indicate any information or documentation that the student must provide prior to starting rotation (i.e. On-site orientation, site-specific paperwork, drug test, physical).

Learning Objectives:

At the conclusion of this Adult (Replace “Adult” with “Pediatrics” if applicable)Medicine Advanced Pharmacy Practice Experience, students should be able to:

Enter any additional objectives at the end of the list. If you feel any of the provided objectives do not apply to your site, discuss with the Experiential Education Department.

1. Collaborate as an interprofessional team member in a variety of healthcare settings.
2. Demonstrate effective written and oral communication skills to healthcare practitioners and patients.
3. Demonstrate mature and professional attitudes, habits, values, and behaviors.
4. Recommend appropriate prescription and nonprescription medications, dietary supplements, diet, nutrition, traditional nondrug therapies, and complementary and alternative therapies to patients and members of the healthcare team, taking into consideration patient’s specific pharmacotherapeutic agents, dosing regimens, dosage forms, routes of administration, and delivery systems in order to promote optimal health care.
5. Formulate a concise and evidence-based patient-centered care plan in collaboration with other health care professionals, patients, and/or their caregivers which considers a patient’s health literacy, culture, and pyschosocial factors to provide optimal health care using the health system’s formulary.
6. Implement, monitor, assess, evaluate, and adjust pharmaceutical care plans with accuracy and timeliness using patient information in order to promote optimal health care. Uses pharmacokinetic principles when dosing medications. Ensure continuity of pharmaceutical care for a patient across health care settings to a diverse patient population.
7. Demonstrate an understanding of the pathopysiology and pharmacotherapy of the most common acute and chronic disease states encountered in the inpatient acute care medicine setting.Enter any additional disease states not listed above that the student should have baseline knowledge of upon entering the rotation.
8. Alzheimersi. Asthma
9. Cancerj. COPD
10. Diabetesk. Heart Disease
11. HIV / AIDSl. Hypertension
12. Influenza & Pneumoniam. Kidney Disease
13. Liver Diseasen. Metabolic Syndrome
14. Obesityo. Parkinson’s Disease
15. Septicemiap. Stroke
16. Identify, report, and analyze medication errors and adverse drug reactions to identify preventable cause and remedial preventive actions.
17. Adhere to legal requirements in pharmacy practice, including, but not limited to, accreditation, legal, regulatory/legislative, safety requirements, and drug administration. Participate in discussions regarding the role of key organizations in public safety and key health care policy matters that may affect pharmacy.
18. Retrieve, analyze, evaluate, and apply (using critical thinking, problem-solving, and scientific reasoning skills) relevant scientific data, evidence-based data, and other information when solving practice problems (patient-specific and general practice) utilizing technology available at the rotation site.
19. Perform systematic literature/reference searches and reviews to provide pharmacotherapy/drug information to healthcare practitioners verbally and/or in writing.
20. Present a patient summary with confidence and in an organized format that includes pertinent information (includes documentation in charts and to preceptor/healthcare team).
21. Provide education to a diverse patient population and healthcare professionals regarding medical conditions, wellness, dietary supplements, durable medical equipment, and medical and drug devices.
22. Participate in discussions regarding development, design, marketing, and reimbursement process for new patient services, management of human and medication resources, the health system’s formulary process,and pharmacy data management systems including pharmacy workload and financial performance.
23. Participate in discussions regarding clinical drug guideline development/analyzation, and drug approval process.
24. Add any additional objective(s) that students will complete that specifically pertain to your rotation.

Prerequisite Knowledge and Skills:

Students must have successfully completed Introductory Pharmacy Practice Experiences and required didactice courses prior to beginning their Acute Care Medicine Advanced Pharmacy Practice Experience. List specific items that students should be knowledgeable about prior to starting your rotation such as disease states, relevant laws and regulations. Students should be familiar with and prepared to apply treatment guidelines for optimal patient care for the following disease states:

1. Alzheimers
2. Asthma
3. Cancer
4. COPD
5. Diabetes
6. Heart Disease
7. HIV / AIDS
8. Hypertension
9. Influenza & Pneumonia
10. Kidney Disease
11. Liver Disease
12. Metabolic Syndrome
13. Obesity
14. Parkinson’s Disease
15. Septicemia
16. Stroke
17. Enter any additional disease states not listed above that the student should have baseline knowledge of upon entering the rotation.

Attendance Requirements: Students are expected to abide by the attendance requirements set forth in the SCCP APPE Experiential Manual. Requirements are located at:

Dress Code Requirements: Students are expected to abide by the dress code requirements found in the SCCP Academic Bulletin and SCCP APPE Experiential Manual. List any site-specific dress code requirements here.

Academic Integrity: Students are expected to abide by the academic integrity policy found in the SCCP Academic Bulletin. MUSC and USC university-specific policies may apply where necessary.

Site-Specific Requirements:

List any parking requirements or other site-specific hospital rules that students must abide by here.

Student 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.
• If possible, provide typical daily schedule indicating when different activities or breaks may take place. Include time to meet with student to discuss student’s performance (at minimum midpoint and final evaluations) and make recommendations for improvement.
• Consider constructing a calendar of dates/times to discuss specific topics, have journal club meetings, or other assignment discussions. Determining in advance what these will be allows the student to be prepared.

Grading Procedures:

Grading will occur via electronic APPE evaluations on E-Value. Students will receive a grade at midpoint that does not count towards the final grade on a transcript. The grade received at midpoint evaluation will be utilized for student self-reflection and to set goals for the second remaining half of the rotation. Students will receive a final grade on the last day of the APPE that will be transferred to the student’s transcript. Grading occurs via an automatic calculation present in electronic evaluations in E-Value.

Grading Scale:

A:90 – 100

B+:85 – 89.99

B:80 – 84.99

C+:75 – 79.99

C:70 – 74.99

D+:65 – 69.99

D:60 – 64.99

F: 59.99

Assignments/Activities:

• Attend & participate in patient care or interdisciplinary rounds.
• Shadow healthcare professionals in other settings, such as Nuclear Medicine, Dialysis, Respiratory Therapy, Cath Lab, etc.

• Recommend appropriate referrals to health care practitioners and other community resources needed to support their continuing care (nutrition, DM counseling, medication assistance programs).

• Leave communication progress notes for physicians in medical records as appropriate.
• Perform anticoagulation counseling, asthma teaching, diabetes teaching, etc as indicated by preceptor.

• Demonstrate responsibility by being on time for all clerkship related activities, dressing professionally, respecting lines of authority.
• Complete all tasks thoroughly and in a timely manner, and communicate appropriately.
• Demonstrate good judgment, initiative, responsibility and maturity.
• Incorporate feedback from preceptor(s) for future behavior.
• Cooperate with patients, pharmacy staff and other health professionals.
• Show assertiveness and independence by undertaking self-directed responsibilities and articulating personal viewpoint.
• Demonstrate pride and purpose for the role of the pharmacist in the total health care of the patient.
• Discuss with the preceptor strategies for meeting the pharmacist’s need for life-long learning. (e.g., participate in local pharmaceutical association meetings, continuing education programs, presentations to community organizations, etc.)
• Demonstrate respect for patients and other health care professionals.

• Obtain a complete medication history, including prescription and OTC medications as well as complementary therapy with herbals and nutritional supplements.
• Obtain information from the medical record including laboratory data, diagnostic tests, vital signs, physicians’ orders, progress notes, and consult notes.

• Recommend appropriate antibiotics for particular suspected and identified organisms.
• Participate in Nutrition Support services.
• Educate the patient regarding discharge medications, what to continue from the previous medication regimen, etc.

• Speak with the patient or patient’s family about drug therapy, past medical history, and other pertinent information.

• Conduct any of the following as indicated by the preceptor: medication calendar review, medication history/bottle review, discharge counseling, etc.
• Review the mechanism(s) of action, indications, contraindications, adverse effects, and drug-interactions (drug-drug, drug-food, drug disease) for each of the patient’s medications.
• Identify the laboratory and diagnostic tests necessary to diagnose and monitor various disease states. Describe the usefulness and limitations of each test.

• Make appropriate recommendations to adhere to Core Measures for acute myocardial infarction, heart failure, pneumonia, and surgical care improvement/surgical infection prevention.

• Perform medication reconciliation in concordance with hospital standard procedures when appropriate.
• Continually reassess medication appropriateness of the therapeutic plan; consider necessary monitoring, adverse effects, allergic reactions, drug interactions, efficacy, lab values, diagnostic procedures
• Review medication list(s) for drug/drug, drug/supplement, drug/food, and supplement/food interactions.
• Assess the appropriateness of the patient’s medication regimen based on indications for use, MOA, safety, efficacy, accessibility, cost and compliance.

• Evaluate patient medication regimens for appropriate use of antibiotics.
• Participate in therapeutic drug monitoring activities, including pharmacokinetic dosing of antibiotics, antiepileptics, and/or immunosuppressants.
• Perform pharmacokinetic dosing adjustments for renal and hepatic impairment.
• Perform dosage adjustments for weight-based medications.

• Discuss with the preceptor the treatment, monitoring, and outcomes of the majority of the common adult medicine patient conditions stated in Learning Objective #7 using actual or simulated patient cases and/or drug therapy problems.

• Communicate with health care providers regarding discharge medications to ensure continuity/appropriate follow up and reduce medication errors.
• Submit any adverse drug reactions to MedWatch.
• Use the format that your preceptor specifies to submit any medication errors found.

• Participate in any Joint Commission preparations.
• Participate in any audits for Board of Pharmacy, DHEC, or Joint Commission preparations.

• Present at least 1 journal club presentation, including analysis and interpretation of the primary medical literature.
• Perform activities that provide cost-savings to the facility as applicable (IV to PO conversions and review of high cost medications).

• Complete at least 2 written drug information responses using appropriate institutional documentation.

• Conduct any of the following as indicated by the preceptor: Morning report presentation, handout presentation to inpatient rounding team on therapeutic controversy, critical evaluation of journal article, new drug update, drug class review, formal drug literature write-up, etc.

• Prepare 2 formal SOAP notes/progress notes each week on an assigned patient.
• Present 1 formal patient case presentation. The audience will be selected by the preceptor.

• Rank patient problems in order of acuity and determine endpoints or goals.

• Present at least 1 inservice to the pharmacy, nursing, or medical staff.
• Counsel at least 1 patient per week regarding OTC, herbal medications, dietary supplements, devices such as inhalers, or other lifestyle adjustments that are pertinent once discharged from hospital.