Symposium 3: Assessing Student Learning
ACCP Academy Teaching and Learning Certificate Program
Access the electronic portfolio at http://academy.accp.com
1. Critique and improve an assessment of a simulated student performance.
A. Identify the problems in an assessment of a 5th year student who had been assigned the task of writing a SOAP note for a Women’s Health elective course.
B. Assess the student performance yourself, providing better criteria-referenced, evidence-based, student-oriented feedback.
2. Create criteria for an assignment-specific ability outcome that you have created.
A. State the outcome.
B. Describe the assignment (if available, upload the assignment directions/materials).
C. Create criteria that clearly and completely describe what constitutes good practice of the ability outcome.
3. Design an assessment instrument.
A. Base the assessment form on the criteria created for #2 above.
B. Include
1. Criteria
2. Grading scale
3. An area for instructor feedback for each criterion
4. Assess a student performance.
A. Use the criteria/assessment instrument you constructed for #2 and #3 above to assess a student performance.
B. Upload a copy of the student performance.
C. Provide criteria-referenced, evidence-based, student-oriented feedback. Upload your assessment of the student performance.
D. Obtain written permission from the student to make the assessment public on the electronic portfolio. Remove all identifying factors that might reveal the identity of the student.
5. Ask your mentor to provide his/her assessment of your assessment of the student performance in #4.
For these portfolio assignments you may use materials you had already generated for previous portfolio assignments in Basic Training, Planning for Effective Teaching, and/or Implementing Teaching Strategies.
Symposium 3: Assessing Student Learning
ACCP Academy Teaching and Learning Certificate Program
Portfolio Assignment 1
Identify the problems in this assessment of a 5th year student who had been assigned the task of writing a SOAP note for a Women’s Health elective course. Then assess the student performance yourself, providing better criteria-referenced, evidence-based, student-oriented feedback.
S: SN is a 30 year old caucasion female who presents to the pharmacist at the OB/GYN office. Her current medications include crinone gel 8% 1 applicatorful QHS, ultranatal care vitamin QDay, aspirin 325 mg QDay and eletriptan 20 mg PRN. SN presents for her first prenatal visit at 9 weeks gestation to discuss concerns about her medication use during pregnancy. Patient has a history of migraine headaches and luteal phase defect. Family history is significant for preeclampsia. Family history for genetic abnormalities is unknown. SN has been vaccinated against hepatitis B, and had chicken pox as a child. Her most recent PAP smear was within the last year, and the remainder of her genitourinary ROS is within normal limits.
O: Ht 5’4”, Wt 135#, BP 122/70, HR 68, RR 14
ABO type AB +, Hgb 13.1, Hct 35.5, WBC 5.8, Platelet 425
Gonorrhea/Chlamydia – negative
Syphilis – negative
HIV (consent received) – negative
U/A: glucose (-), ketones (-), trace protein, LE (+1), Nitrate (+2)
Rubella titer – high Toxoplasmosis – negative
A:
1. Drug use in pregnancy – progesterone gel is being used to treat luteal phase defect in this patient. The medication is pregnancy category B and should be continued in this patient through the end of the first trimester to ensure endometrial integrity. Eletriptan is FDA pregnancy category C. There is no significant clinical evidence of this drug’s use in pregnancy to determine its safety. Small studies of other serotonin receptor antagonists suggest that there are no negative outcomes with their use in pregnancy. Aspirin use in the first and second trimester is controversial as some studies suggest an increased risk of birth defects with its use, although most studies do not support this theory. Use in the third trimester should definitely be avoided due to adverse effects such as uterine contraction inhibition, increased maternal and newborn bleeding and premature narrowing of the fetal ductus arterious. The safest analgesic for use in pregnancy is acetaminophen which is FDA pregnancy category A.
2. UTI – asymptomatic bacteriuria as suggested by positive LE and nitrate results should be treated in pregnancy to reduce the risk of pyelonephritis. The most common causative organism of bacteriuria is E. coli, and the top choices for antibiotics are nitrofurantoin and cephalosporins. 3 day treatment has been shown to be as efficacious as longer duration therapy, and both choices are safe for pregnancy. SN has a history of anaphylaxis to penicillin, the possibility of cross-sensitivity to cephalosporins means that they should be avoided in this patient.
P:
1. Discontinue aspirin 325 mg QDay. Educated patient on the association of aspirin use and adverse fetal outcomes in the third trimester. Discussed that use up to this point is unlikely to have resulted in birth defect, but that it is better to stop the aspirin as soon as possible.
2. Continue eletriptan 20mg prn. Educate patient on potential adverse effects and lack of pregnancy data. Discuss that medication should only be used as a last resort.
3. Start acetaminophen 650mg Q 4-6 hours as needed, not to exceed 4 grams/day. Educated patient on purpose, proper use and potential side effects.
4. Continue crinone gel 8% 1 applicatorful QHS through the end of the first trimester.
5. Start nitrofurantoin 100 mg BID x 3 days. Educated patient on purpose, proper use and potential side effects.
6. Continue ultranatal care vitamin QDay through pregnancy and lactation.
7. Return to physician for next prenatal visit in 4 weeks.
Symposium 3: Assessing Student Learning
ACCP Academy Teaching and Learning Certificate Program
Portfolio Assignment
Original Faculty Assessment of Student SOAP note
SOAP Note Assessment Form
Women’s Health
Subjective (0.5 pts)
Performance Level / Performance Criteria / Comments___ Outstanding / As in Acceptable and all of the following:
X Only contains relevant subjective information. Extraneous/unrelated data not included
___All subjective information is found in the “S” section of the note (i.e., no new subjective info is introduced in the “O”, “A”, or “P” sections)
X Is written as a clear, concise paragraph / You really should assess for/report other common issues during the first trimester. Examples include ROS for morning sickness, reporting allergies (key in this case since you are Rx’ing an antibiotic), assessing calcium intake, reason for use of ASA, etc. Also, the subj should support the objective testing (e.g. telling about the cat in the house to explain the toxo).
Some subjective data (e.g. allergy history) was introduced in assessment - not reported here.
___Acceptable / Contains all of the following:
X Information is accurate based on interview
___Includes the CC, HPI and related ROS
X Includes medications taken by the patient
_X_If CC/problem is currently being treated, includes ROS to assess for efficacy and toxicity of current regimen
___If pertinent to the case, includes FH, SH and/or PMH
X Not Acceptable / Does not contain all criteria for Acceptable
Objective (0.5 pts)
Performance Level / Performance Criteria / Comments_X_ Outstanding / As in Acceptable and all of the following:
X Only contains relevant objective information. Extraneous/unrelated data not included
___If pertinent to the case, includes pattern of past objective findings (e.g., serial BP measurements, previous Chem 7s, etc)
_X_All objective information is found in the “O” section of the note (i.e., no new subjective info is introduced in the “S”, “A”, or “P” sections) / Ok - you were missing some minor things - but I'm allowing groups one or two small misses
___Acceptable / Contains all of the following:
X All information is accurately recorded
X Vital signs
X Physical examination findings needed to define and assess the CC
X Lab data needed to define and assess CC
If CC//problem is currently being treated, includes PE findings and/or lab data needed to assess for efficacy and toxicity of current regimen
Not Acceptable / Does not contain all criteria for Acceptable
Assessment (1 pt)
___ Outstanding / As in Acceptable and all of the following:
X Conveys accurate information regarding likely etiologies/risk factors for the primary problem
X Conveys accurate information regarding the severity/impact of the primary problem and/or identified drug-related problems / The UTI part is fine…but the assessment of the ASA use isn't accurate and doesn't make ANY SENSE since she was using for prevention of preeclampsia, not for pain. You sort of missed the boat, so to speak.
PCN allergy is subj data and should have been introduced earlier
___Acceptable / Contains all of the following:
X Correctly identifies primary problem
X Conveys accurate information regarding control and/or stability of the primary problem
X Conveys accurate information regarding the goal(s) of treatment for the problem
X If primary problem is currently being treated, correctly identifies any real or potential drug-related problems related to current therapy
X Not Acceptable / Does not contain all criteria for Acceptable
Plan (2 pts)
Performance Level / Performance Criteria / Comments___ Outstanding / As in Acceptable and all of the following:
Plan is consistent with clinical practice guideline recommendations and/or primary literature evidence
Includes reasonable time frame for when lab and other tests should be performed, based on patient presentation and product labeling
X Includes a reasonable recommendation for when the patient should return for follow-up based on patient presentation and the primary problem / Despite the limitation in your assessment, you plan is okay. However, I'm being VERY lenient - you should have included the need for repeat UA after therapy to get acceptable. In the future you must be sure to include appropriate lab monitoring if needed.
_X_Acceptable / Contains all of the following:
X Includes appropriate non-pharmacologic and/or specific* drug therapy recommendation(s) for the identified problem that are likely to improve the health and well-being of the patient
X Recommended drug therapy is from formulary OR prior authorization obtained for non-formulary items
If applicable, correctly indicates laboratory parameters or other testing required for monitoring of drug efficacy and/or toxicity
X Includes brief statement of patient education that should be provided
Not Acceptable / Does not contain all criteria for Acceptable
*To be “specific”, the following must be included
· If a drug is to be stopped, it must specifically be discontinued in the Plan section. Otherwise, the assumption is that the drug was continued
· If drug to be started, the plan must include drug name, dose, route, frequency and duration if finite (i.e., include all information that would be required ina prescription
“O” rating = 100% of point value
“A” rating = 80% of point value
“N” rating = 0% of point value
Other comments:
FINAL SCORE: 2.1