0

Bachelor of Pharmacy

PRECEPTOR GUIDE

Part 3 BPharm Students

2017

Placement Module 2 Hospital Pharmacy Placement Programme

1

Contents

Principles of Experiential Learning Placements in the BPharm Programme 2

Overview of the Experiential Learning Placement Modules 4

Overarching Aims of Experiential Learning Placements 4

Structure and Objectives for Placement 2 & 3 5 Overall aims of Placement 2 & 3 5 Duration of Placement 6

Domains and Learning Outcomes for Placement 2 and 3 7

Overview of Learning Activities 11 Essential activities. 11 Optional Activities 12

Hospital Placement Checklist 13

Preceptor’s Roles and Activities 15

Expectations of Students 17

Concerns about Student Behaviour 17

School of Pharmacy Contacts 18

Appendix 1: Overview of e-Portfolio Placements 2 & 3 19 Daily Learning Record 19 Medicine Management and Medication Safety 19 Providing Patient Care 21 Developing as a Medicine Expert 22 Other Evidence for Optional Learning Activities 22 Reflection 23

Appendix 2 Health & Safety Arrangements and Responsibilities for Student Placements 24

Appendix 3: Pharmacist’s Assessment of Part 3 Student’s Performance 25

Appendix 4: Supplementary Pharmacist’s Feedback of Student’s Performance 26

Appendix5: 2017 HPP Pharmacist’s Assessment of Part 3 Student Performance 27

2

Bachelor of Pharmacy – The Hospital Pharmacy Placement Programme (HPP)

Please note: In addition to the information provided in this guide, more information about the placements can be accessed from the Pharmacy Placement Site Information website. https://flexiblelearning.auckland.ac.nz/pharmacy-placements-information/index.html

Principles of Experiential Learning Placements in the BPharm Programme In its simplest form, experiential learning means learning from experience, or learning by doing. Experiential education first immerses students in an experience and then encourages reflection about the experience to develop new skills, new attitudes, or new ways of thinking.1 Experiential Learning Placements fulfill many important opportunities for embedded, contextualised, authentic learning about the role of medicines in healthcare, about pharmacy as a profession and the role of the pharmacist, and about the health consumer experience. The rationale for placements includes:

Acquisition and integration of professional knowledge, skills and attitudes.

Development of professionalism and transitioning from ‘student role’ to ‘career

professional’.

Practical application of classroom and theory learning.

Opportunities to utilise generic skills developed at university.

Development of a ‘whole person, patient care approach’.

Opportunity to clarify and determine career direction.

Opportunity to become workforce literate.

Establishment of workforce contacts.

In the context of the BPharm Experiential Learning Placement Modules the following educational principles describe the framework for placements across the entire programme:

Learning, especially around the development and demonstration of professional

competencies, is a continuum and as such develops over time at a rate determined by

each individual student learner.

Alignment and relevance of learning are critical aspects for the experiential learning

placements to be effective.

Wherever possible, students should be enabled to take advantage of a variety of

learning experiences to inform their development as a pharmacy professional.

Experiential learning should be stepped and incremental.

1 Lewis, L.H. & Williams, C.J. (1994). In Jackson, L. & Caffarella, R.S. (Eds.). Experiential Learning: A New Approach (pp. 5-16). San

Francisco: Jossey-Bass.

3

Recognising the continuum of learning across the programme, we have described

three ‘phases’ of student development, namely ‘Novice’, ‘Developing’, and

‘Approaching Graduate Level’.

At the Novice (Placement Module 1) stage, the focus is on socialisation into the

pharmacy profession and role of the pharmacist.

At the Developing (Placement Modules 2, 3 and 4) stage, the focus is on development

of learning where students will be developing the requisite pharmacy practice skills,

attitudes and behaviours.

At the Approaching Graduate Level (Placement Modules 5) stage, the focus is on

consolidation of learning and opportunities for students to expand their exposure to

patient care across a range of settings.

By the end of Placement Module 5, students should be approaching the

demonstration of professional competencies as described by the Pharmacy Council of

New Zealand’s Standards for Interns.

The e-Portfolio is the compulsory web-based platform through which students gather

a longitudinal record of their learning from all five Placement Modules across the

BPharm programme. It also serves as a vehicle for academic staff to manage the

assessment process including student submission of required pieces of evidence,

assessment by staff, and provision of individualised formative feedback as well as the

overall management of assessment grades for all Placement elements. Through the

e-Portfolio, UoA staff members provide resources to support learning in general as

well as specific guidance in relation to learning activities within each Placement

Module.

4

Overview of the Experiential Learning Placement Modules The revised BPharm curriculum sees an increase in Experiential Learning Placements. Students in the revised curriculum will experience a total of 5 x 10 days Experiential Learning Placement Modules within the following BPharm courses:

Placement 1: PHARMACY 213 (Semester 2, Part II: 10 days)

Placement 2: PHARMACY 311 (Semester 1, Part III: 2 week block)

Placement 3: PHARMACY 312 (Semester 2, Part III: 2 week block)

Placement 4: PHARMACY 411 (Semester 1, Part IV: 2 week block)

Placement 5: PHARMACY 412. (Semester 2, Part IV: 2 week block)

The Experiential Learning Placement Modules equate to 10 weeks of off-site placement learning activities across the whole BPharm progamme. They are supported by pre- and post-teaching and learning activities within the Clinical and Professional Skills Modules of the five courses listed above. The Placement Modules are a compulsory component of the Bachelor of Pharmacy (BPharm) programme. Over the three years in the BPharm programme (Part II, Part III and Part IV) the five Placement Modules will occur in a variety of health practice settings including community, hospital and industry pharmacy sites. Overarching Aims of Experiential Learning Placements

The overarching goals of the Experiential Learning Placements are to allow students to apply their knowledge and to experience new learning in ‘real-life’ practice situations; to learn from patients and professional colleagues; and to undertake activities under supervision that they will perform as interns and pharmacists.

For Placement 2 the aims are: • To expose pharmacy students to hospital pharmacy practice.

• To provide students with the opportunity to observe therapeutic decision-making

and monitoring in practice.

• To elicit a medication history from a patient.

• To construct a care plan for a patient utilising the clinical notes and information

from the patient, under supervision.

• To answer medicines information questions.

• To develop medicines knowledge, medicines review and medicines reconciliation

skills.

5

Structure and Objectives for Placement 2 & 3

This is the students’ second formal experience of Experiential Learning Placements and at this stage, the emphasis is on ‘developing core skills and understandings’ about the many aspects of pharmacy practice. In terms of a continuum of learning and skills development, they are very much at the ‘Developing’ level and it is therefore important that the structure and activities are pitched accordingly.

Overall aims of Placement 2 & 3

To develop core pharmacy practice skills in the provision of patient-centred care in collaboration with other health professionals. This includes the provision, management and optimisation of medicines and pharmacy services. The aim of Part II Placement 1 focused on introducing students to the medicines pathway, the patient experience, and the role of pharmacy and pharmacists. In BPharm Part III, Placements 2 and 3 will build on these three areas and further develop the core skills and understanding about the many aspects of the pharmacist’s role. Part III Placements 2 and 3 will focus on students developing understanding, skills, attitudes and behaviours in relation to the core roles and skills of a pharmacist:

Managing medicines and medication safety

Providing patient care

Developing the identity as a medicine expert with the winder health care team with other healthcare professionals.

Note 1: Placements 2 and 3 will comprise two weeks in a hospital pharmacy setting and two weeks in a community pharmacy. Half of the student cohort will undertake the community placement in semester 1 and half in semester 2. Note 2: The main focus for Placements 2 and 3 is on having students move from observation to actual experience in gathering information, identifying issues, assessing information and sharing information with and about patients, their health and their medicines. Note 3: At this stage, students expected to be developing the core skills and understanding around decision-making, clinical reason, and communicating with a variety of patients/health consumers and health professionals. They are not yet expected to undertake complex decision-making independently with regard to carrying out the entire care-planning process across one patient. Nor will they be expected to make autonomous decisions e.g. with regard to medicines’ review and patient care plans etc. They will, however, be expected to have multiple experiences of practicing the steps in the care-planning process across as wide a range of patients/health consumers as possible. Note 4: For some of the learning activities by the end of placements 2 and 3 student will be expected to demonstrate and ‘ability to do’. For some of the learning activities by the end of placements 2 and 3 students will be expected to demonstrate and ‘understanding of’. For some of the learning activities by the end of placements 2 and 3 students will be expected to demonstrate an ‘awareness of’.

6

Duration of Placement

The hospital pharmacy placement programme (HPP) for BPharm students at Auckland University, is a compulsory module of their BPharm programme and involves attendance and active participation at an approved and consented hospital pharmacy.

Placement Module 2 comprises of 10 full placement days, Monday to Friday for the last two weeks of May. Placement 2 starts on Monday 22nd of May and finishes on Friday 2nd June. Placement Module 3 comprises of 10 full placement days, Monday to Friday in September. Placement 3 starts on Monday 18th September and finishes on Friday 29th September.

A full placement day is expected to be from 8am to 4:30pm with half an hour for lunch.

7

Domains and Learning Outcomes for Placement 2 and 3

Knowledge, skills and attributes will be demonstrated, and assessed, during the Experiential Learning Placements across the following six Domains (Note: these are derived from the New Zealand and Australian Competency Standards for the Pharmacy Profession).

It is expected that by the end of Placements 2 students will have achieved developing levels in the following Learning Outcomes in all six Domains. Domain 1: Professional and Ethical Practice in Pharmacy The focus of this Domain is on:

Developing understandings, attitudes and competencies, including cultural competence, as an ethical professional acting within legal frameworks and standards;

Demonstrating personal and professional integrity to deliver patient-centred care.

Demonstrating self-management skills. Domain 2: Communication and Collaboration

The focus of this Domain is on:

Developing skills, attitudes and behaviours to communicate with health consumers, family/whānau and colleagues to support care and wellbeing;

Developing understandings, attitudes and competencies to engage in effective collaboration within diverse groups.

Domain 3: Health and Medicine Management to Promote Optimal Use of Medicines

The focus of this Domain is on:

Developing the understandings and abilities to work in partnership with health consumers, whānau and other health care professionals to optimise the use of medicines.

Domain 4: Primary and Preventative Healthcare

The focus of this Domain is on:

Developing understandings, attitudes and competencies in providing primary health care in collaboration with health consumers and other health professionals to improve health outcomes.

Domain 5: Supply and Administration of Medicines

The focus of this Domain is on:

Developing understandings, attitudes and skills in the safe and accurate supply of medicines to support the quality use of medicines.

Developing skills and knowledge for pharmaceutical product preparation within a quality assurance framework.

Domain 6: Leadership and Organisational Management

The focus of this Domain is on:

Developing understandings of leadership skills and management processes required to manage resources and information effectively to optimise quality service delivery within a safe and secure work environment.

8

Domain 1: Professional and Ethical Practice in Pharmacy

Learning Outcome Example behavior and evidence guide

1.1 Behaves in a professional manner.

Be punctual and dress appropriately

Demonstrates good time-management and self-responsibility

Exhibit behaviours as outlined in the Experiential Learning Placement Professional Behaviour Assessment Indicators and Criteria

1.2 Complies with legal and ethical requirements.

Checks prescriptions and drug charts for legal, clinical and ethical appropriateness

Maintains patient confidentiality and privacy

1.3 Manages self with a positive disposition towards feedback and continuous improvement of knowledge, skills and attitudes.

Actively seeks feedback

Demonstrate willingness to improve skills and behaviour

Engage in self-reflection

1.4 Recognises and respond to health consumer diversity and needs.

Interacts with a diverse range of patients and reflect on their different needs

Domain 2: Communication and Collaboration

Learning Outcome Example behavior and evidence guide

2.1 Applies key principles of communication.

Elicits a medication history from patients, including the patient’s views on their medicines

Clarifies issues on a prescription/drug chart with a pharmacist and/or technician

Provides a succinct reply to a routine medicines information inquiry from another health professional

Clarifies issues regarding a chart/prescription with a health professional/s

2.2 Demonstrates awareness of varied consumer needs and responds according to individual situations.

Explains the use of a range of individual medicines and varied dosage forms to a variety of patients / health consumers with different needs (e.g. limited English, poor sight, arthritis, cultural differences)

Communicates with patients / health consumers and carers in a sensitive and culturally appropriate manner

9

Domain 3: Health and Medicine Management to Promote Optimal Use of Medicines.

Learning Outcome Example behavior and evidence guide

3.1 Develops a patient-centred approach to enable the safe and appropriate use of medicines.

Demonstrates relationship-building skills when interviewing patients or carers to elicit patient histories and other relevant information

Provides information and advice to patients and carers in a sensitive and culturally appropriate manner

3.2 Applies skills in therapeutic decision-making and management.

Selects appropriate sources of patient information to make therapeutic decisions (e.g. patient interview, medical records, pharmacy records, lab results)

Interprets relevant patient information

Identifies medicines-related problems and potential solutions

Communicates therapeutic decisions with the patient and team

Recommends appropriate monitoring and follow up

3.3 Applies skills in the acquisition, evaluation and provision of information to optimise the use of medicines.

Undertakes relevant/appropriate routine medicines information inquiries

Identifies appropriate sources of information

Critically evaluate medicines information

Communicates findings in an appropriate manner

Domain 4: Primary and Preventative Healthcare.

Learning Outcome Example behavior and evidence guide

4.1 Provides services which contribute to community health

Engages in initiatives such as smoking cessation, antimicrobial stewardship, cardiac rehabilitation, vaccinations, skin cancer awareness , point-of-care testing etc., as appropriate

4.2 Provides advice on health promotion, disease prevention and lifestyle modification

Provides patient-centred advice and information to patients on disease prevention/lifestyle modification as appropriate.

10

Domain 5: Supply and Administration of Medicines

Learning Outcome Example behavior and evidence guide

5.1 Prepares pharmaceutical products accurately and safely

Checks formulae and prepare batch sheets accurately and completely

Performs pharmaceutical calculations accurately

Prepares and labels compounded products complying with legal requirements

5.2 Supplies prescription medicines safely and accurately and advise on their use.

Checks prescriptions and drug charts for legal, clinical, ethical and funding appropriateness

Discusses any concerns with colleagues and prescribers

Accurately dispenses selected medicines

Provides appropriate advice and information on dispensed medicines to patients and carers

5.3 Supplies non-prescription medicines safely and accurately and advise on their use.

Not generally applicable in hospital setting.

Provides advice and information on non-prescription medicines to patients and carers e.g. herbal and complementary medicines.

Domain 6: Leadership and Organisational Management

Learning Outcome Example behavior and evidence guide

6.1 Demonstrates awareness of both management and leadership skills in the context of pharmacy practice

Observes both management and leadership roles within the pharmacy and the wider hospital setting e.g. pharmacist’s contribution to multi-disciplinary meetings.

6.2 Describes roles and responsibilities of key personnel within pharmacy practice

Observes and describes the roles and responsibilities of personnel both within the pharmacy and the wider hospital setting.

6.3 Demonstrates awareness of management and organisational skills to ensure the effective and efficient delivery of services

Undertakes self-reflection on management and organizational practices observed in the hospital setting.

11

Overview of Learning Activities

Essential activities.

Students and preceptors will work together to ensure all essential learning activities for the ten day hospital placement are completed. The placement will include active participation and observation in the following aspects of hospital pharmacy practice. It is expected that the student will have multiple opportunities to undertake some of the learning activities to develop core pharmacy practice skills. Activity One: Medication History Taking: This activity will involve the process of observation, with the aim of self-completion, of gathering information from patients/caregivers and other sources to establish an accurate record of a patient’s medication history. The student will trial their own medication history-taking guide. Activity Two: Medicine Reconciliation: This activity will involve the process of observing, with the aim of self-completion, of collecting a complete and accurate current medicines list, comparing it against the patient’s medication chart and checking for discrepancies under the guidance of a pharmacist. Activity Three: Care Plan/Medication Review: This activity will involve the student interviewing an assigned patient, taking a full medication history (including medicine reconciliation), undertaking a medicine review and preparing a care plan. Activity Four: Medicines information enquiry: This activity will involve the student researching a medicines information request, providing a written answer to the query and detailing their sources of information. A set of default enquiries will be available. Activity Five: Patient Education: The student will observe and carry out, under the supervision of a pharmacist, providing advice to patients on prescribed medicines for an inpatient, discharge prescription or new medication. Activity Six: Medication Safety: This activity will involve the student becoming familiar with the system for managing reporting of adverse drug reactions and incidents and what processes are in place for error minimisation. Activity Seven: CARM report: This activity includes understanding how to complete a report for an adverse drug reaction to CARM. Activity Eight: Chart/Prescription Screening: This activity involves the process of screening the prescription or chart before dispensing begins. Activity Nine: Medicine Supply: This activity will involve dispensing alongside a technician, pharmacist or intern and if possible preparation of an extemporaneously compounded product. Activity Ten: Pharmacy Management: This activity will involve the student becoming aware of systems for managing a hospital pharmacy in terms of staff and financial management. Activity Eleven: Personal reflection journal and learning record: This activity will involve the student recording and reflecting upon their learning experiences throughout their placement.

12

Optional Activities

‘Optional Learning Opportunities’ includes some suggestions for extra learning activities that may be made available to the student, during their placement. Some sites will offer these as routine activities during the placement; however, this will not be possible for all sites.

If the student is particularly interested in any of these optional activities they are encouraged to ask the preceptor who will let the student know if they are possible. These optional activities will not be assessed but will be of great benefit to the student in their understanding of pharmacy practice healthcare in New Zealand.

Suggested Optional Activities

Shadow a pharmacist in a preadmission clinic, outpatient or speciality ward/department pharmacist e.g. emergency department, coronary care unit.

Attend a multidisciplinary meeting with their pharmacist and team.

Attend a consultant ward round with their pharmacist and team.

Attend a clinic with a nurse educator/specialist or medical staff member.

Talk with the medicines safety team about their role in the hospital.

Observe manufacturing; aseptic compounding, Total Parenteral Nutrition, blister packaging.

Identify and observe an example of therapeutic drug monitoring undertaken in the hospital e.g. aminoglycosides.

Observe a complex medication counselling consultation e.g. warfarin, dabigatran, alendronate, insulin.

Observe clinical trial processes.

Shadow an occupational therapist, physiotherapist, dietitian or allied health worker. Observe a NEEDS assessment for a patient by the Needs Assessment and Service Co-ordination (NASC) service.

Shadow a member of the Infectious Diseases (I.D.) team and learn about antimicrobial stewardship, attend an I.D. team meeting.

Discuss ethical issues staff are commonly faced with.

Attend a lecture, demonstration or grand round.

Look at examples of Drug Utilisation Evaluation or Cost Effective Medicines Management policies or programs operating within the hospital.

There are likely to be area-specific and/or hospital-specific activities that may be available. Preceptors will advise appropriate alternative activities.

13

Hospital Placement Checklist Checkbox

Introduction to the hospital pharmacy with an explanation of working areas, staff roles and departmental activities.

Observation of clinical pharmacy practice in the hospital.

Introduction to medication charts, patient observation records, laboratory reporting

and structure of patient notes used within the hospital.

Obtain a medication history from an in or outpatient under supervision, utilising medicines knowledge and medication reconciliation skills.

Perform a medicines reconciliation.

Medicine supply to wards/clinics/departments.

Prepare and present a care plan under supervision.

Understand how to complete a CARM report for an adverse drug reaction.

Observe and complete patient medication education.

Answer medicines information question.

Prepare an extemporaneously compounded product.

14

Suggested programme for Hospital Pharmacy Placement 2

Day 1 in Hospital Phcy

• Preceptor expectations.

•professional behaviour, patient confidentiality, amount of self-directed learning

•dress code, exchange contact details for unanticipated situations

•health and safety

• Orientation to site. •working areas, wards, dispensary

•introduction to staff

•software/technology

•explanation of staff roles and departmental activities

Day 2 & 3 in Hospital Phcy

• Observation of clinical pharmacy practice.

•medication history taking

•ward rounds

•medicine reconciliation

•patient education

•prescription screening

• Care plan.•identify care plan patient

•patient interview

Day 4 & 5 in Hospital Phcy

• Medicines information.

• Dispensary/Ward.•Structure of medication charts

• Care plan.•completion of medication profile and medicine related problems.

• Completion of mid point assessment.

Day 6 & 7 in Hospital Phcy

• Medication Safety & Adverse Drug Reaction reporting.

• Dispensary/Ward.

• Medicines information.

• Areas from mid-point assessment addressed.

• Patient consultation on adherence.

Day 8 & 9 in Hospital Phcy

• Care plan -completion of care plan.

• Patient Education to in-patient, discharge prescription or new medication.

• Pharmacy Management -staff & financial.

• Prepare an extemporaneously compounded product.

Day 10 & Post Placement

• Present care plan to pharmacist(s).

• Optional activities.

• Preceptor complete final assessment and send to Auckland School of Pharmacy.

• Student complete learning activities in e-portfolio.

15

Preceptor’s Roles and Activities

Preceptors have a very important role in providing a suitable programme for each student, acting as a role model, facilitating clinical and experiential learning and acting as a mentor.

Preceptor’s tasks are to:

Provide a programme of learning activities to meet the CPP requirements.

The programme of learning activities should occupy most of the student’s time in the pharmacy. Students are encourage to take notes in a notebook or record information on the templates that they can download from Canvas. They are encouraged to write up their daily learning log after the end of each day. Completing their e-Portfolio is expected to be done in the evenings and after their placement, not during the day at the pharmacy.

Ensure the student is introduced to the pharmacy staff and medical team members. This will help them feel welcome and comfortable to learn.

Facilitate student learning through demonstration, participation, explanation, discussion and formative feedback.

Students really appreciate being able to undertake supervised roles rather than just observing practice especially over prolonged times (hours). Don’t hesitate to correct or highlight errors/ omissions/ inconsistencies in students’ case presentations – they will benefit from learning from your experience.

Identify a suitable/appropriate patient for the student to undertake a medication history interview, and then undertake a medication review and develop a care plan

Students are in their third year of Pharmacy School. This may be the first time they have been formally required to complete a detailed care plan for a ‘real’ patient. When identifying patients for the students to interview, it may help to know that the 3rd year students have completed by May the following range of modules: Dermatology, Infectious diseases, Gastroenterology, Respiratory, Cardiovascular System and by September Hepatic & Renal, Endocrine and Women’s and Men’s Health Modules. Please ensure that the patient gives verbal consent for the student to practice taking a medication history.

Students have had difficulty preparing care plans in the following situations: Patients with 20-25 plus medicines. Such patients represent a challenge for

experienced pharmacists; this may be too challenging for some students Patients with one or two medicines and an unremarkable medical history. Ideally,

it would be recommended to provide a case with a number of aspects, to extend students’ learning experiences

Deaf/ extremely hard-of-hearing patients. Again, this situation would challenge most pharmacists; for inexperienced students, this can be very stressful

Unstable mental health patients. A vital part of this exercise is the conversational aspect of the interview process. Patients who are too unwell to engage in conversation may not provide students with the best opportunity for learning

16

Debrief students if any unexpected activity occurs or if they are entering an area that may be frightening or distressing for them.

Those who have been adequately debriefed while still feeling challenged by the experience will also gain valuable insights and be able to view the experience positively.

Provide students with honest advice that will help them improve their performance as they prepare to enter the pharmacy workforce.

Please offer students any advice as you see fit. They will appreciate the opportunity to discuss this prior to leaving their CPP. You are required to complete the ‘Pharmacist Assessment of Student Performance’ sheet prior to the student finishing their placement. This will enable the Schools of Pharmacy to assess the students’ performances at their placements.

Placement 2 & 3 Post Placement Activities

It is expected that students will take notes during their placement and record information in the templates they can download from CANVAS, however the writing up of the learning experience in their e-Portfolio occurs in the evening and after their placement visits. An outline of the learning activities in their e-Portfolio is in Appendix 1. Students must attend a CPP debriefing workshop following their placements. They must then submit their work via e-portfolio for marking shortly following the workshops. The assessment of the e-Portfolio learning activities is assessed by School of Pharmacy staff members.

17

Expectations of Students Students are expected to attend the hospital pharmacy placement for a ten full days, Monday to Friday for the two placement weeks. A full day is 8am to 4:30pm with half an hour for lunch. Please contact school staff (see contact information page) if the student does not arrive or asks to change the times of their attendance for their placement. Two weeks before attending the placement, students should contact the pharmacy to introduce themselves, find out any specific information that relates to your pharmacy for example parking. Students are also expected to send to you a Student Profile Form. The purpose of this form is so the Pharmacy Staff know a little about the student before their placement.

All students are expected to be dressed in an appropriate professional manner that is aligned to the hospital setting and wear during their placement their name badge which identifies them as a pharmacy student. This must be worn throughout the placement.

If a student is unable to attend part of their programme through illness or bereavement etc., the protocol in the BPharm handbook is to be followed. A medical certificate is required for illness and Pharmacy Placement Administration and the preceptor/supervising pharmacist must be notified as soon as possible.

Students are not permitted to including any information in their –Portfolio which can identify a

patient, pharmacy staff member of pharmacy. All students have submitted a completed

confidentiality form agreeing to obligations set out by School of Pharmacy and the Privacy Act.

Concerns about Student Behaviour

If there are any concerns about student behaviour please contact Lynne Bye (see contact information). This is a professional experiential learning placement, and we have a responsibility to ensure that all students fulfil all criteria with respect to professionalism.

It is also important for the preceptor/s to provide immediate guidance and feedback directly to the student, to ensure any errant behaviour ceases instantly.

18

School of Pharmacy Contacts

Lynne Bye: Director Experiential Learning Placements Lynne is the overall Director for Experiential Learning Placements within the BPharm programme. Lynne’s contact details are:

09 923 6392 or mobile 021768795 l.bye@auckland.ac.nz

Post School of Pharmacy Faculty of Medical and Health Sciences The University of Auckland Private Bag 92019 Auckland 1142

Kim David: PPC Kim provides administration support for experiential learning placements.

09 923 7522 pharmacyplacements@auckland.ac.nz

Fax 09 367 7192 Post School of Pharmacy

Faculty of Medical and Health Sciences The University of Auckland Private Bag 92019 Auckland 1142

Stephanie Yee: Professional Teaching Fellow – Placements Stephanie is a registered pharmacist working in the pharmacy placement team.

stephanie.yee@auckland.ac.nz Post School of Pharmacy

Faculty of Medical and Health Sciences The University of Auckland Private Bag 92019 Auckland 1142

19

Appendix 1: Overview of e-Portfolio Placements 2 & 3

Placement Module 2 & 3 The following sections must be completed for Placement 2 & 3.

Pre-placement Preparation

My Glossary

Daily Learning Record

Hospital or Community Pharmacy Placement section

Reflection

Pre-Placement Preparation Confirmation of placement preparation form.

Contacted placement site

Adhere to privacy code

Read and adhere to Pharmacy Council of NZ social guidelines

Revise hand hygiene

Code of Health and Disability Commissioner

My Glossary

Refer back to Placement 1 ‘My Glossary’ to build on with new terms or expand on previous understandings.

Daily Learning Record Complete the Daily Learning Record Table

Medicine Management and Medication Safety

Chart/Prescription Review

Review as many as possible medicine charts/prescriptions on a ward or in the hospital

dispensary and describe the main issues the pharmacist is looking for prior to the medicine

supply process.

Medication History Taking and Information Gathering

Describe five sources of information you can use to help provide a complete history of a patient’s medications. Medication History Guide

Create your own medication history guide using the resources provided and your learning from Clinical and Professional Skills module 1 and 2. Medication History Taking

Undertake several medicine histories from a variety of patients then choose ONE to reflect on. How was the experience, what have you learnt from it and how did you manage the conversation with the patient in order to gather the information needed?

20

Medicine Reconciliation

Explain the term Medicine Reconciliation in your own words, as if you were describing this to someone who has no understanding of this. Briefly explain how a medicine reconciliation differs from a person’s medication history. How would you define a ‘difference’ vs a ‘discrepancy’ in a medicine reconciliation? List some common types of discrepancies including an example of an intentional and a non-intentional discrepancy. Care Plan/Medication Review

Undertake a full Medication Review/Care Plan for at least one patient. Refer to your medication history taking guide and gather the relevant information from a variety of sources including taking a medication history from the patient. Complete and upload “Background Information for Care Plan” Form Undertake a Medicine Reconciliation to establish a complete accurate medicines list for the patient you are undertaking a Care Plan/Medication Review on. Complete and upload “Medicines Reconciliation” Form Analyse and evaluate the gathered information to identify medicine related problems. Complete and upload the “Medication profile” form. Write a care plan using the form provided to prioritise the identified medicine related problems and provide options and recommendations to resolve these. Complete and upload the “Care Plan” form

Write a formal letter that is appropriate for a health professional involved in the care of the patient you have undertaken a care plan/medication review for. For example the patient’s doctor. (Approximately 500 words). This letter must include:

Brief introduction that you have undertaken a medication review for this patient

Brief summary of the patient’s current status

Summary of the issues you identified backed up with appropriate facts and your

recommendations to resolve the issues you identified. Each identified issue should be

in a separate paragraph.

Current list of prescribed medicines the patient is taking.

Reflect on your Care Plan/medication review process, what you learnt, what aspects went well, and what aspects didn’t go well identify your own learning needs or areas you need to improve on next time you undertake a careplan/medication review.

21

Medicines Management

If a prescriber wants to use a treatment that is not listed in the HML they can apply for

consideration under the Named Patient Pharmaceutical Assessment (NPPA) process. Explain who is eligible to apply for NPPA and what conditions must be met prior to application?

Which organisation is responsible for funding medicines under the NPPA process?

Explain when the Rapid Assessment process would be used, who is involved and who funds the medication. Many hospitals are involved in clinical audits both in the hospital pharmacy department and hospital wide. Briefly describe one of the previous audits performed at your hospital pharmacy host site, why it was carried out and the results.

Describe how medicines are supplied out of hours in your host hospital. Medicine Safety

List some common dispensing errors, how they are documented and any subsequent actions, when dispensing medication. E.g. incorrect dose calculations, incorrect product choice. Describe the control steps you have observed that minimise medication / dispensing errors? E.g. Tall Man lettering, product placement on shelf. List some precautions the hospital pharmacy undertakes when dispensing high risk medicines e.g. colchicine, warfarin, cytotoxic medicines. Complete the following pharmacovigilance form for an Adverse Drug Reaction. List a summary of the information that is required in order to complete a CARM report if there

is a need to report an adverse Drug Reaction (ADR) to NZ Pharmacovigilance Centre.

Controlled drugs are handled differently from other medicines. Describe the process including how the wards order controlled drugs, how this order is processed by the dispensary, how the drugs are delivered to and managed on the wards.

Providing Patient Care Thinking about your consultations/interacting with patients, and describe in your own words the term ‘Patient Centred Care’. Patient Education

Converse with as many patients as possible about their prescribed medication when handing out dispensed medicines in the pharmacy. Use this template to record several patient interactions where you have provided patient education on prescribed medications, then choose ONE to submit for assessment. Describe two cases where you have had to discuss a patient’s adherence to their medication or lifestyle factors. Describe how and why patients are screened for smoking on admission.

22

Developing as a Medicine Expert Medicines Information Enquiry

From the Medicines Information Enquires you have answered select ONE and complete the form. These can be; administration/dosage, adverse effects, availability/supply, choice of therapy, interactions, pharmaceutics related, pharmacology related, pharmacokinetic related. Criteria Interpretation

Briefly describe in your own words what section 29 medicines are, what details must be included in the record that is sent to MedSafe and what information the medical practitioner must provide to the patient. Briefly describe the term special authority. Interpret three Pharmac special criteria restrictions on supply of medicines by stating what the restriction means to the patient and the pharmacist dispensing the item e.g. compounding a cream/ointment, dispensing of methylphenidate Medicine Knowledge

Complete the table for respiratory inhalers covering; Generic name of the medicine/active ingredient; Trade name of the medicine product; Mechanism of action of medicine/active ingredient; Clinical indication; Form of device; Duration of action; What advice would you provide a patient?; Are there any special requirements with regard to this medicine product? Hospital Pharmacy Management.

Based on the operation of the pharmacy you have been in during your placement, describe

pharmacists’ tasks, roles and responsibilities they undertake in the pharmacy, in addition to

providing direct patient care. For example (but not limited to), membership of committees,

teaching, staff training, management, quality improvement initiatives, quality standards and

audit requirements, staff management, financial management, reports, interacting with

professional organisations and advocacy organisations. (Maximum of 300 words)

Other Evidence for Optional Learning Activities

23

Reflection Briefly describe the 5 most important aspects in providing good patient care, you have learnt and observed during your pharmacy placement. Briefly describe, in your view, what your pharmacist’s key contribution to patient healthcare is. What aspects of the pharmacy setting appeal to you and why? Provide two detailed reflections on two aspects of what you learnt, went well, didn’t go well and learning needs identified/actions. Reflecting on your preceptor’s and your own mid and end point assessment of your skills think about your progress and list five specific skills you would like to work on for the future. Learning Plan

Create a learning plan for one of your identified learning needs – do I have the skills/knowledge etc.

24

Appendix 2 Health & Safety Arrangements and Responsibilities for Student

Placements

The purpose of this written communication is:

To clarify expectations with regard to Health and Safety related issues for the student, the placement provider and the University of Auckland.

Arrangements and Responsibilities Of: University of Auckland:

To the student:

Provide information to the student on general Health and Safety prior to their placement. Provide specialist advice and guidance for students with additional support needs. Where appropriate, appoint a visiting tutor and establish the frequency of their visits.

Of the placement provider:

To the Student and University of Auckland:

Plan the work or study programme and associated Health and Safety training to be undertaken by the student.

Provide the student with a full and clear induction to the organisation and its working practices, including Health and Safety arrangements, fire precautions and emergency evacuation arrangements, how to report injuries / illness / incidents, unsafe conditions and hazards.

Nominate the supervisor who will conduct or make arrangements for day-to-day supervision of the student including instruction regarding hazard and Health and Safety precautions.

Comply with the Health and Safety legislation. Facilitate access to the student for visits by the visiting tutor when necessary. In cases of serious injury or incidents involving the student or breaches of discipline by the

student to advise and consult with specified contacts at the University of Auckland. Of the student:

To the placement provider: Abide by all rules regarding Health and Safety requirements, and other practices and procedures

of the placement organisation. Carry out the work programme specified by the placement provider under the supervision of the

specified supervisor(s). Inform the placement provider of any health concerns or disability that may require adjustments. Report any concerns about Health and Safety at their placement to their placement provider. To the University of Auckland: Attend briefing sessions and familiarise themselves with all information provided. Inform the University of any personal factors (e.g.: Health and Safety, disability, linguistic or

cultural) that may affect the level of risk or may require adjustments. Consult with the University prior to seeking any changes in the terms and duration of the

placement. Report any incidents in which they are involved and any Health and Safety issues that are not

addressed by their placement provider to the University of Auckland.

25

Appendix 3: Pharmacist’s Assessment of Part 3 Student’s Performance

The following information should guide the completion of the Pharmacist Assessment Form. The pharmacist assessment form should be completed by the nominated preceptor for the placement. There are two aspects of the pharmacist’s assessment of the placement. A) Professional Behaviour Assessment and B) Specific Task Performance. Please complete both A) and B) at:

Formative mid-point assessment after completion of five days of placement. This is to identify the student’s progress and areas to focus on in the following week. Students will also self-complete the assessment form prior to this. Please discuss both your assessment results with the student.

Final assessment after completion of ten days of placement. This assessment is sent to the School of Pharmacy.

For B) Specific Task Performance please indicate whether knowledge has been applied in the practical setting. Please consider: The level at which the task should be demonstrated i.e. an ‘awareness of’, an

‘understanding of’, an ‘ability to do’ and that these are Part 3 students. The level of preparation the student exhibited. The student’s use of skills, knowledge and attitude in the ability to do a task

consistently within standard. Ways to assess performance are:

Reviewing written documents/notes the student has written during or about tasks.

Observe the task performance.

Examine the end product e.g. label, extemporaneous product.

Discussion and questioning of the task. Feedback from staff on students: The feedback and contribution of the pharmacy staff involved with supervising a student during their placement is important to consider when the nominated preceptor/pharmacist completes the Pharmacist Assessment Form. A feedback form is available for collecting the views of other staff members. How to complete and return the assessment: Please complete all parts of this assessment of the student’s performance during their placement and return by email, fax or post to Pharmacy Placement Administration at the School of Pharmacy as soon as possible within one week of the student completing their placement:

Email pharmacyplacements@auckland.ac.nz Fax 09 367 7192 Post Pharmacy Placement Administration

School of Pharmacy Faculty of Medical and Health Sciences The University of Auckland Private Bag 92019 Auckland 1142

26

Appendix 4: Supplementary Pharmacist’s Feedback of Student’s Performance

The feedback and contribution of the pharmacy staff involved with supervising a student during their placement is important to consider. This feedback form is to collect the views of other staff members who have been involved in the student’s supervision.

FEEDBACK ON STUDENTS Name of student: Date:

Operational area/ward: Supervising Pharmacist/ staff member:

Learning Activity/Topic/Area:

Did the student come prepared and willing to participate in the learning activity? Did the student demonstrate a positive attitude and actively participate? Did the student show integrity interacting with patients, staff and other health professionals?

PLEASE CIRCLE AS MANY WORDS THAT BEST DESCRIBE THIS STUDENT confident diligent knowledgeable suitable dress good listener

polite enthusiastic inquiring tidy appearance good communicator

friendly independent open punctual good spoken English

sociable calm innovative well prepared good written English

chatty eager focused well organised good time manager

disengaged relaxed professional courteous unprofessional

reluctant shy disorganised poor communicator

disrespectful

Please rate the student’s engagement with the learning activity/topic/area: (circle one of the following ratings)

Unsatisfactory* Satisfactory Merit

Further comments: *Please justify your reasons for your choice

Thank you for providing this valuable feedback.

27

Appendix5: 2017 HPP Pharmacist’s Assessment of Part 3 Student Performance

Student: Dates of Placement:

Hospital Pharmacy:

Pharmacist preceptors are to complete this assessment for each student at the end of the visit.

A. Professional Behaviour Assessment. Please tick the appropriate boxes for each of the 12 Indicators.

Indicators Not at all or

rarely*

Some of the

time*

Most of the time

All of the time

1. Student’s appearance and dress conforms to professional and pharmacy standards. (G.A. D5.16)

2. Student is punctual and shows good time management i.e. arrives on time, meets deadlines for completion of tasks. (G.A. D5.13, D5.16)

3. Student behaves in an ethical manner and acts in accordance with the profession’s Code of Ethics. (G.A. D5.5, D5.16, D5.17)

4. Student treats confidentiality and privacy issues appropriately. (G.A. D5.16, D5.17)

5.

Student is respectful i.e. demonstrates regard for others, acts in a manner that shows recognition that he/she is a guest at the practice site as a professional student. (G.A. D5.2, D5.4, D5.15, D5.17)

6. Student shows empathy and interest i.e. demonstrates appreciation of others’ positions and demonstrates consideration towards others. (G.A. D5.4, D5.15)

7. Student exhibits a positive attitude, a willingness to learn, and participates actively. (G.A. D5.7)

8. Student accepts and applies constructive feedback. (G.A. D5.6, D5.7)

9. Student communicates accurately, concisely and confidently. (G.A. D5.2, D5.3, D5.9, D5.15)

10. Student shows integrity interacting with patients, staff and other health professionals in socially and culturally diverse settings. (G.A. 5.1, 5.2, 5.15)

11. Student shows initiative and is self-directed in undertaking tasks i.e. after initial instructions initiates’ activities to complete them. (G.A. D5.14)

12.

Student demonstrates accountability i.e. holds oneself liable for tasks/responsibilities, does not blame others for mistakes or mishaps and accepts responsibility for actions. (G.A. D5.6, D5.7, D5.13, D5.17)

* Extra evidence is required if this box checked

28

B. Specific Task Performance Please assess the student on their performance of the specific tasks using the criteria below, in the following table.

Not Achieved Achieved Merit

The student displayed a poor interest or understanding of the

tasks/activities and/or required significant help and supervision.

The student consistently displayed appropriate interest and

understanding of the tasks/activities and achieved them with expected levels of help and/or supervision.

The student displayed outstanding interest and understanding and

performed all tasks/activities to the highest standard and displayed a

level of ability beyond that expected.

Specific task Circle appropriate achievement level Comments

(Please elaborate on your choice)

Medicine History

Did the student approach the patient in a professional manner?

Did the student use appropriate communication and ask open ended questions?

Was an accurate and complete medication history obtained

Not Achieved*

Achieved Merit

Care Plan

Were the appropriate problems identified?

Were reasonable/appropriate treatment options considered?

Were recommendations individualised to the patient with appropriate monitoring, counselling and follow up?

Not Achieved*

Achieved Merit

Medicines Information Enquiry

Was a good search strategy and appropriate resources used?

Was the answer clear and concise?

Was the answer communicated well either orally or written stating sources used?

Not Achieved*

Achieved Merit

C. Global Placement Module Assessment Criteria Please circle which criteria best reflects the students overall performance during their placement.

Not Achieved* Achieved Merit

The student displayed a poor interest or understanding of the tasks/activities and/or required significant help and supervision.

The student consistently displayed appropriate interest and

understanding of the tasks/activities and achieved them with expected levels of help and/or

supervision.

The student displayed outstanding interest and understanding and performed all tasks/activities to the highest standard and displayed a level of ability beyond that expected.

Supervising pharmacist’s comments * Extra evidence is required if this box checked

Supervisor’s name:

Signature: Date: