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I. COMMUNICATION The student will demonstrate effective written and verbal communication skills. Components: Communication Process Advocacy Inquiry Define the topic and its scope Listen actively & empathetically Identify & Assess your audience Adopt the advocate’s perspective Build your knowledge Build knowledge by questioning Identify criteria to measure the success of your Suspend assessment until the advocate is finished communication Select the most appropriate medium Clarify meaning by rephrasing Design communication plan Monitor the communication - test for signs of comprehension, affect, etc. Rehearse & implement communication plan Prepare the communication environment Deliver Monitor the communication - test for signs of comprehension, affect, etc. Assess Assess Content - Presentation of effective techniques of communication - relationships, models, interviewing, negotiations, and common problems of communication. The audience will range from children, to adult lay people, to peers and other health care professionals, the content will include basic interpersonal information (for forming relationships) , health-related information, and scientific information tailored to the audience Skill - Practice in application of content and process. writing: scientific papers, reports, patient charts and histories, memos, business letters speaking: conversation, lecturing, counseling, interviewing listening: to lectures for content, to individuals for affect and content reading: textbooks, class notes, assessment scenarios, medical charts, etc. Expected Outcomes In communication each graduate will be able to: 1. Respect patient as a person a. elicit and respect patient's values b. exhibit cultural sensitivity c. use interpreter appropriately as necessary d. communicate empathy e. maintain confidentiality f. tactfully handle difficult patients and situations g. conform with ethical guidelines 2. Share information effectively with patients, families, and health care team members a. convey information accurately b. explain options fully c. elicit degree to which communications were understood d. invite questions, clarification, reactions e. utilize effective patient education strategies f. participate in societal need for drug education 3. Recognize effective communication a. models b. techniques c. problems 4. Discuss the need for effective communication a. in a professional peer setting b. in a patient setting 5. Use written language effectively a. sensitive b. clear, comprehensible, organized c. appropriate level for intended readers d. neat and legible 6. Use oral language effectively a. sensitive b. clear, comprehensible, organized c. appropriate for audience d. audible and well-paced 7. Listen effectively a. attentively b. non-judgmental c. patiently d. accurately hears what is being said 8. Read effectively a. focused b. translation c. comprehension II. Evidence-Based Decisions in the Practice of Pharmacy The student will demonstrate competency in using drug information skills to promote evidence-based practice. Components Process for using Evidence-Based decisions in the Practice of Pharmacy 2 Propose (an) action(s) either from memory or from the clinical literature Hypothesize indicators at the organ system, organ, cellular, and molecular levels that would provide evidence that your action is appropriate Explain the relationship between the indicators and the proposed action Collect evidence to support these hypotheses Assess the quality of the evidence Assess your proposed action based on the quality of the evidence Content - Explanation of therapy (drug, regimen and delivery method); detailed explanations within the disciplines of pharmacology, toxicology, biochemistry, anatomy, physiology, pathology, immunology, pharmacokinetics; explanation on the basis of broad principles and concepts in pharmaceutics, medicinal chemistry, physical chemistry, organic chemistry. Skill - Problem prevention and solving. Expected Outcomes In using evidenced-based decisions in the practice of pharmacy the student will be able to: 1 2 3 4 5 6 7 Recognize a health problem: its immediacy and potential threats Conceptualize the anatomical/histological location for the health problem Conceptualize the pathophysiological process of this health problem 3.1 understand and explain its origin and progressive pathogenesis 3.2 understand its means of expression and consequences in molecular, cellular, and physiological terms Conceive and present a therapeutic plan 4.1 develop a strategy to effectively interrupt the origin, points of pathogenesis, and specific threats and consequences 4.2 define therapeutic goals in physiological and molecular terms 4.3 recognize all options, and if drugs, formulations available for treatment 4.4 understand the scientific rationale when selecting specific interventions, whether pharmacologic, physiologic, dietary, or behavior modification Ascertain effectiveness of an applied intervention 5.1 determine if pathophysiological process has been altered by therapy 5.2 employ concrete parameters and indicators of therapeutic success 5.3 recognize that continued reevaluation of the therapeutic process is necessary Recall appropriate pharmaceutical data to support process 6.1 know and present indications for a given drug, its mechanism of action, its half-life and dosage, and application in pharmacy practice situations 6.2 recognize potential drug interactions and side effects 6.3 state dietary implications for specific interventions Practice in application of content and process 7.1 communicate the pathophysiological rationale for the chosen therapy and expected outcomes 3 III. PROBLEM PREVENTION AND SOLVING The student will effectively evaluate information and critically think through issues to provide appropriate solutions to drug-related problems. Components: Problem-Solving Process Define and frame the problem Hypothesize a solution path Identify key issues and assumptions Evaluate & assemble information available; gather new information as required Organize the information Propose a solution for the problem or sub-problems Assess & commit to the solution Communicate &/or implement the result Content - Presentation of models of problem solving, issues leading to faulty process, and techniques in self assessment. Recognition of prior experience. Solving problems related to health care and various types of management. Skill - Application within a patient care forum of prior experience in problem solving. Each skill in the problem-solving process: identification of problems and assumptions, systematically, hypothesis development, hypothesis-testing, assessment. Expected Outcomes In problem prevention and solving the graduate will be able to: 1 Frame the problem clearly and objectively 1.1 organize elements appropriately 1.2 focus on issues having the greatest impact 1.3 define severity and extent of problem 2 Form flexible potential solutions 2.1 apply prior knowledge to a new experience 2.2 identify new information required to solve the problem 2.3 recognize limitations of prior experience or knowledge 2.4 recognize assumptions and understand their uses, drawbacks, and implication 3 Collect and integrate necessary information 3.1 identify sources of information 3.2 efficiently uses sources to obtain information 3.3 propose and carry out research to generate new information 3.4 integrate and interpret factual information 3.5 evaluate information with respect to potential recommendations 4 Formulate an informed plan of action to solve a problem 4.1 recognize internal and external factors influencing plan 4.2 identify potential barriers 4.3 anticipate opposition and develop alternative strategies 4 5 6 7 IV. 4.4 consider potential adverse and beneficial secondary effects of plan Implement a solution 5.1 communicate 5.2 take action 5.3 utilize a “team approach” when appropriate 5.4 plan/carry out long term follow up and reevaluation Apply prior knowledge to a new experience The graduate will develop skills in problem solving, applying the learned process in an appropriate context. 7.1 Recognize that a problem exists 7.1.1 is observant 7.1.2 is empathetic 7.1.3 separate relevant and irrelevant input 7.2 Examine the problem from different points of view 7.2.1 is tolerant of other concerns and opinions 7.2.2 consider the socioeconomic and cultural contexts of the problem 7.2.3 is willing to talk to others with different points of view 7.2.4 consider a problem as an opportunity for change or advancement of knowledge DISPENSING OF PHARMACEUTICALS The student will demonstrate the ability to assess and evaluate the patient’s medication orders, effectively procure appropriate products, prepare, dispense, distribute, and if necessary administer medications in an effective manner which contributes to the healing of individual patients. Components Process of Dispensing Pharmaceuticals and Drug-Related Products Interpret Evaluate Select Procure Prepare Assure quality Dispense Distribute Content: Recognize the process and the importance of each component part. Skill: Proficiency in the process of dispensing medications/medical devices in an error-free manner Expected Outcomes In dispensing pharmaceuticals the graduate will be able to: 1 Interpret the medication order 1.1 orally receive a prescription or drug order 5 2 3 4 1.2 interpret information on a prescription or medication order Evaluate the medication order 2.1 screen patient database for drug allergies and adverse reactions 2.2 complete and interpret patient medication record systems utilizing manual and electronic systems 2.3 identify and remedy interactions or contraindications with sensitivities or allergies, genetic, environmental or biosocial factors (e.g., alcoholic beverage consumption, smoking); or in special patient populations (e.g., geriatric, pediatric, pregnant, post-surgical, ileostomy) 2.4 identify and remedy interactions or contraindications with special diets or dietary practices 2.5 identify a drug or product ingredient in a prescription/medication order by its generic, trade, and common name, usual dosage range, contraindications, directions and cautions for use and storage requirements 2.6 identify a drug product's name from its physical appearance, where appropriate 2.7 determine whether a given drug is obtainable by non-prescription purchase 2.8 determine if the dose or dosage regimen prescribed is toxic or falls within the usual range for the patient and condition being treated to achieve the desired pharmacotherapeutic response 2.9 use patient specific data collected to make a professional judgment about filling or refilling a prescription 2.10 interpret, question, clarify, verify, and validate all drug related orders 2.11 given a prescription or medication order, or relevant information about a disease state, demonstrate the ability to make a professional judgment regarding whether the prescription or medication order should be dispensed Procure necessary components 3.1 understand the principles underlying the development of policies and procedures for acquisition, payment, and return of pharmaceuticals, durable medical equipment, devices, and supplies. 3.2 use quality and cost/benefit concepts to develop drug product selection guidelines for multisource products (e.g., generic substitutions). 3.3 understand how to apply negotiation skills to make economical, quality acquisitions 3.4 develop and implement policies and procedures for inventory management of pharmaceuticals, including controlled substances and investigational drugs, durable medical equipment, devices, and supplies in compliance with legal and regulatory requirements and professional standards. 3.5 develop policies and procedures for the selection, preparing, packaging, dispensing, distribution, and quality assurance of pharmaceutical products, delivery devices, and supplies. Prepare appropriate prescription medication 4.1 identify, select, and determine appropriate ingredients and equipment to extemporaneously prepare dosage forms makes product selections among generic equivalent drugs 4.2 extemporaneously compound the following dosage forms using relevant physico-chemical and pharmaceutic principles: 4.2.1 Topical ointments, creams and lotions 4.2.2 Suspensions 6 4.2.3 4.2.4 4.2.5 4.2.6 4.2.7 4.2.8 5 6 Suppositories Otic preparations Enteral Solutions Parenteral Solutions Oral solid dosage forms (e.g., capsules, powders, solutions) prepares prescription labeling, including auxiliary labels and warnings that meet legal and professional standards of administration directions demonstrates appropriate keyboarding skills 4.2.9 Dispense 5.1 utilize the processes of communication and related techniques for counseling patient 5.2 explain the importance, nature and scope of pharmacotherapeutic plans to a patient 5.3 "translate" professional information into lay terminology 5.4 advise a patient and or caregiver on the appropriate administration, cautions, side effects and storage requirements of their prescribed medication 5.5 advise a patient as to methods which enhance the therapeutic effectiveness of medications: 5.6 demonstrate the use of special devices required to administer drugs, including parenterals 5.7 assess a patient's understanding of the information provided Distribute/administer 6.1 Calculate the rate of administration of a drug when given appropriate data 6.2 Explain factors that must be considered in the administration of medications via the following routes: Oral Parenteral Transdermal Rectal Intranasal Ocular 7 V. PROVIDING PHARMACEUTICAL CARE TO THE INDIVIDUAL PATIENT The student will exercise appropriate clinical judgment to provide optimal pharmaceutical care to patients with common disease states. Components Process for Providing Pharmaceutical Care to an Individual Patient* Review patient’s profile or medical chart and records Review lab tests Obtain info from other healthcare providers Interview patient Interview caregivers Create a patient-specific information base Assess current drug and non-drug therapy to create a drug therapy problem list Determine patient’s health care needs Specify pharmacotherapeutic goals Design a pharmacotherapeutic regimen Design a pharmacotherapeutic monitoring plan Recommend a pharmacotherapeutic regimen and plan Implement a pharmacotherapeutic regimen and plan Evaluate outcomes of pharmacotherapeutic plan Redesign pharmacotherapeutic goals, regimen, plan as needed *Adapted from the ASHP Clinical Skills Program Content - the high impact disease states and their associated drug classes (emphasizing prototypes) above, and the physical assessment skills listed below. Content extends to high impact problems in pharmaceutical care systems. Skills - Application of basic pharmacy practice skills in the pharmaceutical care process. Some of these are among Presbyterian’s Twelve, e.g., problem-solving, information management, ensuring the patient receives quality products (drug delivery), and communication, but specific skills are collecting and interpreting patient information, developing the pharmacist’s care plan, and implementing the monitoring plan. Expected Outcomes 8 In providing pharmaceutical care for the individual patient the graduate will be able to: 1 2 Review the patient profile, medical chart, or records 1.1 Use the patient profile, chart, and records to identify information pertinent to decisions on desired therapeutic outcomes 1.1.1 Understand the types of information contained in the medical record/profile 1.1.2 Describe the location of types of information in varying formats used in profiles/records 1.2 Act legally and ethically to safeguard the confidentiality of patient information 1.2.1 Explain the legal guidelines for disclosing patient information contained in varying types of information systems 1.2.2 Discuss professional and ethical issues for pharmacists in safeguarding patient information 1.2.3 Identify potential threats to patient confidentiality and suggest systems approaches for minimizing these threats 1.2.4 Determine legal and ethical issues of patient data 1.3 Explain the interrelationships of patient medical record data 1.3.1 Identify categories of information to use in making drug therapy decisions 1.3.2 Identify alternative sources of patient information 1.3.3 Explain the relationships of categories of data pertinent to decisions about desired drug therapy outcomes Build a patient-specific data base 2.1 Identify the types of information the pharmacist needs for a patient-specific data base 2.1.1 Identify for a given patient: specific information on demographics or administrative issues 2.1.2 Determine medical history Section 1.01 Acute and chronic medical problems Section 1.02 Current symptoms Section 1.03 Vital signs and bedside or home monitoring information Section 1.04 Allergies/intolerances Section 1.05 Past medical history Section 1.06 Laboratory information Section 1.07 Diagnostic/surgical procedures 2.1.3 Determine drug therapy Prescribed medications Nonprescription medications Past medication use Home/health remedies Compliance with therapy Medication allergies/intolerances Patient concerns or questions on therapy Assessment of understanding of therapy Pertinent health beliefs 9 2.1.4 Determine behavioral/lifestyle Diet Exercise/recreation Tobacco/alcohol/caffeine/substance abuse Sexual history Personality type Daily activities 2.1.5 Determine social/economic background Living arrangements Ethnic background Financial insurance 2.2 Describe the difference between subjective and objective data 2.3 Discriminate between reliable and unreliable patient information sources 2.4 Describe the types of information used in the Pharmacist’s Patient Data Base Model 2.5 Describe the types of information provided by: patients, care givers, other health care professionals 2.6 Formulate an organized interview approach 2.6.1 Describe points to consider when organizing an interview Use of a transition Preparation for an interview Environment for an interview Recording of information Responding to questions 2.6.2 Use open-ended questions to elicit information 2.6.3 Demonstrate probing techniques 2.6.4 Use nonverbal communication skills appropriately 2.7 Generate a patient-specific database 2.7.1 Differentiate between independent focused information gathering 2.7.2 Record and modify a patient-specific database 3 Construct a Patient’s Drug Therapy Problem List 3.1 Describe the functions of a Drug Therapy Problem List 3.1.1 Describe the functions of a Drug Therapy Assessment 3.1.2 Correlate drug therapy and medical problems 3.1.3 Evaluate medical conditions for which no drug therapy is prescribed 3.1.4 Evaluate drug therapies for which there is no identified medical indication 3.1.5 Evaluate the comparative safety, comparative efficacy, and patient related characteristics when determining the appropriateness of drug therapy 3.1.6 Identify therapeutic duplication in a drug regimen 3.1.7 Evaluate potential adverse drug reactions 3.1.8 Determine if any clinically significant interactions exist: drug - drug drug - disease drug - device drug - nutrient drug - lab test 10 3.1.8 drug 4 Recommend approaches if a patient’s social or recreational drug use interferes with medical therapy 3.1.9 Discuss alternative dry regimen approaches if the financial impact of therapy compromises a patient’s health status 3.1.10 Discuss factors which help determine a patients understanding of drug therapy Design and Recommend Pharmacist’s Care Plan 4.1 Identify a patient’s health care needs 4.1.1 Define health care needs 4.1.2 Determine the role of pharmaceutical care 4.1.3 Determine desired outcomes of drug therapy Care of a patient’s disease Elimination or reduction of symptoms Arrest or slow a disease process Prevent a disease or symptomatology 4.1.4 Classify medication related problems Untreated indications Improper drug selection Sub-therapeutic dosage Failure to receive medication Over dosage Adverse drug reactions Drug interactions Medication use without indication 4.1.5 Assess quality of life implications 4.2 Identify pharmacotherapeutic goals Flow Chart for Identifying Pharmacotherapeutic Goals Figure 2 Identify disease characteristics related to the health care needs that influence pharmacotherapeutic goals. Identify health care goals of other health professionals that influence pharmacotherapeutic goals. Identify drug therapy problems that influence pharmacotherapeutic goals. Identify non disease factors that influence pharmacotherapeutic goals. Patient-Related Non-patient-Related 11 Factors Age Gender Renal function Hepatic function Concurrent illness Know hypersensitivity or adverse reactions Therapy costs Health beliefs Living environment Factors Reimbursement for therapy to health care setting Policies of institution Integrate the influences of disease characteristics, goals of other health professionals, drug therapy problems, and nondisease factors to identify pharmacotherapeutic goals. 4.3 4.4 4.5 Recommend therapy 4.3.1 Prioritize pharmacotherapeutic goals 4.3.2 Identify therapy recommendations 4.3.3 Consider regimen specifics Drug selection (safety, efficacy) Patient-related characteristics Age Gender, ethnic background Pregnancy, lactation Patient preference, behavior Simplicity, cost Drug characteristics Dose and dose frequency Route of administration Dosage form Mode of administration Therapeutic efficacy and compliance Length of therapy Design a drug therapy monitoring plan 4.4.1 Determine monitoring methods 4.4.2 Determine monitoring frequency 4.4.3 Assess cost and practicality of monitoring Make a written recommendation 4.5.1 Consider practice setting issues 4.5.2 Consider site-specific policies 4.5.3 Consider practice standards 4.5.4 Incorporate professionalism into written note 4.5.5 Use a SOAP note (S) Subjective (O) Objective 12 5 VI. (A) Assessment (P) Plan 4.5.6 Use a narrative note 4.5.7 Use a computerized intervention monitoring system Monitor the Pharmacist’s Care Plan 5.1 Collect monitoring data 5.2 Assess reliability and validity of collected data 5.2.1 Consider false positive and false negatives 5.2.2 Consider change in patient’s status or condition 5.3 Assess need for primary data 5.4 Assess need for additional data 5.5 Assess achievement of desirable endpoints 5.6 Adjust the Pharmacist’s Care Plan Add a drug Delete a drug Modify recurrent regimen 5.7 Document changes to the Pharmacist’s Care Plan in the patient medical record PROVIDING PHARMACEUTICAL CARE TO PATIENT POPULATIONS The student will provide therapeutic guidance by responding to the many factors that influence health, disease and disability, besides those of a biological nature. These factors include socio-cultural, familial, psychological, economic, environmental, legal, political, and spiritual aspects of health care seekers and of health care delivery. Through sensitivity to the interrelationships of individuals and their communities, the student will respond to the broader context of pharmacy practice. Components Identify significant community health issues Given one of the issues: o identify non-biological factors that influence health, disease, disability, and access to care o identify resources in practice, profession, or community that can be utilized to address the issue o in collaboration with concerned parties, formulate a strategy to address the issue o consider cost efficiency of the proposed strategy o implement the strategy o report the outcome o document the process o assess the outcome o document proposed modifications for future work Content - Basics of delivering pharmaceutical care as part of a managed care environment. 13 Skills - Application of basic pharmacy practice skills in the pharmaceutical care process. This will be more of a managed care approach -- education outreach, and networking, therefore specific skills would be strategizing, management of information in pharmacoepidemiology and statistics, and teaching. Expected Outcomes In providing population-based pharmaceutical care the graduate will be able to: 1 2 3 VII. Process: 1.1 inquire about value systems and lifestyles in a non judgmental fashion 1.2 attribute proper importance to identified socioeconomic issues of health care delivery 1.3 identify barriers to access of health care resources 1.4 become familiar with role of community resources and services provided 1.5 communicate the availability of community resources to patients and their families 1.6 document value of pharmaceutical care in the managed care environment 1.7 act as an advocate for better health for patients and the community Content: 2.1 appreciate the importance of the many non-biological factors that influence health, disease, disability, and access to care 2.2 comprehend appropriate teaching methods to meet the learning needs of individual clients, peers or health-care providers and groups of clients or peers 2.3 knowledgeable about basic group processes and technology to support learning. 2.4 capable of assessing the effectiveness of techniques that monitor healthcare Skill: 3.1 utilize appropriate resources in the community that may provide support for reducing social causes of disease 3.2 match patients' needs to appropriate community resources 3.3 arrange referrals to community resources for patients and their families 3.4 cooperate with community resources through follow-up efforts and support 3.5 use appropriate teaching methods to meet the learning needs of individual clients, peers or health-care providers and groups of clients or peers 3.6 use basic group processes and technology to support learning. 3.7 assess the effectiveness of teaching patients 3.8 assist patients and their families in navigating through bureaucracy 3.9 support community activities designed to improve health 3.10 support social and political activities to improve access to health care 3.11 place patient's and community's welfare above narrow self-interest 3.12 encourage actions designed to enhance the total well-being of individuals, families and communities INTERPROFESSIONAL INTERACTION AND TEAMWORK The student will demonstrate effective interpersonal and team behaviors in a variety of social and professional situations and circumstances 14 Components: Definition: A team is a small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they hold themselves mutually accountable. As a healthcare team member, the competent pharmacy graduate must have technical/functional expertise that complements the team, possess problem-solving and decision-making skills, and have interpersonal skills to assure common understanding and purpose. Process: The process of student socialization and building teamwork skills begins with the commitment to assuring that the component parts of the successful team are attended to; skills, common purpose, goals, and mutual accountability. Expected Outcomes 1 Identify interaction behaviors that are essential for maximum personal effectiveness in interpersonal and inter-group situations. 1.1 1.2 1.3 2 Function independently and effectively in interpersonal and inter-group situations. 2.1 Use appropriate interaction behaviors in interpersonal, inter-group and leadership situations. 2.2 Employ feedback from others to enhance personal effectiveness in interpersonal, inter-group and leadership situations. Contribute opinions, insights, information and leadership assertively and appropriately during group decision making situations. Assume leadership positions and/or participate in community/campus matters that involve human health and concerns that are not health-related. 2.3 2.4 3 Identify personal interaction behaviors and those of others in interpersonal, intergroup and leadership situations. Evaluate the appropriateness of personal interaction behaviors and those of others in interpersonal, inter-group and leadership situations. Provide feedback to increase the effectiveness of others in interpersonal, intergroup and leadership situations. Apply personal interaction behaviors within professional and civic situations. 3.1 3.2 3.3 3.4 Use appropriate interpersonal and inter-group behaviors during professional interactions with patients, other health care providers and the public. Adapt interpersonal and inter-group behaviors to differing professional environments. Contribute opinions, insights, information and leadership assertively and appropriately during the health care team decision making process. Assume leadership positions and/or participate in community matters that involve human health and civic concerns that are not health related. 15 VIII. ETHICAL AND LEGAL JUDGEMENT The student will recognize the ethical dimensions of pharmacy practice and health policy; identify alternatives in difficult ethical choices; analyze systematically the conflicting considerations supporting different alternatives; and formulate, defend, and effectively carry out a course of action that takes account of these ethical complexities. The student will combine a willingness to recognize the nature of the value systems of patients and others with commitment to his/her own system and the ethical choices necessary to maintain his/her own ethical integrity Components: Ethical Judgment Process Thoroughly canvas a wide range of alternative actions; Consider a full range of objectives and associated moral, legal and ethical values ; Carefully weigh costs, drawbacks, and risks against benefits of each alternative Search intensively for further information to evaluate each alternative Conscientiously take into account all new and expert information or opinions, even if they are counter to an alternative initially preferred Reexamine all positive and negative consequences or each alternative in light of new information, even alternatives originally discounted Make detailed provisions for implementation, including contingency plans, should one or more of the risks materialize Content: All pharmacy-related material; therapeutic decisions, management decisions; career decisions Skills: suspending judgment; cost/benefit analysis; Expected Outcomes Students should recognize that all the steps in the decision-making process must be taken, or the decision will not be well-made. Each graduate will be able to: 1 2 3 4 Understand basic ethical concepts and applies them in moral reasoning in the pharmacy and health care context Recognize the ethical dimensions of pharmacy 2.1 ethical dimensions in the treatment of individual patients 2.2 ethical dimensions of issues in health policy 2.3 ethical dimensions in relations with other health care professionals Identify the conflicting ethical considerations in a particular ethical choice 3.1 different values affected by alternative courses of action 3.2 relevant ethical obligations or duties 3.3 relevant moral fights 3.4 relevant considerations of justice Systematically analyze and defend ethical choices in the treatment of an individual patient 4.1 identify alternative courses of action 16 4.2 5 6 7 8 9 determine and obtain pharmacy information or facts relevant to the patient's treatment and care 4.3 determine the ethical values, obligations or duties, and rights implicated in the patient's treatment 4.4 determine and articulate the factors that affect the relative weight to be accorded to different ethical considerations 4.5 select and defend a particular course of action Determine, articulate, and analyze the ethical issues in health policy 5.1 how institutional frameworks and practices affect patient care 5.2 the different ethical considerations bearing on particular health policy issues and choices 5.3 the responsibilities of health care professionals in health policy Determine, articulate, and analyze the ethical issues in relations with other health care professionals 6.1 what pharmacists' social and professional responsibilities are for insuring the integrity of the profession and the quality of care provided by other professional 6.2 how ethical norms, rules, and guidelines developed by professional groups and societies bear on ethical choices Identify relevant case and statutory law bearing on ethical issues and choices; 7.1 analyze and defend positions about its role in ethical choices 7.2 the major variations in state law governing health care 7.3 the responsibilities and duties the law imposes on health care professionals (e.g., the nature and limits of the duty to maintain confidentiality) 7.4 the alternatives in patient care and health practice permitted or proscribed by law 7.5 defend when one's ethical responsibilities require breaching Demonstrate and employ skills necessary to implement ethical choices in pharmacy practice 8.1 communication skills 8.2 know when other persons, expertise, or resources are needed in resolution of ethical choices 8.3 know how to obtain this additional help Effectively integrate the above ethical skills in the care of his or her own patients, including1 9.1 ability to obtain a valid consent or refusal of treatment 9.2 ability to evaluate a patient's competence to consent to or refuse treatment, and how to proceed if the patient is incompetent 9.3 ability to decide when it is morally justified to withhold information from a patient 9.4 ability to care for patients with a poor prognosis, including patients who are terminally ill, in an ethically sensitive manner 9.5 ability to integrate considerations of equity into care of one's patients 17 IX. PERSONAL AND PROFESSIONAL GROWTH The student will approach the practice of pharmacy with awareness of his/her limits strengths, weaknesses and personal vulnerabilities. The student will establish personal values and priorities in order to balance personal and professional commitments. The student will seek help and advice when needed for his/her own difficulties and develop personally appropriate coping strategies. The student will accurately hear and appropriately respond to constructive criticism. The student will be aware of the limits of his/her personal knowledge and experience and has an intellectual interest in general education and pharmacy science. The student will actively set clear learning goals, pursues them, and applies the knowledge gained to the practice of his/her profession. Components: Personal and Professional Growth Process Solicit peer assessment & self-assess knowledge, skills, values & balance to identify learning and growth needs (these will usually manifest as personal or professional problems that cannot be solved with current knowledge & skills) Justify the reasons for learning Develop an overview of the learning plan Identify the necessary skills required Set standards & limits for your learning Collect necessary information Model: create models and examples to illustrate what you have learned Think: explore your understanding by answering questions related to the topic Develop skill: apply the knowledge in a variety of different situations Assess: self-assess your understanding & retention of key facts and concepts Problem-solve: Use the new knowledge to solve the problems that motivated the learning Disseminate: share new knowledge with others Content - New knowledge to solve drug-related problems, career directions, growth of learning skills Skill - Self-assessment of knowledge, skills, and affect, planning, research skills Expected Outcomes The student will grow personally and professionally as demonstrated by their ability to: 1 2 Recognize personal strengths and limitations relevant to his/her practice of pharmacy 1.1 identify preferred learning style 1.2 identify activities that are easy or difficult to perform 1.3 identify areas of academe (or professional) weakness 1.4 recognize personal behavior in a group situation and consequences of that behavior Identify and address problems--emotional, personal, and health related--that might affect his/her health, well-being, or professional capabilities 2.1 delineate options to address the problem 2.2 pursue the assistance of others qualified to help (when necessary) 18 3 4 5 6 7 X. 2.3 initiate steps to rectify gaps in knowledge 2.4 research, review, and extract data from multiple sources 2.5 confer with knowledgeable colleagues, advisors, or experts Recognize and state personal values and beliefs relevant to his/her practice of pharmacy 3.1 determine priorities in professional or academic activities 3.2 describe values concerning a general approach to patients 3.3 state and explain personal views on special topics in medicine, e.g., the right to die 3.4 describe his/her view of a pharmacist's ideal relations with other health professionals and with the community Hear accurately and respond appropriately to constructive criticism from patients, peers, and supervisors 4.1 restate critical comments from others accurately 4.2 acknowledge the merit of critical remarks 4.3 modify his/her behavior in response to constructive comments Cope adaptively with stresses likely to occur during pharmacy training and practice 5.1 describe own physical and behavioral responses to stress and realizes its onset/occurrence 5.2 identify interpersonal situations that are most stressful and takes alternative approaches to handling them 5.3 recognize the effect of personal stress-induced behavior on others 5.4 apply time management skills to the tasks of a student or pharmacist 5.5 practice a personally effective method of relaxation Apply acquired knowledge 6.1 compile, correctly present, and properly reference information 6.2 demonstrate new skills to faculty and/or colleagues, e.g., through presentations, role play, or teaching 6.3 evaluate changes in academic or professional environment and develop some adaptive strategies to meet them Maintain an interest in general education and science 7.1 read relevant literature 7.2 exploit new opportunities for intellectual growth and professional enlightenment e.g., additional courses, workshops MANAGEMENT SKILLS The student will be able to effectively manage human, financial and other resources related to the practice of pharmacy. Components: Management Model Establish premises Formulate objectives Develop and evaluate courses of action Select a particular course of action 19 Commit resources Implement plan Evaluate Assessment and review Content Information: gathering information from books, on-line resources, storing information in paper records, as well as in computer-based systems, gathering from clinical and research observations Personnel: working with staff, including cashiers, clerks, pharmacy technicians, peers, etc.; motivation; performance evaluation. Financial: developing and maintaining a budget; contracting; cost-benefit analysis. Drug Distribution: maintaining an inventory (formulary), developing efficient distribution systems (automation, spacing, resources). Errors: Understanding a quality control system and how to improve when errors occur; inservice training. Skill - Use of computers and defined software; strategic planning, continuous quality improvement, decision-making for selection and quality purposes (see above), basic accounting and inventory, peer performance assessment Expected Outcomes In management the graduate will be able to: 1. Process: 1.1 Recognize when information is needed and have the ability to generate, locate, evaluate, and use effectively the needed information 1.1.1 Use a systematic methodology for the collection, storage, retrieval, and dissemination of data (e.g., patient information, drug information, new prescriptions/medication orders, drug prices). 1.1.2 Explain the importance of and procedures for maintaining and assuring the integrity and security of information systems. 1.1.3 Critically evaluate relevant literature to assess appropriateness of methodologies and conclusions using the concepts and principles of scientific methodology. 1.1.4 Identify issues, opportunities or problems relevant to current practice and the profession in order to identify problems and research opportunities. 1.1.5 Formulate research questions/hypotheses 1.1.6 Using the scientific method, establish/develop protocols collect, analyze and interpret data to reach conclusions about the subject matter 1.1.7 Communicate results of research (see communications section) 1.2 Manage the practice environment 1.2.1 assess the needs of the practice within its social, economic, and political context 1.2.2 understand and apply the current concepts of quality to practice 1.2.3 develop and/or assist in the development of a mission statement to 20 provide guidance for the operation of the practice establish goals and objectives to reflect the mission statement. develop a business plan. identify and know how to obtain and manage resources needed to achieve organizational goals and objectives. 1.2.7 develop and/or refine marketing strategies. 1.2.8 explain how the use of various organizational, communication, and monitoring structures, policies, procedures and processes will impact a given type of pharmacy practice 1.2.9 describe physical facilities of the practice site that comply with legal and regulatory requirements and professional ideals and standards (e.g., Americans with Disabilities Act, state board of pharmacy, Joint Commission on the Accreditation of Healthcare Organizations). 1.2.10 articulate and defend a plan to develop, implement, and maintain security, emergency, and sanitation management systems. Efficiently direct professional support staff for effective professional practice 1.3.1 discuss current philosophies concerning training, supervising and assess the performance of professional and support staff 1.3.2 identify occupational health and safety issues relating to personnel 1.3.3 manage time appropriately 1.3.4 explain the legislation and regulations relating to personnel management Appropriately manage financial aspects of the practice environment 1.4.1 explain a basic budget plan 1.4.2 explain the use of basic accounting documents 1.4.3 utilize systems for third party payments 1.4.4 explain the principles of inventory control and the use of inventory control systems 1.4.5 list taxation and related legal requirements relevant to practice settings Develop a quality control plan for professional practice 1.5.1 recognize that errors occur within a practice environment 1.5.2 discuss error management procedures 1.5.3 create an environment for growth to occur from errors 1.2.4 1.2.5 1.2.6 1.3 1.4 1.5 XI. ADVANCEMENT OF PHARMACY AND HEALTH CARE The student will be able to identify issues of public, professional and institutional concern and works for the common good to bring resolution. Components: Advancing the Profession and Promoting Good Health Develop professional relationships with other care providers and develop and contribute to inter/multidisciplinary activities Develop and use referral strategies 21 Identify a relevant issue of professional, public or institutional policy Assess the impact of these issues on health care Identify the roles & impacts of relevant policy makers and influencers Identify the most appropriate collaborators from your group of colleagues Communicate issue Undertake a Strategy, Research, Implementation processes Assess Impact Content: licensing bodies, professional associations, student associations, Skill: networking, lobbying, and strategizing Expected Outcomes In advancing the profession and promoting good health the graduate will be able to: 1 Process: 1.1 Identify issues of public, professional and institutional policy and potential personal or collaborative interventions to influence them. 1.1.1 demonstrate self-awareness of personal vested interests and values related to health-care 1.1.2 demonstrate awareness of societal values, public debate and power structures related to health-care 1.1.3 interpret and explain the relevance of public policy principles to pharmacy 1.1.4 explain the policy process and roles and impact of interactions among public/institutional policy makers and policy influencers on institutional and public policy. 1.1.5 outline core values, vested interests and attitudes shared by sub-sets of policy makers (this includes, for example, moral, economic, ethical values such as human dignity, equitable access to health-care, cost analysis issues) 1.1.6 map interactions among the various groups, structures and processes involved with creating/influencing public and institutional policy 1.1.7 analyze interactions among the various groups, structures and processes involved with creating/influencing public and institutional policy 1.1.8 collaborate to influence the policy process. 1.1.9 contribute to the activities of the licensing body to enhance and support the self-regulatory aspects of the profession. 1.2 Participate in the review and making of drug use policy for the population. 1.2.1 participate in the development, implementation, and management of a formulary and therapeutic exchange system (e.g., serve on pharmacy and therapeutics committees). 1.2.2 participate in the development of criteria and procedures for conduct of drug use evaluations. 1.2.3 explain treatment/drug use protocols in terms of ensuring optimal therapeutic effect and cost effectiveness. 1.2.4 describe and justify a system by which adverse drug reactions (ADRs) are documented, analyzed, and evaluated. 22 XII. PROMOTION OF GOOD HEALTH AND PUBLIC WELFARE The Presbyterian graduate will be proactively involved in community and professional efforts to promote good health for the public welfare Expected Outcomes In promoting good health and public welfare the student will: 1. 2. 3. 4. 5. Recognize through self-reflection personal cultural and spiritual traditions Articulate ways in which culture and spiritual traditions could influence pharmacy practice Maintain a personal portfolio of participation in causes that promote public health Perform community service, related and un-related to pharmacy practice Provide evidence of community service pertaining to pharmacy 23