Community Pharmacy

Goals

Through Community Pharmacy Introductory Pharmacy Practice Experiences (IPPEs), student pharmacists are expected to master foundational competencies in three domains:

• Communication and Professional Behavior
• The Practice of Pharmacy
• Public Health

Objectives

The student will be able to:

• Demonstrate a concern for patients’ health and identify the health promotion role of the pharmacist in the community.
• Conduct a patient interview and obtain an accurate medication history.
• Demonstrate the ability to process prescriptions accurately and efficiently.
• Convey basic information regarding common prescription and nonprescription medications.
• Demonstrate knowledge of various aspects of community pharmacy practice including but not limited to: inventory procedures, pricing, pharmacist-technician interaction, third party payments and plans, pharmacy licensing, record-keeping, and security.
• Demonstrate an understanding of legal requirements, record-keeping, dispensing, or sale of different medication classes.
• Demonstrate effective patient counseling skills.
• Communicate effectively with other members of the healthcare team.
• Demonstrates accurate, organized, and concise written communication skills (e.g., for required documentation purposes).
• Research and appropriately utilize resources (e.g., current practice guidelines, literature related to evidence-based medicine and practice, list of available resources for meeting an identified patient or population-based need) to improve an individual patient’s care or the care of patients within the practice setting.
• Identify patients for vaccination and screen, prepare, administer, and document immunizations.
• Ask, advise, assess, assist, and arrange follow-up with tobacco cessation-related medications and services for patients.

Student expectations

What role will the student play on the team?

IPPE Community Pharmacy experiences are offered at various sites through the Bay Area at sites including Walgreens, CVS, and Safeway. The main goal for the student is to contribute authentically to patient care and work flow while achieving the learning goals and objectives outlined in this document.

What is expected of students?

Students should be integrated into the practice setting team and thus should approach their roles with a high level of professionalism and commitment. The roles involve various professional activities. Students should become competent in performing their specific duties without constant supervision from the preceptor(s). Examples of student activities are included as Appendix B.

If preceptors give the student an activity beyond his/her scope of training to date, preceptors should be prepared to provide that student with the necessary additional training.

Prior to beginning a community pharmacy experience, first year students complete various training requirements. Students may be required to complete additional training activities required at their site.

Since each experience is different, students will rely on preceptors and the team to explicitly state more specific expectations and objectives.

Preceptor expectations

The preceptor's main role is to act as a resource and point person for the student throughout the experience.  to:

• Set expectations early for the student.
• Orient the student to the clinical atmosphere and relevant sources of information.
• Treat the student like a member of your team.
• Provide the student with enough guidance, support, and on-going real time performance-based feedback to be successful in his/her role.
• Meet with the student often to check-in on goals, expectations, progress, etc.; to provide an opportunity to reflect upon and debrief experiences; and to give and receive feedback.

The student should be contributing to the workflow of the environment, but this is also a learning experience for the student. While constant oversight is certainly not required, regular check-ins and on-the-job mentoring with your student are expected.

How are students evaluated?

A mid-point formative evaluation and a final summative evaluation will be completed for each student. The student will initiate the midpoint self-assessment evaluation, using the tool provided in E value. Students should reflect on the experience and their performance. The midpoint evaluation should be discussed with the preceptor at the practice site at the midpoint of the experience. If a student is not meeting expectations or is not progressing at any point prior to the midpoint formative evaluation, the preceptor should notify the Assistant Director of the Experiential Education, Judie Tran, PharmD ([email protected]).

The preceptor will complete a final summative evaluation via E value, utilizing the same tool that was used and discussed during the midpoint evaluation. Preceptors can log into E value directly to complete the final summative evaluation or can utilize the link that will be emailed at the end of the experience.

What other evaluations will be conducted?

Students will be evaluated on the goals and objectives listed above. As part of the evaluation process, preceptors will be asked to assess 3 entrustable professional activities. These activities for the P1 Community Pharmacy Experience include:

• immunizations

• smoking cessation

• fulfilling a medication order and obtain an accurate medication history

In order to ensure appropriate practice and feedback on these activities, students should receive a “snapshot” evaluation for each of these activities at least once during the experience, prior to the formative midpoint evaluation. The student should initiate this “snapshot” evaluation tool via E-Value and complete with the preceptor’s feedback.

Additionally, students will complete a site and preceptor evaluation at the completion of the IPPE Community Pharmacy experience. Once final grades are submitted for this experience, preceptors will be able to view the student evaluations via E value. Preceptors and sites are able to use this feedback to assess the rotation experience provided for the student.

Intake window and medication order entry process

• Perform initial patient interviews
• Receive and interpret prescriptions
• Assess a prescription for necessary components
• Explain medication information to patients
• Research and answer drug information questions for preceptor and/or patients
• Become familiar with pharmacy computer system
• Create a new patient profile
• Adjudicate third-party insurance claims

Medication dispensing and compounding

• Participate in the medication dispensing process
• Participate in medication storage process
• Participate in the medication order process (controlled and non-controlled products) and understand site inventory procedures
• Pull expired medications
• Perform calculations required to dispense and compound medications
• Learn proper procedures for giving/taking a prescription (new or transfer) via phone
• Assist a patient or caregiver with concerns or issues related to prescription medication coverage, health insurance, or government healthcare programs

Counseling and medication pick-up and patient self-care therapies

• Counsel patients on prescription medications
• Counsel patients on non-prescription medications and therapies
• Counsel patients on medication delivery devices
• Provide accurate medication lists to patients
• Discuss what medications are behind the counter but do not require a prescription
• Spend time in the OTC/self-care area of the pharmacy
• Participate in or observe preceptor providing advanced patient care services

Immunizations

• Identify patients for vaccination
• Screen patients prior to vaccination for appropriateness and counsel on benefits, risks, and potential side effects

Medication history/medication therapy management

• Take an accurate medication history for a new patient profile
• Take an accurate medication history for a Transitions of Care patient
• Participate in the Pharmacy Medication Therapy Management program

Smoking cessation

• Ask patient about tobacco use
• Advise patient on smoking cessation
• Assess patient’s readiness to quit
• Assist and arrange follow-up with tobacco-cessation medications and services

Quality assurance/quality improvement

• Provide an in-service for pharmacy team
• Collect data for a quality assurance project
• Evaluate Additional Document Request (ADR) documentation process
• Learn and discuss the most common type of medication errors at your site
• Develop a pharmacy resource (Pocket Immunization Card)
• Develop a marketing strategy for wellness services
• Discuss responsibilities of pharmacy manager