Learning Experiences

Required

Orientation

Orientation is a required, one calendar month experience intended to introduce the resident to hospital and Pharmacy Department systems and processes providing a solid base from which to develop. Orientation to clinical and operational workflows includes, but is not limited to, computer-based order entry and verification, documentation in the medical record, primary dispensing, sterile compounding, automated dispensing systems, ordering, packaging, storage, distribution, and controlled substance processes. The residents will be oriented to pharmacy managed drug therapy protocols and other clinical activities. The duration of this learning experience is from the date of hospital orientation through the month of July.

Antimicrobial Stewardship/Introduction to Infectious Diseases

Antimicrobial Stewardship and Introduction to Infectious Diseases is a required, one calendar month learning experience.

 

This rotation will focus on the fundamental skills and strategies of antimicrobial stewardship. The resident will participate in daily audit and feedback as well as administrative responsibilities. The resident will attend any meetings relevant to the antimicrobial stewardship program. When performing audit and feedback, the pharmacy resident is responsible for evaluating and recommending optimal antimicrobial treatment plans for inpatients. In addition, they will be responsible for monitoring patients for drug therapy outcomes, providing drug information to medical staff, patients and families, and participating in infectious diseases consult rounds.

 

Common topics that the resident is expected to gain knowledge, skills and abilities through literature review, topic discussion, and/or direct patient care experience may include, but are not limited to

Cardiology

Cardiology is a required, one calendar month learning experience.

The pharmacy resident will gain fundamental knowledge and exposure to common cardiology-related conditions including heart failure, arrhythmias, ischemic heart disease and thrombosis. The pharmacy resident is responsible for evaluating medication appropriateness, monitoring patients for drug therapy outcomes, managing drug therapy protocols, participating in multidisciplinary discharge rounds, and providing drug information to the physicians, nurses, patients, and caregivers. In addition, the resident will conduct journal club and prepare topic presentations for the pharmacy and/or nursing staff.

Critical Care

Critical Care is a required, one calendar month, learning experience designed to guide and prepare the resident to care for patients presenting with a variety of critical illnesses.

 

The preceptors will provide clear expectations and objectives for the pharmacy resident, resources for critical care issues, and timely and constructive feedback. The preceptors will provide readings for core critical care topics and facilitate discussions. Additional topics may be discussed based on the interest of the resident or patient population presenting to the critical care unit. The preceptors will model and facilitate self-reflection and goal setting with the resident.


The resident is responsible for actively contributing to multidisciplinary critical care rounds.  In addition, he/she is responsible for evaluating medications for appropriateness, monitoring patients for drug therapy outcomes, providing drug information to medical staff, patients and families, participating in critical care topic discussions, and performing pharmacist managed protocols including, but not limited to: direct thrombin inhibitor dosing, parenteral nutrition formulation, IV acetylcysteine therapy, vancomycin and aminoglycoside pharmacokinetic dosing, and IV to PO conversions.  The pharmacy resident is also responsible for actively participating in code stroke and code blue response teams.  The resident will be assigned a minimum of one critical care related project during the learning experience.

Internal Medicine

Internal Medicine is a required, one calendar month learning experience designed to prepare the resident to care for patients presenting with a variety of conditions such as diabetes, gastrointestinal-related disorders, respiratory-related disorders, renal insufficiency and neurological disorders.

The pharmacy resident is responsible for evaluating medication appropriateness, monitoring patients for drug therapy outcomes, managing drug therapy protocols, participating in multidisciplinary discharge rounds, and providing drug information to the physicians, nurses, patients, and caregivers. In addition, the resident will prepare educational in-services or other  presentations for the pharmacy and/or nursing staff.


Common topics that the resident is expected to gain knowledge, skills and abilities through literature review, topic discussion, and/or direct patient care experience may include, but are not limited to:

Medical Oncology

Medical Oncology is a required, one calendar month learning experience at Olathe Hospital involving the provision of pharmaceutical care for patients at the Olathe Hospital Cancer Center.

The rotational experience includes a wide range of operational and patient care activities in the 18 chair Cancer Center.  At the completion of the rotation, the resident will have gained experience processing, compounding and monitoring various chemotherapy regimens.  A working knowledge of safety standards, best practices and supportive care issues are emphasized throughout the rotation.

Required - Longitudinal Experiences

Practice Leadership

This required, 10 calendar month longitudinal experience from Aug 1 - May 31 will focus on the administrative and leadership functions of the pharmacy enterprise, professional leadership and medication use policy. The experience will include 3 parts:


1) Interactive didactic sessions/discussions on finance, leadership and medication use policy


2) Attendance at various department and organization meetings


3) Completion of several projects and assignments


Common topics that the resident is expected to gain knowledge, skills and abilities through literature review and topic discussions include:

Project / Research 

Project/Research is a required, 11 calendar month, longitudinal learning experience from Aug-June with a dedicated month in December or February. Each resident must develop and complete at least one major research project on an element of pharmacy practice with potential outcomes that benefit patients and/or the organization. The primary purpose of the learning experience is to provide each resident with experience in development, research, analysis, implementation, and presentation of a major research project.


The preceptor is responsible for aiding the resident in choosing a project that can be completed in the allotted timeframe of one year, assisting in the design and write-up of the research protocol, coordinating the contact of a statistician, and aiding the residents in obtaining IRB approval. Additionally, the preceptor shall ensure that each resident is following his/her prescribed project timeline, help with data collection (if appropriate), advise the residents regarding preparation and development of their posters and/or presentations, guide data analysis, and assist in the preparation of the final manuscript.


The resident will identify and design a project, collect and analyze data and develop a timeline for project completion. The project will be formally presented at the Midwest Pharmacy Resident's Conference. Residents may also be asked to present the results of their projects to the pharmacy staff and/or other interested organizational or community groups. Each resident shall submit a project manuscript of publishable form to the project preceptor and RPD.

Staffing 

Staffing is a required, 12 calendar month, longitudinal learning experience from residency Day 1 - end of residency at Olathe Hospital. Residents will provide inpatient pharmacy staffing as part of their service commitment. Staffing shifts will occur primarily on weekend days and weekday evenings. Shifts will be operational in nature in order for residents to gain experience with medication use activities targeted at ordering, transcribing, preparation, dispensing, and storage. The weekend rotation is generally every third weekend (~15 weekends per residency year) plus one weekday evening per week (~50 per residency year).

Transitions of Care

The transitions of care (ToC) rotation is a required 10 calendar month longitudinal learning experience from Aug 1 - May 31.

 

The goal of the transitions of care rotation is to provide fundamental knowledge for residents to the challenges associated with the transition between care facilities as well as barriers that occur from an inpatient to an ambulatory setting and vice versa.

 

This rotation will require residents to spend two full days per month focusing on patients in transition.  The resident will spend approximately four hours of each scheduled day in each practice environment.  Half of one day will be spent completing face to face encounters in cardiac rehab (determined by patient care demands). The remaining day and a half is focused on recently discharged patients following up in our ambulatory internal medicine clinic, as well as completing gold standard medication reconciliation for the LEAPFROG accreditation.

Elective

Ambulatory Care

This rotation is an elective one calendar month that allows the resident to experience ambulatory care pharmacy practice in both internal medicine and family medicine clinics. Practice responsibilities include warfarin therapy management, drug interaction assessments, chronic medication management, patient counseling, pharmacotherapy recommendations for acute and chronic conditions, and medication cost assessment. In addition, there will be opportunities for multidisciplinary outpatient rounding and independent practice with remote supervision from the preceptor.

This experience allows the resident to see a diverse patient population with a variety of chronic health conditions on multiple medications. Another primary component of the rotation will be discussing drug information questions with providers and nurses. The ambulatory care elective allows the resident to empower patients through preventative care and decrease hospital readmission rates.

Common disease states that the resident will see in clinic include:

·         Anticoagulation

·         Cardiovascular Conditions (Atrial Fibrillation, Heart Failure, Hypertension)

·         Diabetes Mellitus

·         Hyperlipidemia

·         Infectious Disease (Skin and Soft-Tissue, Urinary Tract)

·         Mental Health Conditions (Anxiety, Depression, Schizophrenia)

·         Pulmonary Disorders (Asthma, Chronic Obstructive Pulmonary Disorder)

·         Sleep Disorders


Advanced Antimicrobial Stewardship

Advanced Antimicrobial Stewardship is an elective, one calendar month learning experience.

 

The pharmacy resident is responsible for evaluating and recommending optimal antimicrobial treatment plans for inpatients. In addition, they will be responsible for monitoring patients for drug therapy outcomes, providing drug information to medical staff, patients and families, and participating in infectious diseases consult rounds. 

 

In this advanced rotation, the resident's primary responsibility will be managing patients on the infectious diseases consultation service. They will collaborate with the physicians to provide optimal antimicrobial regimens. A component of audit and feedback from antimicrobial stewardship may be added based on the resident's ability and interests.

 

Residents will be expected to be familiar with basic infectious diseases concepts which will be reviewed and reinforced when necessary.

These include:

 

The resident will gain exposure to advanced infectious diseases topics including, but not limited to, those listed below through patient cases encountered, reading, and discussion with the preceptor.  

Advanced Critical Care  

Advanced Critical Care is an elective, one calendar month learning experience at Olathe Hospital designed to guide and prepare the resident to care for patients presenting with a variety of critical illnesses. This learning experience builds on the required Critical Care rotation by providing additional independent practice, the opportunity to precept an APPE student (if available), and a more in-depth critical care administrative project.

 

The resident will be responsible for scheduling and selecting readings for any desired discussions relating to clinical or administrative topics. The resident will come prepared with appropriate sources, present the information to the preceptor, and discuss any remaining questions.  The preceptor will not schedule formal topic discussions or lectures for the resident but will assist with topic selection but will assist with topic selection.  

Emergency Medicine

The Emergency Medicine rotation is an elective, one calendar month learning experience in the Emergency Care Center (ECC).  The rotation is designed to guide and prepare the resident to care for patients presenting with a variety of illnesses in collaboration with physicians, physician assistants, nurses, respiratory therapists, and care managers.  

The preceptor is responsible for providing clear expectations of and objectives for the pharmacy resident, facilitating case-based discussions, and providing timely and constructive feedback to the resident. 

 

The precepting pharmacist(s) are responsible for instructing the resident on the physiologic concepts and therapeutic management of common and/or critical disease states encountered in the emergency setting.  

In addition to monitoring and consulting on pharmaceutical issues, the resident will provide education to nursing, pharmacy, and medical staff as well as patients and their families.  The preceptor's goal of rotation is to incorporate the resident into the emergency care team and prepare the learner for independent practice in the emergency care setting, with facilitative guidance from the preceptor.

The resident is expected to proactively interact directly with all members of the interdisciplinary team, patient, and patient's family/representatives in the pursuit of efficiently facilitating evidence-based care. He/she will also be expected to triage patients based on acuity of illness and expedite the delivery of medications and drug information to the provider/patient. In addition, the resident is responsible for recommending, verifying, and assisting with medication treatment plans in agreement with evidence-based medicine and best practice. When necessary, the resident will assist with titration of medications and monitoring of patient response at bedside in collaboration with nurse/provider. The pharmacy resident is responsible for actively participating in code stroke, code blue, and toxic ingestion response. The resident will provide an in-service education for nursing staff, as assigned by preceptor.

Advanced Emergency Medicine

Advanced Emergency Medicine is an elective, one calendar month learning experience at Olathe Hospital designed to guide and prepare the resident to care for patients presenting to the Emergency Care Center (ECC) with a variety of disease states. This learning experience builds on the Emergency Medicine learning experience by providing additional independent practice, the opportunity to precept an APPE student (if available), the experience of leading complex topic discussions, and an in-depth emergency policy or care plan/protocol project. 

Expectations of Residents

a. Topic Discussions

i. The resident will select and schedule topic discussions based on gaps in previous learning, patient cases, and page 25-27 of the ASHP Required Competency Areas, Goals, and Objectives for Emergency Medicine Postgraduate Year Two (PGY2) Pharmacy Residencies.

ii. The resident should lead 2 topic discussions per week, some of which will be catered to the student (if available).

b. Precepting

i.  The resident should commit to taking advantage of precepting opportunities with students, including but not limited to creating a schedule, completing evaluations, providing feedback, leading topic discussions, educating on best documentation practices, facilitating conversations with prescribers, and acting as a mentor.

c. Project

i. The resident will complete an administrative project relevant to emergency medicine practices. Potential options for this project include care plan/protocol updates, MUE/DUE, CE, order set updates, or a PT&D proposal.

d. Communication

i. The resident will carry the ECC mobile phone and pager.

e. Pre-requisites

i. The resident must complete Critical Care and Emergency Medicine learning experiences prior to starting the Advanced Emergency Medicine elective learning experience.

ii. Completing Advanced Critical Care and Infectious Disease prior to Advanced Emergency Medicine is preferred.

f. Staffing

i. The resident will staff the ECC independently through any of the following schedule adjustments

a. Extended hours – stay after the Emergency Medicine Pharmacist has completed their shift as the sole pharmacist in the ECC

b. Independent days – staff as the sole ECC pharmacist for a regularly scheduled day

c. Weekend swap – switch shifts with the ERW shift, allowing them to work the W2/W3/W4 while the resident works ERW                                                                                                    i.  Advanced Critical Care required for this option


Advanced  Medical Oncology

This rotation is an elective, one calendar month learning experience at Olathe Hospital involving the provision of pharmaceutical care for patients at the Olathe Cancer Center.

 

The rotation experience includes a wide range of operational, patient care and educational activities in the 18 chair Cancer Center. At the completion of the rotation, the resident will have gained experience caring for patients with a variety of oncology conditions while navigating practice management issues.  A working knowledge of disease management standards is emphasized throughout the rotation.

Obstetrics & Neonatology 

Obstetrics and Neonatalolgy is an elective, one calendar month learning experience involving the provision of pharmaceutical care for patients in the Birth Place.

 

A comprehensive evaluation of a patients' therapy is expected including identification of relevant data, recommendations to the therapeutic plan, monitoring for patient outcomes and follow up recommendations as necessary. The resident will determine the extent of topic discussions needed to supplement the literature provided by the preceptor in addition to that found by the resident. The pharmacy resident is required to develop and apply their knowledge and skills within the designated activities:

Pharmacy Management

Pharmacy Management is a one calendar month, elective learning experience.

The rotation will provide an organized and directed learning experience in the administrative and managerial responsibilities of the director of pharmacy, pharmacy managers and residency program director.

The roles of pharmacists in leadership/management are varied. Responsibilities include, but are not limited to strategic planning, budgeting, recruitment, personnel, communication, accountability and delegation. Priorities change, week-to-week, day-to-day and even hour-to-hour. The rotation will give the resident an opportunity for first-hand experience of life as a leader and manager.

In addition, the resident will spend time with analysts from Information Technology to learn about the relationship between the electonic medical record and the medication use process.

The length of time spent in various activities and with each preceptor will be customized to the resident's preferences, interests and goals.

Advanced Pharmacy Management

Advanced Pharmacy Management is a one calendar month, elective learning experience that builds on the Pharmacy Management elective. The experience is meant to prepare the pharmacy resident for a variety of management-related responsibilities that include but are not limited to continuous department strategic planning and development, human resources and personnel management, performance improvement, rural health management, controlled substance surveillance and more. The priorities and activities are subject to change day-to-day as the demands of the management roles change.

Precepting

Precepting is an elective, one calendar month learning experience designed to facilitate the growth and development of the residents' teaching skills with an emphasis on practice-based educational activities.  This elective learning experience could be used to help the resident achieve goals and objectives related to precepting (Goal 4.2) if further learning opportunity is needed. It may also be chosen by residents who have already achieved the objectives under Goal 4.2 and want to work on leadership and self-reflection to develop and improve their teaching skills. The learning experience is best suited for later in the residency year and the resident is required to have co-precepted at least two advanced pharmacy practice experience (APPE) students prior to this elective. The RPD, the APPE student preceptor(s) and the learning experience preceptor will determine which APPE students will be precepted by the resident.

The preceptor is responsible for providing clear expectations and objectives of the resident, providing resources for precepting and mentorship in practice settings, and maintaining regular contact with the resident in order to provide timely and constructive feedback to the resident.