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The Path to Time Management: Time to Hit the Road!

Learning Objectives

After completing this knowledge-based continuing education activity, pharmacy technicians will be able to

    • Describe how an individual technician’s time management impacts the whole pharmacy’s efficiency
    • List three time management techniques that could improve a technician's function
    • Recognize time management techniques to apply in specific settings and situations

     

    Re-Release Date: September 24, 2023

    Expiration Date: September 24, 2026

    Course Fee

    Pharmacy Technicians: $4

    There is no funding for this CE.

    ACPE UAN

    Pharmacy Technician: 0009-0000-23-027-H04-T

    Session Codes

    Pharmacy Technician:  20YC65-TJX49

    Accreditation Hours

    1.0 hours of CE

    Accreditation Statements

    The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE UAN 0009-0000-23-027-H04-T  will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

     

    Disclosure of Discussions of Off-label and Investigational Drug Use

    The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

    Faculty

     

    Isabella Bean
    PharmD Candidate 2022
    UConn School of Pharmacy
    Storrs, CT

    Sara Miller, PharmD, RPh
    CVS
    Foxboro, MA

    May Zhang
    PharmD Candidate 2022
    UConn School of Pharmacy
    Storrs, CT

    Faculty Disclosure

    In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

    Isabella Bean, Sarah Miller and May Zang do not have any relationships with ineligible companies.

     

    VIDEO

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    Pharmacy Technician Post Test (for viewing only)

    The Path to Time Management: Time to Hit the Road!

    LEARNING OBJECTIVES
    After completing this continuing education activity, the pharmacy technician should be able to
    1. Describe how an individual technicians' time management impacts the whole pharmacy’s efficiency
    2. List three time management techniques that could improve a technician's function
    3. Recognize time management techniques to apply in specific settings and situations

    1. Barbara and Linda are great multitaskers. They are able to work and talk while getting everything done effectively. While ringing out a customer, Barbara continues her conversation with Linda. What should Barbara have done instead?
    a. Paused the conversation, because it makes the customer feel unimportant
    b. Done nothing different—in situations like this, she never makes errors
    c. Asked someone else to ring the customer so she can go on her 15 minute break

    2. Lilly makes it to work within the 7 minute grace period every day. Technically she is on time, but she’s not ready and at her station at her 7:30 shift time. How does this disturb workflow when she takes advantage of the grace period every day?
    a. It doesn’t disturb workflow because she is not late. The grace period is in effect so that she doesn’t have to be in right when her shift starts.
    b. Exploiting the grace period means the other technicians who arrive before the official start time have to cover her station until she comes in.
    c. Employers know how often employees are late and why, and communicate problems like traffic congestion to local governments, so the effect on the workplace is positive.

    3. You’re heading to work and you know it takes exactly 11 minutes to travel there. Your shift starts at 9 am. What time do you leave?
    a. I leave by 8:40 am at the latest so that I have time to park and walk in.
    b. I leave at 8:49 am because I know it takes 11 minutes to get there.
    c. I leave at 9:00 am because I know they can handle me being a little late.

    4. You are entering in an insurance card that you haven’t seen before. You’ve been struggling with it for five minutes and can’t figure it out. You are unsure of how to proceed, but the pharmacist is busy. What do you do?
    a. Politely interrupt the pharmacist to ask your question
    b. Ask a more senior technician if they have seen it before
    c. Go to a different station to avoid this insurance card

    5. Laura is a new pharmacy technician. The customers will ask her where to find an OTC or grocery item frequently, but she doesn’t know yet. She asks you how she can become more familiar with where everything is. What do you say?
    a. Suggest that she ask the manager for front store training so that she can become more familiar with the store
    b. Tell Laura that it takes time to learn the store, and to keep asking the other techs and pharmacists
    c. Tell Laura she that she should identify this problem’s quadrant and decide whether to ask or act

    6. You are working in the pharmacy and a huge order arrives. You know you have to finish putting away the order before your shift ends, but prescriptions and patients keep popping up. What do you do?
    a. Prioritize the customers and prescriptions that are here now and do as much of the order as possible
    b. The other technicians are busy too, but leave it for them because you’ve had to put the order away on three recent days
    c. Multitask by putting the order away as you ring customers and retrieve and count controlled substances

    7. The phone is ringing! When you answer it, a provider is on the line. She’s very frustrated because she’s been on hold for 10 minutes, and she “doesn’t have the time for this kind of thing” and “needs an answer ASAP.” She has a clinical question about a medication you fill very frequently. What is the most appropriate response?
    a. ACT—you’ve been a tech for four years; you’ve seen this medication dozens of times. You know enough to answer the provider’s question.
    b. ASK—you’re in the middle of something else right now. Ask another tech to handle this provider.
    c. ASK—the pharmacist should take the call, since it involves a clinical question and you may not know all the details.

    8. The phone is ringing! When you answer it, a provider is on the line. She’s very frustrated because she’s been on hold for 10 minutes, and she “doesn’t have the time for this kind of thing” and “needs an answer ASAP.” She has a clinical question about a medication you fill very frequently. What quadrant of workplace activity best describes this situation?
    a. Quadrant 1: important and urgent
    b. Quadrant 2: important but not urgent
    c. Quadrant 4: not important and not urgent

    9. Flu season is coming. Martha, an experienced pharmacy technician, knows that the store serves a very elderly population. She decides to ask the pharmacist to order more high potency flu vaccines, in anticipation of a higher customer demand. This best describes which time management technique?
    a. Good organization
    b. Planning ahead
    c. Multitasking effectively

    10. You’ve just transferred pharmacies, and you’re trying to figure out the lay of the land. It’s really hard to find things in your new pharmacy. Some meds are ordered by brand name, some by generic. Topicals, inhalers, and DME are all combined on the same shelf. When you bring this up to other techs, they sympathize but say you’ll figure it out eventually, like they had to. Which time management technique would best solve this issue?
    a. Acting instead of asking
    b. Multitasking effectively
    c. Good organization

    References

    Full List of References

    References

       

      Prepping Pharmacist Preceptors on the Pharmacists’ Patient Care Process (PPCP)

      Learning Objectives

       

      After completing this application-based continuing education activity, pharmacists will be able to

        • Describe the PPCP model and its uses
        • Apply the PPCP when students address clinical problems in the workplace
        • Identify areas where pharmacy students need the most guidance when using the PPCP

        Two healthcare professionals talking while looking at a vial filled with medication capsules

         

        Release Date: July 21, 2023

        Expiration Date: July 21, 2026

        Course Fee

        Pharmacists: $7

        UConn Faculty & Adjuncts:  FREE

        There is no grant funding for this CE activity

        ACPE UANs

        Pharmacist: 0009-0000-23-028-H04-P

        Session Code

        Pharmacist:  23PC28-XPK68

        Accreditation Hours

        2.0 hours of CE

        Accreditation Statements

        The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE UAN 0009-0000-23-028-H04-P  will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

         

        Disclosure of Discussions of Off-label and Investigational Drug Use

        The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

        Faculty

        Kimberly Ma
        PharmD Candidate 2024
        UConn School of Pharmacy
        Storrs, CT

        Jeannette Y. Wick, RPh, MBA, FASCP
        Director, Office of Pharmacy Professional Development
        UConn School of Pharmacy
        Storrs, CT

        Faculty Disclosure

        In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

        Kimberly Ma and Jeannette Wick do not have any relationships with ineligible companies

         

        ABSTRACT

        Preceptors often work with students to review patient cases in an organized way. Experts developed the Pharmacists’ Patient Care Process (PPCP) in 2014 to provide a template that is consistent and concise, but also comprehensive. Using this process, students and licensed pharmacists develop SOAP notes to document the subjective and objective data they need to complete an assessment, and ultimately make a plan. PPCP stresses an important point: follow-up is critical and a well-written SOAP note can be extremely helpful in the follow-up process. This continuing education activity uses a case study to demonstrate how the PPCP process should work and emphasize areas where preceptors can provide tangential learning. It includes PRO TIPS for preceptors when they supervise students who are attempting to complete PPCP. It highlights the most common errors and suggest ways that preceptors can work with students to improve their experiential education.

        CONTENT

        Content

        INTRODUCTION: A PATIENT CASE

        JM, an 8-year-old white male presents to your clinic. It’s a pediatric care clinic located in an area where many financially challenged families live. After talking with his parents, you learn he was recently diagnosed with central precocious puberty (CPP). His endocrinologist recommends initiating therapy and would like to know what treatment you recommend. His parents also have questions.

        Your spry pharmacy student jumps at the opportunity to write a SOAP note using the “PPCP.” To you, PPCP sounds like an illegal drug that was abused in the 1980s. She explains that the Pharmacists’ Patient Care Process (PPCP) is a standardized model for collaborative medication management. She clarifies what it entails and how to apply the process in a clinical setting.

        PPCP’s Importance

        Schools of pharmacy have taught the PPCP for the past few years. Preceptors who are unfamiliar with the process may find it helpful to review the PPCP as many students will take this approach when addressing clinical problems in the workplace.

        PPCP: THE DETAILS

        Teamwork in healthcare has achieved major goals for many patients (although we have room for improvement): accessible, affordable, and high-quality care. In addition to the many healthcare team members, pharmacists are critical contributors to care plans. Medication expertise equips pharmacists with the knowledge to reduce drug adverse events, prevent medication errors, and provide invaluable input for decision-making.1

        In 2014, the Joint Commission of Pharmacy Practitioners (JCPP) developed a standardized process for medication management that could be used across interdisciplinary teams and dubbed it PPCP. JCPP’s members developed the approach using principles of evidence-based practice. The five steps—collect, assess, plan, implement, and follow-up—are tied together with careful communication and documentation.2 Pharmacists can remember the steps as the pneumonic “CAP-IF.”

        SOAP Notes

        The subjective, objective, assessment, and plan (SOAP) note provides a method of documentation for the collect, assess, and plan steps of the PPCP. SOAP notes are probably familiar to most preceptors, as clinicians have used them for roughly 50 years.3 Table 1 highlights the key components of SOAP notes.

        Table 1. Components of a SOAP Note1

         

        Objective Information Subjective Information
        ·       Current medication list (prescription and nonprescription)

        ·       Medical history

        ·       Physical assessments (i.e., blood pressure, heart rate, weight, height, respiratory rate, etc.)

        ·       Laboratory results

        ·       Chief complaint

        ·       Symptoms

        ·       Patient lifestyle habits, preferences, and beliefs

        ·       Patient goals for care

        ·       Socioeconomic factors

        Assessment
        ·       Problem: statement highlighting the chief complaint or main medication-related problem

        ·       Rationale: the reasoning for the intervention cited from guidelines and supporting evidence from the collected information

        ·       Goals of care: possible barriers to adherence, socioeconomic considerations, and desired outcome of intervention

        Plan
        ·       Specific recommendation or intervention based on practice guidelines (i.e., initiation of drug therapy, referral to another provider, or non-pharmacologic lifestyle modifications)

        ·       Plan for upcoming sessions, specific monitoring parameters, and progress indicators

         

        Collect

        Thorough collection of the right information supplies pharmacists with tools to make safe, effective decisions. A combination of objective and subjective information paints a more complete picture of a patient’s clinical status. If possible, pharmacists should obtain and verify their information across multiple sources. Past medical records, active medication lists, and laboratory results are great places to start.

        When soliciting subjective information, pharmacists should use open-ended questions. Prompting patients with questions formatted to avoid “yes” or “no” answers allow providers to obtain more information in less time, prioritize chief complaints better, and minimize implicit assumptions.4

        Back to the Case

        Your head is spinning trying to sort all the “P’s” in PPCP, CPP, and JCPP, but your student assures you that she will start with collecting relevant clinical information. First, you and your student perform a physical assessment of JM including taking his height and weight. JM takes no medication except an occasional antihistamine, but if he took other chronic medications, this would be the time to direct your student to perform a medication reconciliation. Next, you prompt JM’s parents with open ended questions, and they recall JM’s past medical history. You should ask your student if JM needs to be involved in the discussion (see SIDEBAR). After meeting with JM and his parents, here is the relevant information your student jots down:

        Subjective information

        • At age 5, JM frequently soaked through his underarm clothing with pungent perspiration, so since then, he uses a strong deodorant
        • He is starting to develop pubic and underarm hair
        • He has some acne on his face and upper back
        • JM occasionally tells his parents he feels “different” than his classmates because he is so much bigger and taller
        • He has no past surgeries or hospitalizations
        • Takes OTC multivitamins daily and loratadine for allergies in the spring

        Objective Information

        • Height = 4’8” inches
        • Weight = 102 pounds
        • DHEA Sulfate = Tanner stage III - 60 ug/dL (N = < 28 ug/dL)
        • Clinical exam findings = testicle size indicates puberty
        • X-ray bone age hand and wrist = greater than 2 standard deviations, 156 months (expected = 108.9 months)
        • Luteinizing hormone (LH) = 0.4 units/L (N = < 0.3 units/L)

        SIDEBAR: Pediatric Involvement in Healthcare Decisions5,6

        In pediatric cases, clinicians may choose to consult only parents when making decisions regarding their child’s medical care. However, this practice, which is rooted in legal precedence, should shift to involve affected children to some extent. The American Academy of Pediatrics advocates that adolescents actively participate in decisions based on their ability and maturity. 5 While research is lacking on how exactly to assess a child’s aptitude to participate in decision making, some studies show that children can participate as young as age 5.6 Regardless, it doesn’t hurt to ask children if they have questions or concerns. In the case, JM is 8 and has voiced his concern previously about his height and size. Therefore, including him in the conversation is a possibility if his parents agree.

        Preceptors can and should provide tangential learning when working with special populations. Reminding students that adolescents, older adults, people who have cognitive decline or dementia, and people for whom English is a second language will need careful counseling. Pharmacists and pharmacy staff will also need to select their words carefully and accommodate these patients’ needs. Assigning students to do some research on the various needs in these populations is an excellent way to help them develop skills and a professional identity.

        Upon looking at your student’s notes so far, you assure her she has done well. However, you still have some questions. You remind her that sometimes information like height and weight requires additional evaluation and ask her to calculate JM’s BMI; she finds that it’s 22.9. You ask your student, “How does JM’s height and weight compare to the expected height and weight of boys his age?” To which she replies, “Pediatric growth charts will give us a better idea!” After consulting the growth charts, she determined and documented that JM falls within the 112th percentile for both measurements.

        To make learning comprehensive, you could ask the student if the only kind of precocious puberty is central in nature. This will help your student learn to differentiate among different forms of similar diagnoses.

        Assessment

        An assessment of comprehensive patient information helps prioritize the problems that require attention. Pharmacists should consider all information when identifying the problem, the rationale, and the goals of therapy. Some example questions pharmacists can consider include1

        Medication appropriateness

        • What is the indication for each medication?
        • What is the correct dosing?
        • What are the common adverse effects?
        • What are the possible drug interactions?

        Factors that impact access to care

        • What cultural factors create barriers to care?
        • What socioeconomic factors impact the patient?
        • What is the patient’s level of healthcare literacy?
        • What goals does the patient or his parents have?
        • What barriers impact patient adherence?

        Additional services

        • What preventive care measures does the patient qualify for?
        • Which immunizations has the patient received?
        • What other concerns does the patient have?

        THE CASE RESUMED...

        After compiling the objective and subjective information on JM, the student finds guidelines in the Journal of Clinical Endocrinology for the management of CPP.7 Due to JM’s symptoms and lab values showing consistencies with CPP, the guidelines recommend initiating a gonadotropin releasing hormone (GnRH) analog. Depending on JM’s and his parents' preferences, the endocrinologist can choose either an injectable (leuprolide) or long-acting implantable device (histrelin) provided the insurance covers it or the cost is manageable.

        Once again, you should have some questions for your student. For example, asking the student to list the search terms and search engines she employed can shed light on her process. Another question might be, “Are these the only guidelines available?” You can show her that you used PubMed, as she did, but when you used Google Scholar, you found an excellent review article that lists five other publications. You suggest she look at them since expert recommendations can vary. She might also contact the endocrinologist and ask if he plans to follow the guidelines she identified, and if not, why not.

        The endocrinologist messages back saying he agrees leuprolide and histrelin are both reasonable options to consider for first-line therapy. However, he also cites a 2019 update published on Hormone Research in Paediatrics. These guidelines recommend a third U.S. Food and Drug Administration (FDA)-approved option for the treatment of CPP, triptorelin.8 He says the student should consider this choice as a potential treatment for JM as well.

        After reading the endocrinologist’s note, you emphasize to your student the importance of citing multiple guidelines when drafting an assessment. In this case, the FDA approved an additional treatment, triptorelin, in 2022. You walk through your student’s process of finding clinical information to identify more ways she can improve next time. Furthermore, you point out how the endocrinologist’s insight exemplifies the importance of interdisciplinary care.

        Simultaneously, you and your student read through all three monographs and discuss the major differences you’d like to share with his parents. You ask the student to practice her delivery of the information, and she says, “Leuprolide is a long acting injectable administered intramuscularly (IM) or subcutaneously. Your doctor will administer the IM formulation every month, three months, or six months. “Triptorelin is similar to leuprolide, but is only available as a six month IM formulation. The other option is for your doctor to administer the subcutaneous formulation every six-months.9 On the other hand, histrelin comes as a long-acting 1¼ inch implant surgically placed into the upper arm every 12 to 24 months. For the first 24 hours after the surgery, JM should avoid swimming or bathing. As long as JM avoids heavy play or exercise for the first week, he will not have to worry about any further restrictions after that. The implant also requires surgical removal.”10

        Now, you prompt the student to recall that JM’s parents expressed concern about what would happen if JM experienced an adverse reaction to the long-acting implantable device. They asked, “What is the procedure like?” and “If JM has a reaction to the implant, must he continue to wear it for 12 months or can the doctor remove it easily before then?”

        The student does more research and says she will assure JM’s parents that this outpatient procedure lasts only 10 minutes, though the appointment may last 60 to 90 minutes. Most surgeons will just numb the area; however, children may undergo sedation if necessary. The surgeon will insert the narrow implant into a small approximately 5 mm opening made in the skin on the inner surface of the arm. With this option, JM can return to school the same day. The student plans to mention that complications don’t commonly occur, but minor discomfort and bruising may.11 The student plans to continue, “The implant may be removed immediately if JM presents at any time a severe allergic reaction or adverse effect. However, this is not common.”

        Before you and the student document the assessment section of your SOAP note, the student indicates she will ask JM if he has questions. He shares that he “HATES needles” but is also scared of the surgery hurting.” The student plans to tell him not to worry because he won’t feel any pain during the operation. He can also choose to sleep during the surgery if he prefers.

        Here, the preceptor should step in with gentle corrections about patient-appropriate language. First, most Americans have no idea what a 5 mm incision will look like. You ask her to calculate its length in inches and explain it by comparing it to something the child will recognize, like the size of small dice or a stack of 20 playing cards. Next, it’s critical to remind the student that we must never tell patients that something won’t hurt. This is a lesson students should learn during immunization training and creates an opportunity for cross training (applying this principle to other areas of pharmacy) that applies regardless of patient age. Healthcare professionals should never say, “This will not hurt a bit!” or anything similar. People have different pain thresholds making it impossible to predict whether it will hurt. Student pharmacists need to develop language they are comfortable with and use it. A good response if people ask if it will hurt is, “It may hurt or sting a little but just for a minute or two.” In this case, the preceptor suggests saying, “The doctor will numb the area.”

        Finally, the preceptor may point out that “operation” can be a scary word for children. The student needs to use a word like “procedure” or find a way to avoid either of those words.

        The preceptor should also point out that JM’s parents had also said they were worried about two things: (1) potential side effects and (2) the cost of care. They heard on the news that expenses associated with these medications can add up quickly. The cost of care and determining what the patient’s insurance will cover is probably foremost in the endocrinologist’s mind, too.

        In terms of potential side effects, your student says that both GnRH analogs have similar side effect profiles. From the pediatric studies she read on GnRH adverse effects, she shares that signs of puberty may increase transiently with therapy before growth velocity eventually slows down. Some children experience weight gain, changes in appetite, body aches, headaches, gastrointestinal (GI) symptoms, or signs of a common cold. Parameters like physical growth and bone mass density may decrease during treatment but usually return to normal one year after treatment discontinuation.9, 10

        Before selecting JM’s treatment option, it’s critical to evaluate insurance coverage since it’s on the forefront of everyone’s concerns. The student needs to determine if they have insurance and what the plan covers. She starts by finding information on ballpark cost. She reports a histrelin implant costs around $40,000. If the patient requires mild sedation when the doctor inserts the implant, the cost may increase. However, in some cases, the implant may be used for up to two years. Leuprolide’s median annual cost ranges from $20,000-$40,000 depending on the formulation.12 A single injection of triptorelin costs roughly $19,000, making the annual cost nearly $40,000 as well. Then says she will remind JM’s parents that while this may give them an idea, the cost may vary outside of that range.

        Plan

        Following the assessment, pharmacists work to develop a personalized patient care plan in collaboration with other healthcare professionals. The plan should reflect recommendations from the most recent evidence-based clinical practice guidelines. Pharmacists should focus on optimization of care in a safe, effective, and cost-effective manner.

        1. Address medication-related problems and optimize medication therapy
        2. Set specific, measurable, achievable, realistic, and timed (SMART) goals in the context of the patient’s healthcare goals and access to care
        3. Involve patients to engage in education, empowerment, and self-management
        4. Support non-pharmacologic interventions as appropriate

        SMART Goals. When creating an action plan for patients, pharmacists should aim to set goals that are SMART.

        • Specific instructions provide other clinicians with accurate information about the patient.
        • Measurable outcomes provide clinicians the ability to evaluate the patient’s progress and whether the plan requires adjustments
        • Achievable and realistic goals
        • A timeline for the plan ensures healthcare providers routinely follow up with their patient

        A PLAN FOR JM

        After you document JM’s main problem, rationale, and goals for care in the assessment section, you move on to create his plan. Following careful consideration of the assessment, you and your student decide to recommend starting histrelin to treat his CPP since his insurance will cover it once the endocrinologist completes prior authorization forms. (Here, you suggest that the student find the prior authorization forms and volunteer to complete as many sections as she can for the endocrinologist. You explain that she can expedite the process and this is a skill she can apply to many different pharmacy practice locations.) Choosing histrelin is also a needle-free option, which may make JM happy. You remind your student that the plan should also include scheduling necessary appointments and follow-ups with JM’s other providers in addition to counseling on the specific adverse effects of the medication detailed in Table 2.

        Table 2. Example SOAP note for JM 7

        Name: JM

        Age: 8    

        DOB: 10/02/14

        Allergies: Seasonal allergies, NKDA

        Chief Complaint: Patient referred to clinic by endocrinologist for medication therapy; patient was recently diagnosed with central precocious puberty (CPP)
        Subjective Information

        JM is an 8-year old white male presenting to the clinic. He recently met with his endocrinologist on 6/28/23 and has been referred to the clinic for drug therapy to treat CPP. His parents confirm JM’s use of deodorant to combat excessive perspiration and body odor since the age of 5. He has also developed pubic and underarm hair in addition to acne on his face and upper back. His parents are concerned regarding JM’s reported insecurities at school due to his larger size.

        PMH: no surgeries or hospitalizations Medications: daily multivitamin, OTC loratadine (prn for allergies)
        Objective Information

        Clinical exam findings = testicle size indicates puberty

        112th percentile for weight and height

        Relevant Labs: Bone age of 13, LH 0.4 units/L, DHEA sulfate 60 ug/dL

        Height: 55 in Weight: 102 lbs BMI: 22.9 BP: 110/61 mmHg HR: 75 bpm Temp: 98.6 ℉ RR: 15
        Assessment

        Problem: Patient requires medication therapy for untreated indication.

        Rationale: According to the Journal of Clinical Endocrinology Practice Guidelines for Central Precocious Puberty, JM requires hormone suppression therapy. Symptoms of rapid linear growth, advanced skeletal maturation, and basal LH levels > 0.3 units/L require treatment with GnRH analogs until the normal age of puberty.

        Goals of Care: The goal of treatment is to reduce signs of premature pubertal progression while ensuring therapy is well tolerated and medication side effects are minimized. Patient’s parents would like to choose an option that is cost effective and safe.

        Plan

        Initiate histrelin 50mg SQ implant to be administered by JM’s surgeon every 12-24 months depending on safety and efficacy parameters evaluated at follow up appointments

        Schedule surgery appointment with JM’s surgeon at earliest convenience

        Schedule follow up in 3 months to evaluate pubertal progression, growth velocity, skeletal maturation, and tolerability

        Counsel JM/JM’s parents on possible adverse effects including weight gain, changes in appetite, initial flare of puberty symptoms, GI symptoms, body aches/pains, and signs of common cold

        Counsel JM’s parents on providing support to make JM feel good about himself. Children who are undergoing rapid development at this age may feel different when comparing themselves to other children their age.

        Implement

        During the implementation phase, pharmacists set the action plan into motion. This may include the administration of vaccines, initiating or discontinuing a medication, or scheduling the next follow-up appointment. Pharmacists, primary care physicians, or caregivers work together to provide care based on the goals made in the planning step.1

        Follow-up and Monitor

        The pharmacist in collaboration with other health care providers should follow-up with the patient as recommended in practice guidelines and referring back to the SOAP note. Continuous monitoring of medication appropriateness, adherence, safety, laboratory results, and patient concerns will indicate if the plan requires revision. Routine medication reconciliations, check-ups, or conversations with patients improve outcomes and help to achieve goals of therapy.

        Putting it All Together

        Upon completion of the SOAP note, you send the endocrinologist your recommendations. You contact JM’s parents to discuss scheduling a follow-up appointment in three months with the endocrinologist and counsel on histrelin.

        IMPLICATIONS FOR PRECEPTORS

        The Benefits. The PPCP model creates a reproducible framework that demonstrates clinical pharmacists’ contributions to medication-related outcomes.13 In addition to improving the quality and completeness of patient medical records, SOAP notes give pharmacists a place to start when working up a new patient. As students practice developing SOAP notes, preceptors should emphasize how the lessons they learn in one case can apply to future cases.

        The Drawbacks. As more pharmacy programs integrate PPCP into their curriculum, new students will have access to courses that teach the model. But because the PPCP model is relatively new, many licensed pharmacists have not yet familiarized themselves with the process. Extracting the necessary information to write quality SOAP notes can also be time consuming. Depending on the setting, pharmacists may not have enough time to walk through every step with students. Finally, the PPCP method does not encompass all clinical situations. The framework relies on pharmacists to exercise clinical judgment and reasoning to modify the model as needed.

        Uncomfortable Topics. Students often have little exposure to difficult topics. These may include end-of-life issues, psychiatric diagnoses, cultural or ethnic differences, drug abuse/misuse, and gender-related topics. In this case, students may feel strong discomfort in discussing matters related to sex and sexual development. Preceptors need to help students reduce their hesitancy when communicating with you and the patient because improper communication can lead to poor collection of relevant information. Keep in mind strong note-writing skills facilitate good care. Two things help: (1) practice, and (2) finding resources designed to help with difficult topics. The Conversation Project (https://theconversationproject.org/resources/healthcare/) is one such resource that can help students become more comfortable with difficult topics.

        In addition, students may have implicit and explicit biases for uncomfortable topics such as the use of hormone blockers, which may bring to mind their use in transgender children. Creating a safe place for your student to share opinions provides a great opportunity for you to teach students how to avoid these biases. Preceptors need to remember that learning—especially if it changes a student's perspective or points out a student's mistake—can be threatening, and students can feel vulnerable while learning. It’s an emotional experience.6

        To help guide students through these experiences, the SIDEBAR provides 10 additional tips preceptors can use when supervising the PPCP.

        SIDEBAR: PRO TIPS for Preceptors Who Supervise the PPCP

        (1) Don't let the acronym scare you! This is a new name for a process you've probably used knowingly or unknowingly for years.

        (2) Encourage independence. Hand over the problem to the student once you've described the problem and fielded the student's questions. Establish a time for the student to be prepared to discuss it but check in periodically to see if the student is having trouble.

        (3) Rescue when necessary. Some students will need more support than others. If a student is clearly flummoxed, spend more time and provide more direction.

        (4) Promote interdisciplinary communication. Having students discuss a clinical problem with another clinician, either with you or on their own, fosters interdisciplinary care. Students will also learn from the other clinicians, which will lighten your load!

        (5) When students present findings, always ask them to describe things like the search terms and search engines they used or the obstacles they encountered. Help them refine their processes to reduce barriers or find more appropriate resources.

        (6) Consistently prompt students to determine if the case is typical or unusual. Asking questions based on a modification of the case can help students learn more globally.

        (7) Don't "stay in your lane"! In this CE, the practice site is an ambulatory care location specific to pediatrics. The lessons a student learns in this rotation, if they go beyond pediatrics, will be invaluable. Helping students develop communication skills or analyze how disease states present or are treated in adults or other special populations will increase their clinical acumen in future rotations.

        (8) Address implicit biases or misconceptions. Students may not know that an attitude or opinion is biased, incorrect, or simply rude.

        (9) Debrief. After the PPCP is done, provide feedback, ask others who may have been involved to provide feedback, and ask the student to perform a self-assessment.

        (10) Appreciate reverse mentoring. Remember that students often teach us new things!

         

        Common Sources of Error

        Collecting too little information. Not all the information pharmacists need to collect will be obvious. In the patient case, the student collected important objective information like height and weight. However, without something like growth charts to evaluate JM’s height/weight compared to other kids his age, the information does not help in the assessment. Preceptors can aid students who are new to documenting SOAP notes when they are required to dive deeper into collected information. Students should not make assumptions as to what other clinicians know off the top of their heads. In this case, other areas where the preceptor helped the student included directing her to seek other expert opinions like the endocrinologist. That puts the “inter” in “interdisciplinary” care!

        Collecting too much information. Pharmacists and students should collect information worthy of appraisal. In other words, only collect the necessary information that will contribute to the identification, prevention, and resolution of either the chief complaint or medication-related problems. If pharmacists/students do not actively use collected information to make the assessment or plan, they should omit it in the note. Documenting more information does not equate to better information. This leads to overly lengthy or confusing SOAP notes. Here, as in the previous error, preceptors should ask students to examine and explain their processes.

        Not verifying information. All information should be verified across multiple sources like when performing traditional medication reconciliations. This prevents possible errors in note-taking that may arise from outdated documentation.

        Sourcing one guideline. Depending on the disease state, the frequency in which guidelines are updated can vary. Preceptors should emphasize the importance of looking for multiple guidelines and paying attention to their publication dates. Occasionally, the FDA may approve new treatment options after the release of clinical guidelines or updates. In this case, the student completely missed an additional treatment option as a result of sourcing a single guideline from 2013. Similar to how preceptors should encourage students to verify collected information across multiple sources, preceptors should also encourage students to cross-check sources that aid in their assessment.

        The assessment lacks evidence. As mentioned above, the assessment should communicate the assessor’s thought process. The information collected by the pharmacist/student should justify why the problem is a problem. If there is no subjective or objective information to back up the assessment, the assessment has no basis.

        Forgetting recommendations on current medications. Pharmacists/students should not forget to include instructions for the patient’s current medications, not just the newly prescribed medications.

        Forgetting non-pharmacologic recommendations. The plan section also encompasses non-pharmacologic interventions such as referral to another provider, ordering additional laboratory tests, education, or counseling on lifestyle interventions. Pharmacists/students should remember that not all patients require initiation of a new medication.

        Being vague. When initiating new therapy appropriately, pharmacists/students should always provide specific recommendations with the drug name, dose, and frequency. Vague instructions such as “Initiate hormone blocker therapy” are unhelpful. Similarly, instead of “monitor for side effects,” pharmacists/students can list the specific symptoms that present most commonly.

        Poor communication. Errors due to poor communication directly hinder the PPCP. Furthermore, clinicians with experience are not necessarily better communicators. Therefore, pharmacists should engage in education/training to constantly improve communication skills. SOAP notes should effectively communicate the pertinent information used to create a plan and document important details for the patient’s medical record.

        Setting it and forgetting it. The PPCP is not a linear process. While this framework provides clinicians a place to start and a checklist of sections to complete in order, pharmacists should remember to review and revise all sections at any given time. For example, pharmacists may identify new information they should go back to collect as they work on their assessments. Preceptors should encourage their students to occasionally step back and evaluate the completeness and coherence of the SOAP note. Sometimes patient cases will require students to revise sections of the SOAP note they already completed.

        And a New Case

        Just before the end of the month, the endocrinologist sends yet another patient with precocious puberty to you. The patient LD is a 9-year old Hispanic female. Her endocrinologist recently diagnosed her with idiopathic precocious puberty and wants to know which treatment you recommend. Her parents also want to know why this is happening to their daughter. Before taking LD’s family from the clinic waiting room, you decide to let your student take charge of this case while you supervise. You ask your student “Now that you have practiced writing SOAP notes and know a little about this disease state, how will you approach the PPCP this time?”

        The student says to you...

        “I stored all my notes from the last case on precocious puberty from earlier this month. I have a document containing the guidelines from the Journal of Clinical Endocrinology along with several updated publications that cite all additional first-line medications approved after the original guideline’s release. I will start with the collection of subjective information such as LD’s symptoms and medical history followed by objective information, specifically pertaining to her growth statistics. I should calculate BMI and her height/weight percentiles since precocious puberty is usually associated with accelerated growth. Next, I will examine her relevant lab values. Since the patient is female, I will be looking out for progesterone levels this time. If possible, I shall cross-reference all of the information I collect across multiple sources.”

        “Before I move onto making an assessment, I understand LD’s parents may feel very concerned about their daughter's condition. I don’t want to forget to address their question. I will explain that idiopathic precocious puberty does not have a definitive cause. To help them better understand, I’ll mention that idiopathic cases may result from anything ranging from a head injury in childhood to exposure to certain chemicals. Regardless of the cause, I will assure them there are several treatment options that may be appropriate for LD at this time. I can walk them through the pros and cons of all the available options.”

        “Next, I would prompt LD’s parents with open-ended questions to learn more about their major concerns, potential barriers to medication therapy, and insurance eligibility. I know these are important considerations for my assessment. It would also be appropriate for me to engage with LD using appropriate language for a 9-year-old girl. I realize the topic may be uncomfortable to discuss, but without taking initiative of the discussion I may forget to include pertinent details in my SOAP note.”

        “Finally, using the information I collected about the family’s preferences and LD’s medical history, I will draft the chief complaint, rationale for treatment, goals of therapy, and eventually a completed plan. The plan will include which treatment I recommend along with the dose, frequency, and which adverse effects are most common. I will write when I recommend a follow-up with her endocrinologist and make note of which lifestyle modifications may support her specific treatment. If the endocrinologist is on board, then we can collaboratively implement and follow-up with the patient as appropriate.”

        You are overjoyed to hear that your student has taken what she learned from the previous case and applied it to this case as well. Although some of the parameters were different, such as the patient’s sex, she was able to anticipate how the changes may impact her SOAP note this time. While you identify a few areas in which she can improve, you are happy that she is continuing to expand her clinical pharmacy knowledge.

        Conclusion

        The PPCP model can be applied to any healthcare setting in which pharmacists practice. This comprehensive approach to patient-centered care has established a streamlined method of documenting patient information to be shared among healthcare teams. As the PPCP continues to grow in clinical settings, practicing pharmacists should become familiar with its methods and applications.

        Pharmacist Post Test (for viewing only)

        Prepping Pharmacist Preceptors on the Pharmacists’ Patient Care Process (PPCP)
        Post-test
        Learning Objectives
        After completing this continuing education activity, preceptor-pharmacist will be able to
        • Describe the PPCP model and its uses
        • Apply the PPCP when students address clinical problems in the workplace
        • Identify areas where pharmacy students need the most guidance when using the PPCP
        POST TEST
        1. Which of the following correctly lists the steps of the PPCP process in order?
        A. Collect, plan, assess, follow-up, implement
        B. Collect, assess, plan, implement, follow-up
        C. Plan, collect, assess, follow-up, implement
        2. Which of the following best describes the JCPP’s reason for developing the PPCP?
        A. To establish a more efficient method of medical documentation
        B. To provide an opportunity for pharmacists to expand their clinical role
        C. To create a reproducible method of managing patient medications

        3. Which of the following examples is a common error pharmacy students make when using the PPCP?
        A. Avoiding discussion involving uncomfortable topics such as those sexual in nature
        B. Spending too long counseling the patient as opposed to documenting the SOAP note
        C. Omitting recommendations to follow up with the patient’s primary care provider
        4. Which of the following is a common source of error with the PPCP?
        A. Using a single clinical guideline for recommendations
        B. Spending the most time documenting the assessment section
        C. Cross-referencing medication lists against too many sources
        5. A nurse practitioner calls your clinic and would like you and your student to work up a patient with stage II hypertension. The patient is a 64-year-old African American male who is currently taking amlodipine 2.5 mg and chlorthalidone 6.25 mg. His blood pressure was 150/90 mmHg at his last doctors appointment. Which of the following would be an appropriate first step?
        A. Increase the dose of his medications. The SOAP note does not need to be performed as his blood pressure remains elevated due to subtherapeutic dosing.
        B. Ask the patient about his/her medication adherence recently. This information will dictate how you decide to approach the patient.
        C. Contact the patient’s local pharmacy for a complete list of active medications. This will be valuable information to collect prior to assessing the patient.
        6. A student working on a SOAP note cites a 2012 guideline from Europe. The preceptor notices the student forgets to consider a first-line treatment option that was approved in 2022. What should the preceptor do at this point?
        A. Call the physician to get his/her opinion on the newly approved medication
        B. Discuss the importance of citing multiple sources with the student
        C. When the student finishes the note, add in the missing information
        7. Laboratory values belong under which of the following sections of the PPCP?
        A. Assessment
        B. Objective information
        C. Subjective information
        8. Your student is counseling a patient who has dementia. When you ask him to practice how he would counsel the patient, he looks puzzled and asks “What for? He has dementia and he won’t understand anyway.” How do you proceed?
        A. Ask the student to find guidelines on how to determine when and how dementia patients should be counseled.
        B. Tell him it was a trick question and that he is correct that dementia patients should never be counseled.
        C. Explain pharmacists are legally required to offer counseling and he should be prepared if the patient requests it.
        9. A preceptor and student are working in an ambulatory care clinic. A patient presents to the counter and says she has been experiencing terrible adverse effects from one of her medications. The patient places a bottle of sertraline on the counter. She believes this is the medication causing her persistent insomnia. After talking with the doctor, she has switched to taking it in the morning, but she claims it does not help. How should the preceptor advise the student to continue?
        A. Advise the student to counsel the patient on ways to manage this adverse effect of sertraline. The student may consult the monograph or other recent guidelines.
        B. Remind the student that persistent insomnia is a flag to contact the provider. The psychiatrist can handle this as it isn’t in the scope of the preceptor’s practice.
        C. Advise the student to start by evaluating the patient’s past medical history and evaluating her medications before sending her back to see her doctor.
        10. A general practitioner refers a patient with mild asthma to your clinic. He has recommended the patient to start SMART therapy and would like you to supply your recommendations through a SOAP note. Under your supervision, the student finishes collecting the necessary objective and subjective information and has begun a draft of the assessment as follows:
        “The patient needs medication therapy for an untreated indication. According to the GINA guidelines, the patient should initiate a low dose inhaled corticosteroid plus a long-acting beta agonist combination in low doses as needed.”
        Which of the following best describes the feedback the preceptor should give the student when applying the PPCP model?
        A. The student has done a good job so far. However, the assessment should also consider patient concerns such as insurance coverage.
        B. The student has done a good job so far. The student should provide specific doses and monitoring parameters for completeness.
        C. The student has done a good job so far. The student should call the provider to check if they follow the GINA guidelines, and if not, why.

        References

        Full List of References

        References

           
          REFERENCES
          1. Joint Commission of Pharmacy Practitioners. Pharmacists’ Patient Care Process. Published May 29, 2014. Accessed June 21, 2023. https://jcpp.net/patient-care-process/
          2. Cooley J, Lee J. Implementing the Pharmacists' Patient Care Process at a Public Pharmacy School. Am J Pharm Educ. 2018;82(2):6301. doi:10.5688/ajpe6301
          3. Podder V, Lew V, Ghassemzadeh S. SOAP Notes. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 January. https://www.ncbi.nlm.nih.gov/books/NBK482263/
          4. Takemura Y, Sakurai Y, Yokoya S, et al. Open-ended questions: are they really beneficial for gathering medical information from patients?. Tohoku J Exp Med. 2005;206(2):151-154. doi:10.1620/tjem.206.151
          5. Taub S. Learning to Decide: Involving Children in their Health Care Decisions. Virtual Mentor. 2003;5(8): virtualmentor.2003.5.8. pfor3-0308. Published 2003 Aug 1. doi: 10.1001/virtualmentor.2003.5.8.pfor3-0308
          6. Elnicki DM. Learning with emotion: which emotions and learning what?. Acad Med. 2010;85(7):1111. doi:10.1097/ACM.0b013e3181e20205
          7. Fuqua JS. Treatment and outcomes of precocious puberty: an update. J Clin Endocrinol Metab. 2013;98(6):2198-2207. doi:10.1210/jc.2013-1024
          8. Bangalore Krishna K, Fuqua JS, Rogol AD, et al. Use of Gonadotropin-Releasing Hormone Analogs in Children: Update by an International Consortium. Horm Res Paediatr. 2019;91(6):357-372. doi:10.1159/000501336
          9. Lexicomp. Wolters Kluwer Health, Inc. Updated June 20, 2023. Accessed June 21, 2023. https://online-lexi-com.ezproxy.lib.uconn.edu/lco/action/doc/retrieve/docid/pdh_f/129683?cesid=afdPrd0aazi&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dleuprolide%26t%3Dname%26acs%3Dfalse%26acq%3Dleuprolide#rfs
          10. Lexicomp. Wolters Kluwer Health, Inc. Updated June 6, 2023. Accessed June 21, 2023. https://online-lexi-com.ezproxy.lib.uconn.edu/lco/action/doc/retrieve/docid/pdh_f/128793?cesid=4Ds6TlNfgKm&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dhistrelin%26t%3Dname%26acs%3Dfalse%26acq%3Dhistrelin
          11. Supprelin LA (Histrelin) Subcutaneous Implant Procedure. Children’s Hospital of Philidelphia. Published May 4, 2021. Accessed June 21, 2023. https://www.chop.edu/treatments/supprelin-la-histrelin-subcutaneous-implant-procedure
          12. Kaplowitz P, Hoffman, R. Precocious Puberty Medication. Medscape. Updated January 24, 2022. Accessed June 21, 2023. https://emedicine.medscape.com/article/924002-medication
          13. Harris IM, Phillips B, Boyce E, et al. Clinical pharmacy should adopt a consistent process of direct patient care. Pharmacotherapy. 2014;34(8):e133-e148. doi:10.1002/phar.1459
          14. Silverman LA, Han X, Huang H, Near AM, Hu Y. Clinical characteristics and treatment patterns with histrelin acetate subcutaneous implants vs. leuprolide injections in children with precocious puberty: a real-world study using a US claims database. J Pediatr Endocrinol Metab. 2021;34(8):961-969. Published 2021 Jun 21. doi:10.1515/jpem-2020-0721

          What in the World: A Global Look at Healthcare and Drugs-RECORDED WEBINAR

          About this Course

          This course is a recorded (home study version) of the CE Finale Encore Webinars.

           

          Learning Objectives

          Upon completion of this application based CE Activity, a pharmacist will be able to:

          1.       Describe the key components of global healthcare systems
          2.       Discuss the performance indicators of global health systems
          3.       Compare pharmaceutical drug spending levels and trends globally
          4.       Define medical tourism and analyze its associated risks and benefits

          Release and Expiration Dates

          Released:  December 16, 2022
          Expires:  December 16, 2025

          Course Fee

          $17 Pharmacist

          ACPE UAN

          0009-0000-22-055-H04-P

          Session Code

          22RW55-CBA96

          Accreditation Hours

          1.0 hours of CE

          Additional Information

           

          How to Complete Evaluation:  When you are ready to submit quiz answers, go to the BLUE take test/evaluation button.

          Accreditation Statement

          The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

          Pharmacists and Pharmacy Technicians are eligible to participate in this application-based activity and will receive up to 1.0 CE Hours (or 0.1 CEUs)  for completing the activity ACPE UAN 0009-0000-22-055-H04-P, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.

          Grant Funding

          There is no grant funding for this activity.

          Faculty

          Bisni Narayanan, PharmD
          Outpatient Pharmacy Services
          Yale New Haven Health System
          Pharmacy Supervisor- Operations
          Hamden, CT

          Faculty Disclosure

          In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

          • Dr. Narayanan has no relationships with ineligible companies

          Disclaimer

          The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

          Content

          Post Test

          World Health Post Test – CE Finale

          After completing this continuing education activity, pharmacists will be able to
          1. Describe the key components of global healthcare systems
          2. Discuss the performance indicators of global health systems
          3. Compare pharmaceutical drug spending levels and trends globally
          4. Define medical tourism and analyze its associated risks and benefits

          Which of the following are key components in global health systems?

          a. Wait times, patient satisfaction, propensity to result in personal bankruptcy, number of healthcare professionals employed, accreditation

          b. Type of ownership (public vs. private), patient’s financial obligations, extent of coverage (e.g., preventive, inpatient, outpatient care, etc.)

          c. Antibiotic resistance, risk of exposure to blood borne diseases, long distance travel, exposure to unusual infections

          What is a common problem encountered in the universal payer model that is frequently used as a performance measure?

          a. High out of pocket cost of care

          b. Long wait times

          c. Higher mortality rates

          In comparison to other high-income countries, where does the U.S system’s administrative efficiency rank?

          a. 9th

          b. 10th

          c. 11th

          A student under your supervision is filling a prescription for a newly approved drug. She asks if it is a biologic and you say no, it is a drug (also called a small molecule) and explain the difference between a drug and a biologic, most of which are specialty medications. She says that she heard that long patent lives on innovative drugs fuel pharmaceutical drug spending. What do you tell her?

          a. “You are incorrect. The largest contributor to increased spending for pharmaceuticals is specialty medications”

          b. “You are incorrect. The largest contributor to increased spending for pharmaceuticals is COVID-19 therapeutics.”

          c. “You are incorrect. The largest contributor to increased spending for pharmaceuticals is over the counter medications.”

          Handouts

          VIDEO

          Anticoagulation Management Pearls

          About this Course

          UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

          The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

          When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

          Target Audience

          Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

          This activity is NOT accredited for technicians.

          Pharmacist Learning Objectives

          At the end of this knowledge-based continuing education activity, the learner will be able to:

          1. Describe effective anticoagulation management strategies.
          2. Describe components of effective anticoagulation education session.
          3. Identify barriers to learning.

          Release Date

          Released:  06/01/2022
          Expires:  05/31/2025

          Course Fee

          $17

          ACPE UAN Code

          ACPE #0009-0000-22-026-H04-P

          Session Code

          22AC26-EXW48

          Accreditation Hours

          1.0 hours of CE

          Bundle Options

          If desired, “bundle” pricing can be obtained by registering for the activities in groups. This series consists of thirteen anticoagulation activities in our online selection.

          You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

          Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

          In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

          Additional Information

          Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

          The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

          More Information About Traineeship

          Accreditation Statement

          ACPE logo

          The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit 1.0 hours (or 0.1 CEUS) for the online activity ACPE #0009-0000-22-026-H04-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

          Grant Funding

          There is no grant funding for this activity.

          Requirements for Successful Completion

          To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

          Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

          Faculty

          Anuja Rizal, Pharm.D., RPh, CACP
          Anticoagulation Clinical Coordinator
          UConn Health Center
          Farmington, CT

          Faculty Disclosure

          In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

          Dr. Rizal has no relationship with an ineligible company and therefore has nothing to disclose.

          Disclaimer

          This activity may contain discussion of off label/unapproved use of drugs. The content and views presented in this educational program are those of the faculty and do not necessarily represent those of the University of Connecticut School of Pharmacy. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

          Program Content

          Program Handouts

          Post Test Evaluation

          View Questions for Anticoagulation Management Pearls

          1. The Joint Commission revised National Patient Safety Goal is intended to:

          1. Ensure all providers are providing same level of care
          2. Set standards on provider’s level of knowledge of anticoagulant medications
          3. Reduce the likelihood of patient harm associated with the use of anticoagulant therapy
          4. Provide guidance on how to deal with providers who do not adhere to the standards
          5. None of the above

           

          2. Which of the following are important Anticoagulation Management Considerations?

          1. Assessing pt’s fall risk
          2. Patient Education and Adherence
          3. Selecting appropriate drug
          4. All of the above
          5. None of the above

           

          3. Staff education should consist of:

          1. Professionalism in the workplace
          2. Strategies to manage difficult coworkers
          3. Diversity training
          4. Effective time management strategies
          5. How to delegate

           

          4. Which of the strategies is best when managing patients with language barriers?

          1. Ask pt. to bring in family members who can help interpret
          2. Ask pt. to bring in friend who can help interpret
          3. Ask bilingual coworker to help interpret
          4. Use google translate
          5. Use qualified interpreter

           

          5. When speaking to deaf patients it is important to:

          1. Make indirect contact to avoid conveying incorrect tone/meaning thru facial expressions
          2. Speak slowly and clearly
          3. Learn ASL
          4. Use Visual Aids
          5. Repeat instructions

           

          6. Which of the following statements are false?

          1. Using pamphlets or videos will enhance learning for the Visual learners
          2. A person can only have one learning style
          3. It is important to tailor the education to meet the pt’s learning style
          4. Kinesthetic learners learn best by gaining hands on experience
          5. Asking pt’s to repeat your points back to you by asking questions and calling for audience answers enhances learning for the Auditory learner

           

          7. The best strategy to manage the non-compliant patient is to:

          1. Identify and address barriers to adherence
          2. Use motivational interviewing
          3. Minimize polypharmacy
          4. Utilize available family and social support
          5. All of the above

           

          8. Select the most appropriate response:

          1. Medicare codes 99495 and 99496 are reimbursable for transitional of care services
          2. Transition of care addresses patients moving from one state to another
          3. Transition of care is handled solely by hospital staff
          4. Provide transition of care assistance to elderly patients who request it
          5. None of the above

           

          9. Select the most appropriate response:

          1. Americans have been reported to have high health care literacy
          2. Low health care literacy can be managed by ensuring patients learn how to speak English
          3. Using interpreters can help combat low health care literacy
          4. Low health care literacy indicates cognitive decline
          5. None of the above

           

          10. AIDET stands for:

          1. Acknowledge, Introduce, Duration, Explanation, Train
          2. Acknowledge, Inform, Duration, Explanation, Train
          3. Acquaint, Inform, Describe, Extent, Teach
          4. Acknowledge, Introduce, Duration, Explanation, Thank you
          5. Acquaint, Introduce, Describe, Extent, Teach

          Developing an Anticoagulation Clinic

          About this Course

          UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

          The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

          When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

          Target Audience

          Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

          This activity is NOT accredited for technicians.

          Pharmacist Learning Objectives

          At the end of this knowledge-based continuing education activity, the learner will be able to:

          1. Discuss the benefits of establishing an anticoagulation clinic.
          2. List the steps required to establish and run and anticoagulation clinic.
          3. Describe the important aspects of operating an anticoagulation clinic.
          4. Describe the financial considerations of running an anticoagulation clinic.

          Release Date

          Released:  06/01/2022
          Expires:  05/31/2025

          Course Fee

          $17

          ACPE UAN Code

          ACPE #0009-0000-22-031-H04-P

          Session Code

          22AC31-YXV46

           

          Accreditation Hours

          1.0 hour of CE

          Bundle Options

          If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

          You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

          Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

          In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

          Additional Information

          Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

          The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

          More Information About Traineeship

          Accreditation Statement

          ACPE logo

          The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE ACPE #0009-0000-22-031-H04-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

          Grant Funding

          There is no grant funding for this activity.

          Requirements for Successful Completion

          To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

          Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

          Faculty

          Anuja Rizal, Pharm.D., RPh, CACP
          Anticoagulation Clinical Coordinator
          University of Connecticut Health Center
          Farmington, CT

          Faculty Disclosure

          In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

          Dr. Rizal has no relationship with an ineligible company and therefore has nothing to disclose.

          Disclaimer

          The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

          Program Content

          Program Handouts

          Post Test Evaluation

          View Questions for Developing an Anticoagulation Clinic

          1) Which of the following is not an advantage of having an Anticoagulation Clinic?
          a) Improved patient communication and follow up
          b) Improved TTR ad better clinical outcomes
          c) Consistent dosing and monitoring
          d) Formalized patient education
          e) None of the above

          2) What characteristics are essential when selecting an Anticoagulation Clinic Medical Director?
          a. Extensive anticoagulation knowledge base
          b. Approachable and available
          c. Helps achieve goals of the clinic
          d. Strong advocate for the clinic
          e. All of the above

          3) What is an Anticoagulation Clinic’s primary goal?
          a. Optimize safety and efficacy
          b. Improve efficiency
          c. Provide cost effective care
          d. Improve pt. satisfaction

          4) Which of the following is an advantage of a Pharmacist run Anticoagulation Clinic?
          a) Able to draw venous samples
          b) Autonomy in both dosing and billing
          c) Extensive knowledge of warfarin’s pharmacokinetic and pharmacodynamic properties
          d) Able to assess vital signs

          5) What are the requirements of having a collaborative practice agreement run Anticoagulation Clinic?
          a. Pharmacists are required to submit minimum monthly therapeutic summaries
          b. Pharmacists may only enter into collaborative practice agreement with prescribers permissible under state law
          c. The physician must have an established relationship with patient
          d. The collaborative practice agreement needs to be renewed yearly for each patient
          e. All of the above

          6) What are ongoing costs of running an Anticoagulation Clinic?
          a) Printer
          b) Personnel salaries
          c) Office furniture
          d) Fax
          e) Scanner

          7) Which of the following clinic tasks MUST be performed by a pharmacist?
          a. Schedule patient appointments in the clinic for initial visit, follow up INR visits and education visits
          b. Interpret INR results by assessing patient specific factors and adjust warfarin dose as needed
          c. Order supplies
          d. Retrieve INR results either from an outside laboratory
          e. Identify past due INR patients and address as per policies and procedures

          8) What are the characteristics of an ideal anticoagulation software program?
          a. Data integrity
          b. IT support after clinic hours
          c. Ability to trend data for individual patient
          d. A and C

          9) Anticoagulation clinic staff training should:
          a. Be documented
          b. Be provided in an appropriate learning environment
          c. Involve real world situations
          d. All of the above

          10) What characteristics should you look for when selecting an anticoagulation clinic support staff?
          a. Strong interpersonal skills
          b. Strong computer and data entry skills
          c. Previous anticoagulation knowledge
          d. A & B

          Pharmacist Reimbursement for Anticoagulation Services

          About this Course

          UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

          The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

          When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

          Target Audience

          Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

          This activity is NOT accredited for technicians.

          Pharmacist Learning Objectives

          At the end of this application-based continuing education activity, the learner will be able to:

          1. Identify the reimbursement issues with a pharmacist-run anticoagulation service or clinic.
          2. Describe the process for billing for anticoagulation services.
          3. Identify challenges and obstacles for reimbursement issues for anticoagulation services.
          4. Discuss solutions to the challenges of reimbursement for pharmacist-run anticoagulation services.

          Release Date

          Released:  06/01/2022
          Expires:  05/31/2025

          Course Fee

          $8.50

          ACPE UAN Code

          ACPE #0009-0000-22-032-H04-P

          Session Code

          22AC32-XZY77

          Accreditation Hours

          0.5 hours of CE

          Bundle Options

          If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

          You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

          Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

          In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

          Additional Information

          Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

          The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

          More Information About Traineeship

          Accreditation Statement

          ACPE logo

          The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ADD ACPE ACPE #0009-0000-22-032-H04-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

          Grant Funding

          There is no grant funding for this activity.

          Requirements for Successful Completion

          To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

          Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

          Faculty

          Michael Smith, Pharm.D., BCPS, CACP,
          East Region Clinical Manager
          Pharmacy Hartford Healthcare
          William W. Backus Hospital
          Norwich, CT

          Faculty Disclosure

          In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

          Dr. Smith has no relationship with an ineligible company and therefore has nothing to disclose.

          Disclaimer

          The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

          Program Content

          Program Handouts

          Post Test Evaluation

          View Questions for Pharmacist Reimbursement for Anticoagulation Services

          1. Pharmacist, as recognized providers, can directly bill Medicare for services

          1. True
          2. False

           

          2. Medicare can be billed for:

          1. Evaluation and management of an INR level
          2. Performing a finger-stick POC INR test
          3. Calling a patient to report their results
          4. A and B

           

          3. The level of service for a clinic visit for HOPPS billing is

          1. Set to the same guidelines for “incident to billing”
          2. Set by institution policy
          3. Arbitrary
          4. Must be code “99211”

           

          4. Physician supervision rules:

          1. are the same for both on and off-campus clinic sites
          2. pertain only to “incident to” billing
          3. May be satisfied by having an advanced practice nurse on site
          4. Increase the allowable billing level when they are followed

           

          5. A point-of-care INR test:

          1. Can be billed separately as a lab procedure
          2. Must be performed by a lab technician in order to be billed
          3. Are not considered valid by Medicare
          4. Are not covered

          Risk Management in Anticoagulation

          About this Course

          UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

          The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

          When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

          Target Audience

          Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

          This activity is NOT accredited for technicians.

          Pharmacist Learning Objectives

          At the end of this knowledge-based continuing education activity, the learner will be able to:

          1. Discuss the education and training needs of pharmacists who participate in anticoagulation services.
          2. Discuss the documentation needs of a pharmacists-run anticoagulation service or clinic.
          3. Identify corporate infrastructure needs to support anticoagulation services or clinics.

          Release Date

          Released:  06/01/2022
          Expires:  05/31/2025

          Course Fee

          $17

          ACPE UAN

          ACPE #0009-0000-22-033-H04-P

          Session Code

          22AC33-PVX33

           

          Accreditation Hours

          1.0 hour of CE

          Bundle Options

          If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

          You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

          Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

          In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

          Additional Information

          Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

          The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

          More Information About Traineeship

          Accreditation Statement

          ACPE logo

          The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE #0009-0000-22-033-H04-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

          Grant Funding

          There is no grant funding for this activity.

          Requirements for Successful Completion

          To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

          Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

          Faculty

          Michael Smith, Pharm.D., BCPS, CACP,
          East Region Clinical Manager
          Pharmacy Hartford Healthcare
          William W. Backus Hospital
          Norwich, CT

          Faculty Disclosure

          In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

          Dr. Smith has no relationship with an ineligible company and therefore has nothing to disclose.

          Disclaimer

          The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

          Program Content

          Program Handouts

          Post Test Evaluation

          View Questions for Risk Management in Anticoagulation

          1. High quality risk management programs protect…

          1. The patient
          2. The provider
          3. The institution
          4. All of the above

           

          2. The three most important ways to reduce risk are:

          1. Education, providing a quality service, and complete documentation
          2. Physician involvement, light workload, and malpractice insurance
          3. Commercial management software, education, and malpractice insurance
          4. Providing a quality service, good customer service, and malpractice insurance

           

          3. Application, analysis and synthesis of new knowledge can best be taught through:  

          1. Lecture
          2. Reading
          3. Case presentation and practice-based learning
          4. Observation

           

          4. A high quality protocol will include:

          1. Rigid dosing guidelines
          2. Process for medication refill requests
          3. Critical value cut-offs
          4. All of the above
          5. A B and C

           

          5. It is important to document all patient interaction:

          1. True
          2. False

          6. Documentation must be recorded by using:

          1. Commercial software
          2. A quality home-grown system
          3. A paper record
          4. A or B
          5. Any medium as long as it’s complete and retrievable

           

          7. Limiting risk through risk sharing can be accomplished by

          1. Physician oversight
          2. Patient education
          3. Both A and B
          4. Risk cannot be shared between involved parties

           

          8. Adhering to institutionally approved clinic policies helps to minimize the risk of the individual practitioner

          1. True
          2. False

           

          9. Quality improvement activities:

          1. Increase risk
          2. Decrease risk
          3. Have no effect on risk

           

          10. When a pharmacist’s recommendations are reviewed and approved by a physician:

          1. The physician assumes all the risk
          2. The pharmacist still carries risk
          3. The pharmacist does not need to document
          4. The pharmacist can only bill for the lab test

          Teaching and Learning Certificate Program 2024-2027

          In this comprehensive 28.5 CPE credit activity (with an additional 3.5 hours of optional CE credit), pharmacists, preceptors and residents will learn the concepts of teaching and learning as it relates to classroom, discussion group and experiential learning. Participants may participate at any level they choose, however, a Practice-based Certificate of Achievement will be awarded to those who have completed all phases of the education.

          I learned so much and the materials learned have greatly help to improve the APPE and PGY-1 Rotations that I managed. Thank you for providing a well-informed, self-paced program that can accommodate working professionals!”  

          -Lauren C.

          University of Connecticut Faculty and Adjunct Faculty

          • For registration without CE credit:  Contact Joanne Nault (joanne.nault@uconn.edu) and provide your NetID for access to the learning management system.  For those without a NetID, please contact Judy Vigneau at  860-486-9576 and  complete the Adjunct Faculty Appointment Form and email to  Judith.vigneau@uconn.edu 
          • .You must be actively (within the last 3 years and willing to take new students) taking UConn students to register for FREE.
          • For registration with CE credit:  Visit our registration site.  After you register successfully, UCONN will send a confirmation e-mail with details concerning how to proceed.  You must be actively (within the last 3 years and willing to take new students) taking UConn students to register for half price CE.

          Target Audience

          Pharmacists, pharmacy preceptors and pharmacy residents who are interested in enhancing their skills in the area of teaching and learning.

          This activity is not accredited for technicians

          Learning Objectives

          Module 1-Teaching Basics

          Topic Faculty strong>Learning Objectives:
          Blooms taxonomy-1.5 hour Wick 1. Differentiate between higher and lower order thinking
          2. Compare and contrast old and new Bloom’s taxonomy
          3. Describe the different levels of the taxonomy
          4. Apply the taxonomy for planning lecture/activities
          Learning objectives: Beginning with the end in mind-1 hour Wick 1. Compare and contrast learning objectives and learning goals
          2. List the 3 parts of a learning objective
          3. Write learning objectives that contain a measurable verb
          4. Develop learning objectives that demonstrate higher order learning
          Understanding learning styles-1 hour Wick 1. Discuss the concept of learning style
          2. Evaluate the effectiveness of learning styles tool(s)
          3. Formulate a view on the role of learning styles
          Teaching philosophy and portfolios-1.5 hours-OPTIONAL Rickles-OPTIONAL 1. Explain the purpose of a teaching philosophy
          2. Describe the components of a philosophy
          3. Discuss the fundamental element of a teaching portfolio
          4. Describe the material from oneself and from others that are contained in a teaching portfolio
          5. Create a draft teaching portfolio
          Syllabus Creation-1 hour Salvo 1. Describe the purpose of a comprehensive syllabus
          2. List and explain the components of a syllabus
          3.  Compare and contrast the elements included in various syllabi
          4. Create or modify a course/rotation syllabus
          Writing Exam Questions-1 hour Ehret 1. Compare and contrast the difference between true/false and one-best answer type questions
          2. Construct effective stems and options for multiple choice exam questions
          3. Detect problems with poorly written test questions
          Assessments Beyond Examinations- 1.5 hour Wick 1. Explain the difference between criterion and norm-based grading
          2. Weigh pros and cons of various assessment techniques
          3. Discuss best practices for developing a rubric
          4. Develop a rubric for evaluating an active learning activity
          Designing inter-professional Education Activities-1 hour Dang 1.  List general principles, goals,and competencies of inter-professional education (IPE)
          2.  Describe opportunities and challenges in developing and implementing IPE activities
          3.  List strategies for incorporating IPE activities in the didactic or experiential environment
          Explicit Instruction-1 hour Kleven 1.  Identify the main elements of explicit instruction
          2.  Analyze a lesson plan outline using explicit instruction functions
          3.  Explore strategies for processing content

           

          Module 2-Taking Teaching into the Pharmacy

          Topic Faculty Learning Objectives
          Empowering Preceptors to Teach: Defining Roles & Responsibilities-1 hour Seo 1. Explain the importance of precepting and mentoring in professional development
          2. Define each of the 4 preceptor roles in teaching clinical problem solving (instructing, modeling, coaching, and facilitating)
          3. Determine which preceptor role would be appropriate to use to help a resident progress, given specific case examples
          Assessing your Student Pharmacists or Residents Performance Through Feedback- 1.5 hour Hritcko/Wick 1. Explain the role of the preceptor’s assessment in the overall evaluation of a student pharmacist by the school of pharmacy
          2.  Develop strategies to collect student performance data throughout the rotational experience
          3.  Identify methods to ensure that the evaluation of student pharmacists are fair, objective, and accurate
          4.  List strategies to provide constructive feedback to students who are not achieving rotational goals and objectives
          5.  Explain the for providing positive feedback to students
          6.  Demonstrate effective feedback to students
          Professional Identity-2 hour Wick/Luciano/Yazdanpanah 1.  Describe the professional identity formation process
          2.  Apply the steps to help student and pharmacists at points in their careers develop a professional identity
          3.  Identify activities that contribute to Professional Identity develop appropriately
          Conflict Management & Communication in Pharmacy Practice Experiences- 1.5 hour White 1.  Differentiate between the various types of conflict that pharmacists and/or residents confront at their practice sites
          2.  Identify common emotional and physical reactions to conflict and possible strategies to defuse the situation
          3.  Explain how to use communication skills to resolve conflicts between preceptors and students while on their pharmacy practice experiences

           

          Module 3: Stepping Up Your Game

          Topic Faculty Learning Objectives
          Active learning, tools of the trade-1 hour Kleven
          1. Define active learning.
          2. List and describe various active learning strategies
          3. Determine the best active learning strategy for a given situation.
          4. Visualize concerns about active learning.
          Effective Online Teaching & Learning- 1.25 hours Wick/Nolan 1. Recognize best practices in developing online courses
          2. Describe 5 basic elements of course development
          3. Differentiate between topics that are amenable to online teaching and those that are not
          4. List some tricks and tips for making online learning more engaging
          Integrating Pharmacy students into practice-0.75 hours Hritcko/Wick 1. Describe benefits and potential barriers to successful integration of students into pharmacy practice
          2. Recognize opportunities to integrate students that will be valuable to students, preceptors, and practice institutions
          3. Identify strategies and resources available to support pharmacy preceptors
          Patient Cases:  Discussion, Construction and Assessment-1 hour  Wheeler 1.  Discuss theory behind case-based teaching
          2.  Identify a strategy for discussing patient cases with students
          3.  List some tools that could assist students with preparation for case discussion
          4.  Explain the relationship between patient case design/discussions to Bloom’s taxonomy of learning
          5.  Identify strategies for assessing student performance

           

          Module 4: Playing with the Big Dogs (Go Huskies!)

          Topic Faculty Learning Objectives
          A Review of Introductory Statistical Concepts(OPTIONAL)-2 hours Sobieraj 1. Define a framework for the application of evidence-based medicine to clinical practice
          2. List the criteria that contribute to the quality of a trial
          3. Distinguish between categorical and continuous variables and how this impacts outcome assessment in a trial
          4. Interpret descriptive statistics in a given trial
          5. Define, interpret, and calculate a relative risk, odds ratio, relative and absolute risk, and number need to treat
          6. Use a 95% confidence interval to determine clinical and statistical significance
          7. Define type I and type II error and their impact on trial results
          Incorporating Scholarship into your Day- 1 hour Sobieraj 1. Identify research tips for various steps involved including formulation of a research question, biostatistics for researchers, working with the IRB, obtaining grant funding, and writing a manuscript
          2. Provide examples of scholarship of teaching from the classroom setting
          3. Provide examples of scholarship from the preceptor’s perspective
          Ethical issues in Authorship and Scholarship-1 hour Wick 1. Identify the ICMJE criteria for authorship
          2.  Discuss issues related to authorship criteria, student-faculty publications, and duplicate publications
          3. Develop personal approaches for handling authorship criteria, author order, student-faculty publications, and duplicate publication cases
          Clinical Teaching Venues:
          Applying Pedagogy in a Big Wide World- 1.5 hours
          White 1. Compare and contrast the roles and responsibilities of full time tenure track and non-tenure track faculty
          2. Describe the advantages of being an adjunctive instructor of students and residents
          3. Describe how to apply teaching skills to various settings
          4. Describe how to gauge feedback aside from student evaluations of teaching
          Continuing Professional Development-1 hour Nault 1. Explain the concept of Continuing Professional Development (CPD)
          2. Outline the steps involved in the CPD process
          3. Prepare an individualized CPD plan
          ACPE Continuing Education Standards:  How to plan and deliver an exceptional activity- 1 hour Fitzgerald 1. Describe the ACPE standards for continuing pharmacy education
          2. Explain the components of a needs assessment
          3. Identify ways to measure outcomes from continuing education
           Teaching Example-1 hour  CE Participant 1. Prepare a presentation using teaching and learning concepts
          2. Deliver a presentation using teaching and learning concepts

           

          Activity Faculty

          Devra Dang, PharmD, BCPS, CDE
          Associate Clinical Professor, University of Connecticut, School of Pharmacy, Storrs, CT

          Megan Ehret , PharmD, MS, BCPP
          Associate Professor, University of Maryland, School of Pharmacy
          Baltimore, MD

          Jill Fitzgerald, PharmD
          Director, Experiential Learning and Continuing Professional Development and Associate Clinical Professor
          University of Connecticut, School of Pharmacy, Storrs, CT

          Philip Hritcko, PharmD, CACP
          Dean, School of Pharmacy
          University of Connecticut School of Pharmacy, Storrs, CT

          Nathaniel Rickles, PharmD, PhD, BCPP
          Associate Professor of Pharmacy Practice
          University of Connecticut School of Pharmacy, Storrs, CT

          Marissa Salvo, PharmD, BCACP
          Associate Clinical Professor Pharmacy Practice,
          University of Connecticut School of Pharmacy, Storrs, CT

          Teresa Seo, PharmD, BCPS, FASHP
          Department of Pharmacy Services
          UConn Health – John Dempsey Hospital
          Farmington, CT

          Diana Sobieraj, PharmD
          Assistant Professor, Senior Research Scientist and Program Manager
          University of Connecticut School of Pharmacy/Hartford Hospital Evidence-based Practice Center, Hartford, CT

          Kathryn Wheeler, PharmD, BCPS
          Associate Dean of Academic Affairs
          Associate Clinical Professor of Pharmacy Practice
          University of Connecticut School of Pharmacy, Storrs, CT   

          C. Michael White, PharmD, FCCP, FCP
          Department Head and Professor
          University of Connecticut School of Pharmacy, Storrs, CT

          Jeannette Y. Wick, RPh, MBA
          Assistant Director, Office of Pharmacy Professional Development and Visiting Instructor,
          University of Connecticut School of Pharmacy, Storrs, CT

          Heather Kleven

          Joanne Nault

          Laura Nolan

           

          Faculty Disclosure

          In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

          None of the above listed faculty have actual or potential conflicts of interest associated with this presentation.

          Acitivity Fees

          General Registration–  $359.00

          University of Connecticut Faculty and Adjunct Faculty – Free of charge without continuing education credit; or for $179.50 (50% group discount) continuing education credit.

          • For registration without CE credit:  Contact Joanne Nault  (joanne.nault@uconn.edu) and provide your net ID for access to the learning management system.  For those without a NetID, please contact Judith Vigneau (judith.vigneau@uconn.edu) complete the Adjunct Faculty Appointment Form.pdf and email to Judith Vigneau (judith.vigneau@uconn.edu)
          • For registration with CE credit:  Register using Registration Button above. Once registered a confirmation email with further details will be sent.

          Grant Funding

          There is no grant funding for this activity.

          Requirements for Successful Completion

          For those wishing to receive CE Credit and ACPE Teaching Certificate of Achievement:

          •  Complete all of the required online modules and participate in the activities, including an evaluation of each activity within the huskyct system.
          • Prepare and deliver a “teaching experience”
          • Complete and send in the Verification of Participation form found on the HuskyCT site, and submit to Joanne Nault
          • Once all of the activities have been completed, Visit our online CE Center at https://pharmacyce.uconn.edu/login.php and complete the course evaluation to have your CE credits uploaded to the CPE Monitor system

          For those wishing to receive UConn School of Pharmacy Teaching Certificate of Completion (no CE Credit):

          • Complete all of the required online modules and participate in the activities
          • Complete the evaluation forms found under each activity on the HuskyCT site
          • Prepare and deliver a “teaching experience”
          • Complete and send in to Joanne Nault the Verification of Participation form found on the HuskyCT site

          ACPE logo

          The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Twenty-eight and one half contact hours (2.85 CEU’s) will be awarded to pharmacists who view the presentations, participate in the activities and complete the evaluations, and deliver their teaching example. Statements of credit for 0009-0000-24-030-H04-P, will be sent to CPE Monitor and can be printed from your CPE Monitor Profile. A Certificate of Achievement will be sent to those who complete all activities, evaluations and submit a complete Verification of Participation Form. Upon successful completion of the optional activities  ACPE UAN 0009-0000-21-035-H04-P,  and ACPE UAN 0009-0000-21-036-H04-P we will award 1.5 contact hours (0.15 CEU’s) and 2.0 contact hours (0.20 CEU’s), respectively.

          Initial release date:  July 15, 2024
          Planned expiration date:  July 15, 2027

          Disclaimer:
          The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

          UConn Medical Writing Certificate

          Emblem saying one of the best writing classes in Reedsy's 2023 class

           

          In this comprehensive 30.5 hour CPE credit activity, pharmacists, and pharmacy technicians (and any other interested healthcare providers) will learn the concepts and mechanics of medical writing from continuing education activities to policy writing to medical marketing.  A Practice-based Certificate of Achievement will be awarded to those who have completed the pre-requisites and all phases of this practice-based certificate program 0009-0000-20-076-B04-P and 0009-0000-20-076-B04-T.

          Learning Objectives for Pharmacists and Technicians:
          At the completion of this activity, the participant will be able to:

          • Demonstrate the ability to apply the principles of good writing to common documents used in pharmacy, medicine, regulatory writing

          • List specific approaches needed for various types of medical writing

          • Write a variety of documents pertaining to medicine and pharmacy, including continuing education activities, slide kits, and scholarly works

          • Assemble a portfolio of writing pieces that demonstrate the learner’s areas of expertise

          See below to see all of the activities and their  learning objectives

          To Register Click on Orange Registration Button above

          Activity Learning Objectives Number of Credit Hours
           Introduction to Medical Writing 0
          1. Fundamentals of Writing -List the principles of good writing
          -Recognize common errors in one’s own and others’ writing
          -Apply Plain Language Guidelines
          -Analyze writing samples for error, readability, and flow
          3
          2. References and Libraries -Compare and contrast reference types
          -Select appropriate references
          -Identify copyright infringement pitfalls and how to avoid them
          -Compose AMA citations for common reference types
          2
          3.  Working with Clients -Describe clients’ typical expectations from medical writers
          -List the necessary components in an LOA or contract
          -Contrast clients expectations with one’s own strengths and limitations
          -Complete an analysis of one’s readiness to pursue medical writing
          0.75
          4.  Developing Visuals

          -Discuss when it may be appropriate to add visual aids into your writing
          -List the basic components needed for constructing tables and figures
          -Given information, construct a suitable table or figure
          1
          5. Scholarly Works -Outline the various types of scholarly publications
          -Recall the key sections of scholarly manuscripts
          -Identify and consult journal specific “Authors’ Guide” throughout the writing process
          -Demonstrate ability to effectively peer review a manuscript
           

          2

          6. Continuing Pharmacy & Medical Education -Discuss the purpose of quality continuing education
          -Describe the elements of a good needs assessment proposal to obtain funding for continuing education
          -Recognize the medical writer’s role in continuing education development
          -Produce a 1200 word document with two learning objectives and three post-test questions that incorporates the principles taught here
           

          2

          7.  Short Pieces & Educational Materials

          -Recall available  educational media platforms
          -Select a media platform tailored towards a specific audience
          -Describe the essential components of patient education brochures and professional posters
          -Evaluate the effectiveness of circulating patient education brochures and professional posters
          2
          8. Powerful Presentations -Identify the techniques necessary to create engaging presentations
          -Demonstrate the ability to construct slide decks and graph inserts properly
          -Differentiate high quality presentations from low quality presentations
           

          2

          9. Communication -Describe informative, succinct, and professional correspondence with attention to protected health information
          -Format professional documents of all types
          -Recall the elements of a concise invoice
          -Dissect customer complaints
           

          0.75

          10. Research Documents -Identify  the purpose  of the various research documents
          -List the different  types of writing styles
          -Demonstrate the ability  to reference relevant resources
           

          2

          11. Regulatory Writing -Describe  the purpose  of regulatory writing and its importance
          -Identify regulatory documents  required for target products  at various development stages
          -Use regulatory guidance to format and create proper documents
          -Define the internal review process
          1
          12. Medical Marketing of Healthcare Products -List the ways in which writing for medical marketing projects differs from other types of writing
          -Recall regulations that govern medical marketing
          -Identify requirements that most pharmaceutical companies insist upon
           

          1

          13. Finding Employment -List three ways to begin a search for medical writing jobs
          -Identify companies (or types of companies) that hire medical writers
          -Match your interests and abilities to suitable medical writing jobs
           

          0.5

          14. Policy Writing

          -Define Standard Operating Procedure
          -Describe the components of the SCP document
          -Discuss the format and writing style
          0.5
          Submission of Writing Example (Final Project) To complete the UConn Medical Writing Certificate Program, participants must produce a final project of approximately 5500 to 6000 word. Each participant will select a final project in collaboration with a UConn Medical Writing Certificate Program faculty member. The participant and the faculty members will select the type of assignment (e.g., needs assessment, continuing education activity homestudy, manuscript for submission to a journal), agree on a formal outline, and establish deadlines for draft and revision submissions. 10

           

          Activity Faculty

          Kelsey Giara, PharmD
          Medical Writer
          Pelham, NH

          Kelsey Fontneau Maytas, PharmD
          CVS Pharmacy Manager
          Shelton, CT

          Sara Miller, PharmD
          CVS Pharmacist
          Franklin, MA

          Bisni Narayanan, PharmD
          Specialty Clinical Pharmacist
          Yale New Haven Health
          Hamden, CT

          Stefanie Nigro, PharmD, BCACP, BC-ADM
          Associate Clinical Professor
          UConn School of Pharmacy
          Storrs, CT

          Paul Staffieri, PharmD
          Clinical Manager
          The Mount Sinai Hospital
          New York, NY

          Angela Su
          PharmD Candidate 2024
          University of Connecticut School of Pharmacy
          Storrs, CT

          Conner Walker, PharmD
          Medical Writer
          WriteAngle, Inc.
          Torrington, CT

          Jeannette Y. Wick, RPh, MBA
          Director, Office of Pharmacy Professional Development and Visiting Instructor,
          University of Connecticut School of Pharmacy, Storrs, CT

           

          Faculty Disclosure

          In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

          None of the above listed faculty have a relationship with ineligible companies.

           

          Acitivity Fees

          General Registration– $1999.00

          • Register above using the Orange Registration Button.  Once registered a confirmation email with further details will be sent

          Grant Funding

          There is no grant funding for this activity.

          Requirements for Successful Completion

          For those wishing to receive CE Credit and ACPE Certificate of Achievement:

          • Complete all of the required online modules and participate in the activities, including an evaluation of each activity within the HuskyCT system.
          • Prepare and submit a “writing example”
          • Complete and send in the Verification of Participation form found on the HuskyCT site, and submit to Joanne Nault
          • Once all of the activities are complete, visit our online CE Center at https://pharmacyce.uconn.edu/login.php and complete the course evaluation to have your CE credits uploaded to the CPE Monitor system

            ACPE logoThe University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Thirty and one half contact hours (3.05 CEU’s) will be awarded to pharmacists and pharmacy technicians who view the presentations, participate in the activities and complete the assignments and evaluations, and deliver their final submission. Statements of credit for ACPE UAN 0009-0000-23-057-B04-P/T will be automatically sent to CPE Monitor and can be printed from your CPE Monitor Profile. A Certificate of Achievement will be sent to those who complete all activities, evaluations and submit a complete Verification of Participation Form.

            Initial release date:  December 1, 2023
            Planned expiration date:  November 30, 2026

            Disclaimer:
            The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

            Teaching Philosophy and Portfolios (Optional)

            Learning Objectives:

            1. Explain the purpose of a teaching philosophy
            2. Describe the components of a philosophy
            3. Discuss the fundamental element of a teaching portfolio
            4. Describe the material from oneself and from others that are contained in a teaching portfolio
              Create a draft teaching portfolio

            Activity Faculty

            Nathaniel Rickles, PharmD, PhD, BCPP
            Associate Professor of Pharmacy Practice
            University of Connecticut School of Pharmacy, Storrs, CT

            Faculty Disclosure

            In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

            Dr. Rickles does not have any relationship with an ineligible company.

            Activity Fees

            This activity costs $15

            Grant Funding

            There is no grant funding for this activity.

            Requirements for Successful Completion

            ACPE LogoThe University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. One and one half contact hours (0.15 CEU’s) will be awarded to pharmacists who view the presentation, and pass a post test with a 70% or better.  Statements of credit for 0009-0000-21-035-H04-P, will be sent to CPE Monitor and can be printed from your CPE Monitor Profile.

            Initial release date:  July 15, 2021
            Planned expiration date:  July 15, 2024

            Disclaimer:
            The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.