P4 Experiential Learning Activity Log

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P4 Experiential Learning Activity Log
Core Requirements Documentation
Student Name:
Experiential Learning Site:
Rotation Start Date:
Preceptor: For each assignment, please initial to indicate whether it was completed or not. If unable to complete, please indicate why.
See rotation syllabus if more detailed explanation of assignments required.
Assignment
Reason not completed (ex.- site
Completed
did not offer opportunity, etc)
AMBULATORY CARE ROTATIONS ONLY
Complete 4 patient care notes/week (total 20/rotation). Provide detailed written SOAP note for 4 of these cases (1 per week).
Document on PITT Form 40 drug related problems with patient-specific solutions.
Complete and present 1 formal and 1 informal case presentation.
Provide drug information responses, including references, to 3 drug information requests.
Perform medication counseling for 20 patients and provide written summaries for 4 of these.
Optional – See syllabus for additional assignments if available at site.
ACUTE CARE ROTATIONS ONLY
Maintain daily monitoring forms for 25 patient days.
Complete and present 1 formal and 3 informal case presentations.
Document on PITT Form 40 drug related problems with patient-specific solutions.
Provide drug information responses, including references, to 3 drug information requests.
Attend 1 interdisciplinary meeting and provide written summary of what was discussed.
Optional – See syllabus for additional assignments if available at site.
INSTITUTIONAL PHARMACY PRACTICE ROTATIONS ONLY
Complete and present 1 formal and 1 informal case presentation.
Prepare 1 written adverse drug reaction and 1 written medication error report or investigation.
Document on PITT Form 25 drug-related problems or patient-centered encounters/interventions.
Maintain a log of 15 intravenous products prepared using sterile technique.
Provide drug information responses, including references, to 3 drug information requests.
Attend 1 interdisciplinary meeting and provide written summary of what was discussed.
Discuss drug distribution process with preceptor.
Discuss the role of the pharmacist in medication safety with preceptor.
Optional – See syllabus for additional assignments if available at site.
COMMUNITY PHARMACY ROTATIONS ONLY
Document on PITT Form 20 prescription counseling experiences provided to patients.
Document on PITT Form 20 OTC counseling experiences via brief SOAP notes.
Discuss with preceptor pharmacy procedures to assess prescriptions for appropriateness.
Discuss with preceptor pharmacy procedures for inventory management.
Discuss with preceptor controlled substance management including security and record keeping.
Discuss with preceptor procedures to handle medication errors, expired medications, and hazardous substances.
Fill 250 prescriptions.
Optional – See syllabus for additional assignments if available at site.

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