Final Evaluation-Hospital Practice Clerkship

Final Evaluation – Hospital Practice Clerkship

(PMPR 352 / PHAR 373)

University of Illinois College of Pharmacy Evaluation Instrument

Evaluation Scale

5	Consistently exceeds expectations; performs at a level of a practicing pharmacist; demonstrates competence in all areas



4	Occasionally exceeds expectations; performs at a level of an advanced fourth year pharmacy student; demonstrates competence in 85-99% of tasks assigned



3	Meets expectations; performs at a level of an average fourth year pharmacy student; demonstrates competence in 70-84% of tasks assigned



2	Falls below expectations; performs below the level of an average fourth year pharmacy student; demonstrates competence in 60-69% of tasks assigned



1	Does not meet minimal expectations;consistently performs below acceptable standards;demonstrates competence in < 60% of the tasks assigned

1. Explains and participates in the system of drug distribution within the hospital setting

Completes all procedures involved in the distribution process

Utilizes proper method of distribution for urgently needed medications ("stat" and "now" orders)

Determines the course of action for dealing with discontinued medications

Is attentive to details in carrying out duties

Takes steps to ensure accuracy of work

1 2 3 4 5 N/A

Comments/suggestions for improvement:

2. Explains and participates in the Intravenous Admixture System used in the hospital setting

Documents calculations and procedures

Takes steps to ensure accuracy of work

Completes all procedures involved in the compounding and distribution of intravenous products

Is conscientious in following appropriate work procedures

Is attentive to details in carrying out duties

1 2 3 4 5 N/A

Comments/suggestions for improvement:

3. Explains and participates in the system for narcotic control in the hospital setting and the reason for the structure

Performs all procedures involved in the control and surveillance of controlled substances

Participates in the distribution of controlled substances, under supervision

Is attentive to details in carrying out duties

Takes steps to ensure accuracy of work

1 2 3 4 5 N/A

Comments/suggestions for improvement:

4. Effectively communicates with patients, and other health care providers (physicians, nurses, pharmacists, pharmacy technicians, etc.)

Obtains or provides accurate and concise information in a condensed manner

Uses appropriate oral, written, and nonverbal language

Exhibits reliability and credibility in dealing with others

Deals professionally and ethically with colleagues and patients

Maintains confidentiality

Is sensitive to the needs, feelings, and concerns of patients and other health care providers

Articulates own viewpoint when dealing with health care providers and in addressing controversial issues when appropriate

1 2 3 4 5 N/A

Comments/suggestions for improvement:

5. Demonstrates an understanding of the pharmacist’s role in committee work within the hospital setting

Lists committees that have pharmacy representation

Describes purpose for pharmacy representation on committee

Attends committee meetings

1 2 3 4 5 N/A

Comments/suggestions for improvement:

6. Finds, fixes, and prevent drug-related problems when participating in the system of drug distribution within the hospital setting

Seeks out and utilizes important facts and information in identifying drug related problems

Uses good judgement in reaching sensible, practical solutions to problems

Recognizes and evaluates and articulates available alternatives

Thinks through decisions for possible consequences

Recommends therapy changes, if appropriate

Selects appropriate parameters to monitor efficacy and toxicity

Determines appropriate time to re-assess patient

Reassesses changes at the appropriate time

1 2 3 4 5 N/A

Comments/suggestions for improvement:

7. Explains the concept of Quality Assurance (QA) and the role of the Joint Commission on Accreditation of Health Care Organizations (JCAHO)

Discusses the role of JACHO in the accreditation of health care organizations

Describes the QA and/or CQI process in place at the clerkship site

1 2 3 4 5 N/A

Comments/suggestions for improvement:

8. Makes sound decisions

Uses good judgement in developing sensible, accurate solutions to problems

Discerns out and utilizes important facts and information in decision making

Recognizes and evaluates available options

Gives thought to possible consequences of decisions

1 2 3 4 5 N/A

Comments/suggestions for improvement:

9. Organizes/Plans

Uses own and others’ time efficiently and effectively

Is systematic and methodical in approaching tasks

Sets meaningful and realistic goals

1 2 3 4 5 N/A

Comments/suggestions for improvement:

10. Learns in a self-directed manner

Acts on identified strengths and weaknesses, and develops a learning plan

Self-motivated to implement learning plan

Pursues additional knowledge independently

Demonstrates awareness of professional organizations and there relevance to life-long learning needs

Uses feedback in the planning of activities designed to achieve objectives

Is well-prepared for discussion of assigned topics

Is able to anticipate future needs of a practicing hospital pharmacist

1 2 3 4 5 N/A

Comments/suggestions for improvement:

11. Please comment on the candidate’s impact on your practice setting during this rotation and provide any additional comments not covered in the above mentioned sections.

Student Comments

FINAL GRADE:

(NOTE: Letter grades will be converted to a percentage for the purpose of calculating an overall grade. (Example: B+ = 89%; B = 85%; B- = 80%) Preceptors may record the final grade as a percentage if they so desire.

Student’s Signature: ________________________________ Date: _______

Preceptor’s Signature: ______________________________ Date: _______

University of Illinois College of Pharmacy

Hospital Practice Rotation – PMPR 352 / PHAR 373

Final Evaluation

Student:

Preceptor(s):

Site:

Module:

Final Grade: