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Practice Educator Guide to:Assessment of Student

Learning (IPG SPT-Pharmacist)

Office of Experiential Educationhttp://cpd.pharmacy.ubc.ca/content/oee-

preceptors

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http://cpd.pharmacy.ubc.ca/content/oee-preceptors

http://cpd.pharmacy.ubc.ca/content/oee-preceptors

Table of Contents

Introduction............................................................................................................................3

Instructions.............................................................................................................................9

Practice Educator Evaluation of the Student: Course SPT Part I..............................................10

Practice Educator Evaluation of the Student: Course SPT Part II.............................................13

Care Provider - Plan Care.......................................................................................................20

Communicator - Written/documentation skills......................................................................23

Communicator - verbal, non-verbal skills...............................................................................24

Collaborator..........................................................................................................................25

Manager................................................................................................................................26

Advocate...............................................................................................................................28

Scholar..................................................................................................................................29

Professional...........................................................................................................................31

Copyright© Faculty of Pharmaceutical Sciences, University of British Columbia 2013.

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Introduction

The assessment and evaluation of student learning is an important aspect of any educational program. Indeed, many experts in the area of assessment of student learning agree, “assessment drives learning”. Meaning that students will learn and retain largely what we assess them on. Therefore, what and how we assess students must be closely linked to what we want them to learn. In the entry-to-practice program in the Faculty of Pharmaceutical Sciences at UBC, we are in the process of enhancing our assessment and evaluation practices to support this notion. As practice educators, you play an important role in supporting student learning and providing the students as well as the Faculty with accurate assessments of our students in a practice environment.

This Practice Educator Guide to Assessment of Student Learning was created by Ingrid Price, PhD (Senior Instructor) and Angela Kim-Sing PharmD (Director, Office of Experiential Education). It is our hope that this guide will be useful to you and we welcome any comments and feedback you may have.

Purpose of AssessmentStudents often think of assessment as something separate from learning (e.g., a mark received in a course). However, assessment is part of the learning process as it not only guides learning (i.e., provides information to the student about what is important to learn) but, if conducted properly, can provide students with feedback during the learning experience to help direct and focus their learning.

Two types of assessment Formative assessment is ongoing and progressive in nature. It is meant to provide students and

educators information regarding how the student is performing in the course to allow for improvement, if needed. Formative assessment allows the student to identify what they are doing well / what they have learned, what they still need to learn and how to improve. A common type of formative assessment is verbal feedback. Providing a supportive learning environment along with constructive feedback is critical to student’s learning. At the midpoint of the rotation, the student should be able to incorporate the practice educator feedback to adjust their learning, make corrections and develop a plan for improving in the specified area.

Summative assessment involves making a judgment (unsatisfactory, satisfactory, superior) through comparing the student's clinical performance to a set of criteria (e.g., the AFPC learning outcomes referred to throughout this guide). Summative assessment, or evaluation, is provided at the end of a unit of learning (e.g., course, clerkship) and is needed to help the faculty make decisions about student advancement and promotion. In the advanced pharmacy practice experiences (APPE fourth year rotations) you are providing judgment about the student’s capacity for safe and independent practice.

Importance of AssessmentExpectation of assessment is implied when you are teaching or precepting a student. It will take time if you do it right, and you do have to spend time with the learner, to know if they are developing appropriately.It is important to the student and to UBC that your evaluation of the student is supported by written comments.


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Assessment is comprised of five basic steps:1. Define expectations (72 hr. Checklist)2. Assess learner performance3. Identify the differences and similarities between the faculty’s expectations for performance

(based on assessment criteria) and the student’s actual performance4. Document observations as soon as possible5. Convey this information to the learner

As a UBC Practice Educator, you will assess the student in the areas of: Patient Assessments Clinical skills (history taking, medication management, identification of DRPs, counseling and

patient education) Clinical Judgment / Application of knowledge – critical thinking and problem solving Communication skills – oral, non verbal, written and listening skills Collaboration Advocate Professional

Best practices: How do I assess student learning? Observe student activities/interactions multiple times: Accurate and reliable assessment

requires multiple observations of the student and regular interactions between yourself and the student.

Gain input from others: Important to get input from others – pharmacists (e.g. interpersonal, communication skills, team work, professionalism, clinical management and teaching abilities), technicians (e.g. honesty, reliable, and working well with others), patients (e.g. empathy, compassion, ability to convey new knowledge). Complete a written evaluation every two weeks and a final (Summative) evaluation at the conclusion of the rotation.

Provide specific, regular feedback: One of the best ways to ensure students learn is to provide constructive and timely feedback on what they do well and what that could improve upon (Formative).


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Quick Tip

Keep cue cards in your top pocket to quickly jot down your observations.This will help jog your memory when it comes to providing feedback and it can be used to inform the mid-point and final evaluation of the student

The Feedback Conversation Remind the student to complete the self-evaluation at mid rotation, prior to meeting with you.

(See Practice Educator Evaluation of the Student page). This will allow you to start the conversation by asking them “What have you identified as your strengths and areas for improvement?” Often students will identify the same concerns you have with their performance. Also, people (including students) are not good at identifying what they did well – so be prepared for the student to be quite specific about what they didn’t do well and have difficulty articulating the areas where they are performing adequately.

When students can self identify their weaknesses it makes the situation less comfortable and becomes a great starting point for establishing new goals and strategies to achieve those goals.

Remember that feedback is a supportive and positive process to improve learning. Effective feedback is:

o Specific: Gives the receiver more to work with. For example, saying “John, you did a great job today” is less effective than “John, you were really good in explaining to Ms. J how the medication works, you used appropriate language and gave her lots of opportunities to ask you questions”

o Regular and fairly immediate: Given at the end of each day. This is largely proactive, to avoid problems/issues from inhibiting learning and productivity.

o Uses “I” statements: The person giving the feedback should own their statements as opposed to engaging in finger pointing and using “you” statements. It is easier for the receiver of the feedback to hear constructive feedback that uses the word “I” instead of “you”. For example, when giving feedback it is easier to hear “I was confused when you were explaining…” as opposed to “You confused me when you were explaining…”. By taking ownership of the observation, individuals receiving feedback are less likely to become defensive and be able to hear (and hopefully do something with) the feedback given.

o Focuses on things that can be changed: Effective feedback should be focused on behaviours, not personality traits or things about the person that cannot be changed (e.g., a person’s accent).

Never assume you know why a student did or did not do something – you are simply providing feedback on what you observed. Allow the student to consider why a behavior did or did not occur.

How do I know what grade to assign? Don’t get caught up in the numerical grading process, but rather focus on the experiential

learning, which is about developing the student’s knowledge and skills. It may be helpful to think about where the student started in terms of their skills and how much they have developed over time, in addition to objective criteria that they need to meet.

In addition to your evaluation of the student, there are a number of other elements that the FOPS use to evaluate student competence during their clerkship. This includes the learning portfolio activities – patient case write-ups, drug information, Interprofessional education (IPE) activities and reflection. In addition the use of a 360-evaluation strategy (multi-source feedback) that involves collecting feedback from patients, pharmacy technicians or other health care provider are considered.


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In the Guidelines for assessing performance , is the student expected to achieve all the bullets for the Unsatisfactory, Satisfactory or Superior ranking?

The items listed under each category are meant to provide you with examples for each area of Unsatisfactory, Satisfactory and Superior to outline the university expectations for student performance and to help you with the student assessment. They are meant to provide you with a “picture” of what a student who is achieving this level of performance might look like and, as such, are meant as guidelines rather than requirements.

Therefore, the student is not expected to achieve all the criteria for each grade category. If the student performance borders between criteria for Unsatisfactory and Satisfactory, but the

majority of the performance is Unsatisfactory – then grade the student as Unsatisfactory and assign a numerical grade of 3

If the student performance borders between criteria for Unsatisfactory and Satisfactory, but the majority of the performance is Satisfactory – then grade the student as Satisfactory and assign a numerical grade of 4

Most of our students will fall in the Satisfactory category. Very few students at this stage of their development will be Superior.

How do I know if the learner is having difficulty? Go with your gut feeling. If you think something isn’t right then it probably isn’t - address it immediately and contact the

course coordinator for guidance. Both the practice educator and the student must be supported in the process. The longer you wait to contact the course coordinator the more difficult it is to resolve the issue within the rotation timeframe.

The best way for you to support the student in the development of their skills is to provide an objective assessment. Remember to focus on their behavior (what you have observed, or not observed) rather than trying to figure out why this is occurring. If the student’s performance is Unsatisfactory – you must provide comments with specific patient care examples.

How many errors are too many? This is a difficult question with no simple answer. Students are going to make mistakes, as these

are learning rotations. Often the student’s reaction to the error is more important than the error itself. Making an error is one of life’s greatest lessons and we would hope that the student takes the necessary steps to prevent future errors. However if the student is making the same error repeatedly contact the course coordinator for guidance. Contact us so that we can intervene and discuss with the student what the real issues are. Students need to be supported in their learning and we can provide that support, as well as refer the student to a school counselor if appropriate. With students that are unsuccessful, it is never just one thing – it is usually a mix of competency and professionalism issues +/- personal issues.

Is it my responsibility to fail the student? Your role as a practice educator is not to pass or fail students but to provide an objective

assessment of student performance so that the university can assign the appropriate grade to a student.

As part of the clerkship, you provide one piece of evidence regarding the student’s performance that is combined with other assessments to determine the overall success of the student.

There is no mathematical formula to determining Unsatisfactory, Satisfactory or Superior performance. What “adds up” to an overall Satisfactory or Unsatisfactory ranking depends on


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the number of behaviors exemplified as well as the degree to which these behaviors are displayed.

Never use the words “pass” or “fail” with the student. Your role as a practice educator is to provide an objective assessment and provide as many written examples as possible to support your assessment.

In the clerkships, multiple stakeholders inform the evaluation of student learning. The decision to promote the student is made by a committee of practice faculty from the professional practice labs, CAPs courses as well as the OEE coordinators. Student learning is the ultimate responsibility of the University. The University makes the final decision on student promotion, as it is the University that grants the degree.

Is there a difference in how I grade student competence for each clerkship?When assessing a student’s competence in any one area, remember that, depending on the clerkship, students are at different stages of their learning process and level of competence. This must be taken into consideration in your assessment of them.

SPT Part I – early learners. These students have not been on rotation before so this is their first opportunity to employ clinical problem solving in a practice setting. These students will have some content knowledge but have not had the opportunity to apply this knowledge as a student pharmacist. They will likely require a fair amount of assistance from you to be successful and may take longer than usual to complete tasks. They may also have difficulty being patient-focused in their interactions and may focus more on their own performance in an attempt to practice these skills.

SPT Part II – mid-range learners. Since this is their second clerkship, these students have some experience employing clinical problem solving in a practice setting. They have greater content knowledge now and have had more opportunity to apply this knowledge to practice-related problems. These students should be able to complete tasks with minimal assistance by the midpoint of their clerkship and will likely need additional time to complete tasks. These students will likely be partially patient-focused and partially self-focused in their dealings with patients.

How can I be Proactive? Review the evaluation form prior to the clerkship so that you know what the student needs to

accomplish while at your site. Complete the evaluation form in a timely manner, especially the mid-point evaluation. Given

that assessment is part of the learning process, it is not helpful to the student to find out at the end of the clerkship (summative) that their performance is unsatisfactory. It is imperative that the student receives a formal mid-point evaluation, so they have the opportunity to improve on skills and knowledge that require strengthening.

If you have any questions or concerns, contact the course coordinator. We are here to help you – it is our job to support both you and the learner.

What’s the difference between Assessment and Evaluation? In the education literature, the word “assessment” refers to information that is collected by

faculty members to determine what the student is learning and to identify any areas for improvement. So, assessment is considered “formative” in nature as it provides the student and educator with information to help improve the learning of the student. Indeed, assessment is often called “formative assessment”. “Evaluation” uses the information collected through assessment to provide a judgment on whether or not the student met certain criteria in order to


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receive a passing grade. So, assessment is ongoing, progressive and often not for marks; evaluation is final and mark-oriented. When you work with your student, you will be employing both assessment strategies (e.g., feedback, midpoint assessment) and evaluations (final evaluation or judgment). Evaluation is also called “summative assessment”. Throughout this document, we will use the term assessment rather than evaluation.


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Instructions

Student evaluation process: Mid-point Practice Educator Assessment of the Student:

o At the mid-point of the rotation the practice educator should complete the assessment form reflecting on the performance of the student as well as add any comments regarding any one category that the practice educator identifies as particularly note worthy (either positive or negative)

o Estimated time for this activity: 10-15 minutes

Final Practice Educator Assessment of the Student:o Overall assessment of the student’s performance at completion of the rotation. Include

qualification comments explaining why a certain ranking has been assigned for each category that has been assessed for the student.

o Estimated time for this activity: 30-45 minutes.

The assessment form may be completed using a web based form and emailed to the course coordinator or [email protected]. Alternatively the completed evaluation form with the student’s signature can be placed in a sealed envelope and given to the student to submit in their learning portfolio.

The following pages provide details regarding the assessment categories. This includes a definition of each category, and guidelines with specific indicators to differentiate between Unsatisfactory, Satisfactory and Superior performance within each category. The categories and indicators are taken from the Association of Faculties of Pharmacy of Canada (AFPC) June 2010 document - Educational Outcomes For First Professional Degree Programs in Pharmacy (Entry-to-Practice Pharmacy Programs) in Canada with the overall goal of graduating Medication Therapy Experts.

Overall performance:In addition to evaluating student performance within certain areas, we would like you to provide an overall assessment of the student’s performance during their rotations. There are several options on how to do this. One option is to take an average of the final assessment rankings in each category and assign this to the students overall performance. However, you may feel that some areas of performance are more significant than others – if this is the case, then you may weight these areas more heavily. Regardless of how you approach assigning the overall performance, we ask that you qualify why you assigned the student the overall rank that you did by providing comments to support the overall ranking. For example, if a student performed well in every category but communication was an issue, you may choose to give them an overall performance score that is not “mathematically” reflected in their performance scores for each individual section. Including some comments explaining this will help us understand your reasoning.


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mailto:[email protected]

Practice Educator Evaluation of the Student: Course SPT Part I

Site Date

Student Name

Practice Educator Name

Care Provider – Assess PatientsMid point

1 2 3 | 4 5 6 | 7 8 9Unsatisfactory Satisfactory Superior

Comments

Final 1 2 3 | 4 5 6 | 7 8 9Unsatisfactory Satisfactory Superior

Comments

Care Provider – Plan CareMid point


Comments


Comments

Communicator – Written / documentation skillsMid point


Comments


Comments

Communicator – Verbal and non verbal skillsMid point


Comments


Comments


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CollaboratorMid point


Comments


Comments

ManagerMid point


Comments


Comments

AdvocateMid point


Comments


Comments

ScholarMid point


Comments


Comments

ProfessionalMid point

Acceptable Unacceptable

Comments

Final


Comments


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Mid-Point Evaluation (To be completed by the Student and signed by the Practice Educator). It is the responsibility of the student to alert the Course Coordinator to any assigned “unsatisfactory” or “unacceptable” grade. The student must immediately fax the evaluation form to 604.822.3035 so that appropriate learner support can be provided.

Comments

Practice Educator Signature ___________________ Date ____________________________

Student Signature __________________________ Date ____________________________

Final Evaluation (To be completed by the Practice Educator and signed by the Student)Both the student and practice educator must immediately notify OEE of any assigned “unsatisfactory” or “unacceptable” grade.

Overall Performance 1 2 3 | 4 5 6 | 7 8 9Unsatisfactory Satisfactory Superior

Comments

Practice Educator Signature ____________________ Date ____________________________



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Practice Educator Evaluation of the Student: Course SPT Part II

Site Date

Student Name

Practice Educator Name

Care Provider – Assess PatientsTwo (2) Week


Comments

Midpoint 1 2 3 | 4 5 6 | 7 8 9Unsatisfactory Satisfactory Superior

Comments

Six (6) Week


Comments


Comments

Care Provider – Plan CareTwo (2) Week


Comments


Comments

Six (6) Week


Comments


Comments

Communicator – Written / documentation skillsTwo (2) Week


Comments


Comments


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Six (6) Week


Comments


Comments

Communicator – Verbal and non verbal skillsTwo (2) Week


Comments


Comments

Six (6) Week


Comments


Comments

CollaboratorTwo (2) Week


Comments


Comments

Six (6) Week


Comments


Comments

ManagerTwo (2) Week


Comments


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Comments

Six (6) Week


Comments


Comments

AdvocateTwo (2) Week


Comments


Comments

Six (6) Week


Comments


Comments

ScholarTwo (2) Week


Comments


Comments

Six (6) Week


Comments


Comments

ProfessionalTwo (2) Week

Comments


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Midpoint


Comments

Six (6) Week


Comments

Final


Comments

Mid-Point Evaluation (To be completed by the Student and signed by the Practice Educator). It is the responsibility of the student to alert the Course Coordinator to any assigned “unsatisfactory” or “unacceptable” grade. The student must immediately fax the evaluation form to 604.822.3035 so that appropriate learner support can be provided.

Comments

Practice Educator Signature _________________________ Date ______________________


Final Evaluation (To be completed by the Practice Educator and signed by the Student)Both the student and practice educator must immediately notify OEE of any assigned “unsatisfactory” or “unacceptable” grade.

Overall Performance 1 2 3 | 4 5 6 | 7 8 9Unsatisfactory Satisfactory Superior

Comments


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Practice Educator Signature __________________________ Date ______________________



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Care Provider – Assess PatientsAbility to establish patient-centred relationships with patients or caregivers, and collect the relevant information from various sources to identify and resolve drug therapy issues [AFPC Relevant Outcomes: Care Provider 1.1-1.4]

Guidelines for assessing performance

Unsatisfactory Adopt paternalistic or uncaring roles with patients or place their personal values in preference

to the patient’s values Complete patient assessments in an unstructured or formulaic and minimally flexible manner

(e.g. does not respond to patient questions during the assessment, does not skip sections irrelevant to the patient – asks elderly patient about illicit drug use or pregnancy for male)

Satisfactory Complete patient assessments in a thorough, yet efficient, professional manner Consistently provide patient-centred care that is consistent with ethical guidelines governing

health care professionals

1.1 Develop and maintain professional, collaborative relationships required for patient care. Establish and maintain a professional, caring practice environment; Demonstrate that the patient’s goals are the priority; Determine when it is ethically and professionally appropriate to involve caregivers; Acknowledge and respect the roles and responsibilities of the pharmacist, the patient and/or

caregivers, and the patient’s other health care professionals.1.2 Elicit and complete an assessment of required information to determine the patient’s medication- related and other relevant health needs. Elicit the reason(s) for the patient’s visit to the pharmacy or encounter with the pharmacist; Obtain and evaluate relevant history from the patient, his/her chart, caregivers and other health

care professionals; Order, request, retrieve and/or assess relevant lab tests and diagnostic assessments; Interpret findings of relevant physical assessments that are required to determine appropriate

medication therapy, and; Complete an assessment of the patient’s ability to take / use / administer his/her medications.1.3 Assess if a patient’s medication-related needs are being met. Evaluate the safety and effectiveness of a patient’s medications with consideration of the

patient’s values and preferences, characteristics, conditions, functional capabilities, other medications and access to health care / monitoring;

Determine whether a patient is appropriately managing his/her therapy, including appropriate administration and adherence in particular for chronic disease management;

Determine whether a patient’s medications are achieving the desired goals including consideration of efficacy and adverse effects;

Determine whether a patient requires medication assessment and reconciliation; Where appropriate, identify a patient’s medication-related needs as specific medication -

therapy problems, and: Determine if a patient requires additional care or services consistent with established

collaborative practice agreements.


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1.4 Determine if a patient has relevant, priority health and wellness needs. Recognize signs, symptoms and risk factors that relate to medical or health problems that fall

into the scope of practice of other health care professionals. Recognize signs and symptoms associated with medical emergencies; Recognize problems with activities of daily living important to the patient’s well-being, and: Identify opportunities for advocacy, health promotion and disease prevention with individuals to

whom they provide care.

Superior Determine and develop the professional relationship most appropriate for complex patients or

those with complex care needs. Effectively modify their patient assessment approaches to provide appropriate care to patients

with uncommon or complex needs. Routinely and appropriately goes above and beyond and incorporates expanded activities (e.g.

health promotion, disease prevention, inter-professional collaborative practice) into their patient assessments.

Effectively detect and efficiently resolve situations presenting ethical dilemmas.


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Care Provider - Plan Care Ability to make decisions and plan care effectively for patient based on the assessment, prioritization of patient’s needs and appropriate evidence. Ability to follow up care, evaluate the outcome of therapy and recommend medication related changes as necessary. [AFPC relevant outcomes: Care Provider 1.5-1.8].


Unsatisfactory Lack confidence, or are inappropriately over confident, in their decision-making ability when

providing patient care. Critical gaps in knowledge, skills or attitudes required to care for patients with common drug

therapy problems. Critical inability to apply their knowledge/skills effectively to identify patients’ drug-therapy

problems. Develop patient therapeutic and monitoring plans that are incomplete, non-specific, unrealistic

or do not foster autonomy of the patient or the incorporation of self-care. Minimize attempts to ensure team and patient agreement with and understanding of

therapeutic and monitoring plans. Are not aware of or are not committed to their obligation to collaborate with the patient and

his/her care providers in order to provide follow-up of care.

Satisfactory Demonstrate appropriate confidence in their evidence-based decision-making and

recommendations when providing patient care. Demonstrate mastery of required knowledge and skills, resulting in their ability to effectively

manage patients with common drug-therapy problems. Consistently identify patient’s common and/or critical drug-therapy problems in an efficient and

accurate manner. Consistently identify patients who require referral and make referrals to the appropriate care

providers. Provide an appropriate, efficient rationale for referral, and provide patients with appropriate

referral notes. Consistently develop accurate, efficient patient therapeutic and monitoring plans that

incorporate best practices and that respect the autonomy of the patient and incorporate the principles of self-care as appropriate.

Consistently gain team and patient agreement with and ensure understanding of therapeutic and monitoring plans.

1.6 Develop a care plan that addresses a patient’s medication-therapy problems and priority health and wellness needs. Prioritize a patient’s medication-related needs; Establish goals of medication therapy with the patient (desired endpoints, target values and

timeframes for medication therapies); Assess alternative strategies and negotiate the therapeutic option best suited to the patient; Integrate the recommended therapeutic options for a patient’s medication-related needs into a

coordinated plan;


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Determine monitoring parameters for desired therapeutic endpoints and potential adverse effect, specifying target values and start, frequency and end time-points for monitoring;

Decide specific actions to be taken by the pharmacist as necessary for management of medication-related needs, specifically determining whether it is appropriate to:

o Dispense a medication according to a new prescription; o Dispense an authorized refill of a medication; o Authorize an extension of refills of a medication; o Modify a patient’s medications; o Recommend changes in medications; o Prescribe medications or therapies; o Administer a medication, and/or; o Refer the patient to other health care professionals for assessment and management;

Determine if a patient requires information or other support to facilitate his/her management of needs related to activities of daily living, health promotion or well-being, and:

Know the responsibilities of the pharmacist and patient, and when other health care professionals should be contacted.

1.7 Implement the care plan. Undertake specific actions as specified in the care plan (e.g. prescribing, ordering lab tests); Educate the patient regarding the care plan to facilitate understanding and adherence; Facilitate continuity of care through referral and communication with relevant care providers; Convey information on maintaining and promoting health; Convey information about available social support services to assist with daily living, and; Schedule required follow-up in accordance with a patient care plan.

Follow-Up1.8 Elicit clinical and / or lab evidence of patient outcomes. Determine the clinical status of the patient, including completing physical assessments required

for monitoring of medication therapy; Evaluate the efficacy of the care plan relative to the desired goals; Evaluate the safety of the care plan including the presence of adverse drug reactions or effects; Determine changes in pharmacotherapy that are required. Assess and manage patients’ new medication-related needs.

Superior Confidently provide a wide range of primary health care services. Confidently and effectively articulate the expanding role of their profession, and consistently

fulfill expanded roles where providing patient-centred care. Determine and develop the professional relationship most appropriate for complex patients or

those with complex care needs. Effectively modify their patient assessment approaches to provide appropriate care to patients

with uncommon or complex needs. Routinely and appropriately incorporate expanded activities into their patient assessments. Consistently formulate sound decisions in appropriate time frames, even on matters of

complexity or where limited evidence exists, appropriately analyzing available data and using their knowledge base to make sound clinical recommendations.

Anticipate and effectively manage challenges to identifying a patient’s drug-therapy problems


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Integrate the therapeutic and monitoring plans for multiple drug-therapy problems to support efficient patient self-care.

Efficiently formulate appropriate management plans including plans that address complex, poorly defined or controversial issues.

Demonstrate ease and confidence when gaining agreement with and implementing patient management plans.


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Communicator - Written/documentation skills Definition: Ability of student to support continuity of care by accurately documenting patient and care information in a clear manner. [AFPC Relevant Outcomes (Care Provider and Communicator) 1.10 & 2.2]


Unsatisfactory Documentation that is either too limited or too lengthy. Create written communications that are unclear, with missing or confusing rationalization. Completed documentation that has grammatical or spelling errors, uses non-traditional short

forms or misrepresents their actions or the actions of others. Uses unapproved abbreviations for medicines, incomplete dosing information, etc.

Satisfactory1.10 Support the continuity of patient care by documenting their patient care activities Document in a timely, retrievable, usable manner. Fulfill professional responsibilities for documentation. 2.2 Communicate in writing Write clearly, using organized processes and appropriate vocabulary; Correctly apply the rules of syntax, grammar and punctuation, Adapt the content of their recommendation/rationale to specific contexts and target audiences.

Superior Consistently support continuity of care by appropriately documenting patient and care

information in a clear manner. Consistently ensure that documentation is error free and consistent with best practices for

patient safety. Effectively document to provide patient-centred, collaborative care and to ensure safe and

effective distribution of medications.


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Communicator - verbal, non-verbal skillsDefinition: Ability of student to support continuity of care by communicating with patients and other health care providers in a clear manner. [AFPC Relevant Outcomes (Communicator) - 2.1 & 2.3]


Unsatisfactory Unprepared for presentation or scheduled patient encounter. Disorganized when presenting or sharing information. Communicates in a manner that results in misunderstanding, inefficient use of time and

potentially ineffective interventions. Unable to respond to basic questions regarding presented information. Lack of eye contact. Responds ineffectively to challenging situations (e.g., becomes angry or defensive). Not listening to patient or health care provider.

Satisfactory2.1 Communicate non-verbally and verbally with others

Use active listening skills and responds appropriately to others. Exhibit empathy, tact and respect in their dealings with others. Demonstrate sensitivity, respect and empathy in intercultural and inter-professional situations. When speaking, use organized processes and appropriate, precise expressions and vocabulary. Tailor the content of their communication to specific contexts and audiences (e.g., respects

differences in language and health literacy). Adapt their communication techniques to facilitate efficient and effective clinical encounters. Effectively communicate to provide patient-centred, collaborative care and to ensure safe and

effective distribution of medications.

Present information Capable and appropriately confident presenting or sharing information in a timely, professional

and effective manner. Responds effectively to questions. Effective and appropriate use of visual and educational aids to support learning.

Superior Manage challenging communication situations with ease and in an efficient, professional

manner. Uses a range of communication techniques appropriately and flexibly to manage situations of

conflict, including patient or inter-professional conflict, ethical dilemmas, or sensitive professional situations.

Use non-traditional or innovative approaches to engage the patient. Use communication technologies in an innovative manner to enhance learning.


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Collaborator Ability of student to develop appropriate intra and inter-professional relationships and work effectively in partnership with a range of team members to achieve negotiated, agreed-upon objectives. This includes working with pharmacy technicians, other pharmacists, as well as other health care professionals. [AFPC Relevant Outcomes (Collaborator) – 3.1, 3.2]


Unsatisfactory Unable to show leadership abilities when it is appropriate or required. Are unclear or defensive when articulating their role relative to other health care providers. Undertake activities to provide care that is more appropriately provided by other team

members.

Satisfactory Accept leadership roles where appropriate; Routinely collaborate and communicate with care providers to ensure safe and optimal patient

care; Actively make their expertise available to others and willingly agree to share relevant

information, using language that can be understood by all; Recognize and respect the roles, responsibilities and competence of other professionals; Make their points of view known, listen to and respect the opinions of others, defend points of

view if necessary; Contribute to planning, organizing and performing of work to be done, and integrating evidence

while evaluating the results; Respect the rules established by the team; Help maintain a healthy work environment and assist with conflict management; Consistently demonstrate basic interpersonal skills required for harmonious, effective

professional relationships including effectively managing inter-professional conflict Demonstrate appropriate flexibility in the activities undertaken or care provided Participate in local health initiatives as requested and appropriate e.g. health promotion

programs, outreach.

Superior Effectively and efficiently manage inter-professional conflict in a manner that increases the

successful management of both patient’s needs and opportunities for professional advocacy. Shows initiative in creating and leading inter-professional teams. Is recognized as a leader by others in the inter-professional team. Assist the team in clarifying relative roles and responsibilities to ensure effective achievement of

objectives. Develop and maintain collaborative relationships with a network of care providers, resulting in

efficient, effective collaborative care. Have formalized processes/procedures for collaborative care.


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ManagerAbility of student to use management skills in their daily practice to optimize the care of patients, to ensure the safe and effective distribution of medications, and to make efficient use of health resources. [AFPC Relevant Outcomes (Manager) - 4.1 & 4.2]

Guidelines for Assessing Performance

Unsatisfactory Does not appreciate the influence of workflow/human resources management on the quality of

team work, or appear un-motivated or incapable of fulfilling this role. Place undue focus on the distribution aspects of the dispensing process, or accept responsibility

for primarily technical tasks relative to provision of professional services. Are challenged to set appropriate priorities or work within reasonable time frames. Assume roles that disrupt the efficiency and safety of the medication distribution system. Is unclear on their appropriate role in managing medication distribution, either performing tasks

that are more appropriately delegated, or permitting pharmacist’s professional services to be provided by technical or untrained staff.

Minimize the importance of errors, do not assume responsibility, or place patients at risk by not disclosing errors.

Disregard unsafe practices via either not recognizing them as unsafe or not recognizing their responsibility to manage unsafe practices.

Disregard activities required to maintain the financial health or sustainability of the practice, such as not providing professional services (e.g., MedsCheck or pharmaceutical opinions) or inappropriately or incompletely billing for professional services

Satisfactory Ensures both the safe distribution of medications and the provision of care/professional services

required for safe and effective medication use. Effectively manage their personal practice environment and recognize the importance of

efficiency in the workplace. Effectively manage their time to ensure patients receive optimal care. Ensure that, when they are responsible for the dispensing of medications, all medications

compounded, dispensed or sold are appropriate, accurate, effective and safe, and are provided in a manner consistent with all legal requirements.

Ensure, while they are responsible for dispensing of medications, the safety and quality of the drug distribution system.

Consistently ensure that dispensing occurs only in conjunction with provision of required patient care.

Effectively manage adverse drug events, errors, and incidents in a fair manner consistent with current best practices, including disclosure, professional apology and formal reporting.

Routinely evaluate their own practice, recognizing unsafe or less than optimal procedures/practices and accept responsibility for rectifying these situations.

Manage their personal practice Set priorities and manage their time to balance patient care, workflow and practice

requirements


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Superior Ensure safe and effective distribution while focusing on providing expanded professional

services appropriate to patient need. Consistently identify and implement improvements in workflow or practices that improve the

quality of care provided or support the provision of new professional services. Can efficiently manage situations where conflicts in roles of pharmacy staff arise, engendering

respect while ensuring adherence to legislation, Human Rights, standards of practice, codes of ethics and best practices are followed.

Manage the safe and efficient distribution of medications Evaluate the factors critical to safe and efficient medication distribution systems including

pharmacy layout / design, workflow, technology and automation and; Anticipate, recognize and manage human, environmental and medication distribution situations

that place patients at risk disclose, manage and report adverse drug event;Participate in quality assurance and improvement program Manage workload to prioritize provision of professional services; Disclose, manage and report errors, incidents and unsafe practices;Function as a role model for professional and support staff, Understand the impact of funding and payment policies on the provision of professional services.


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AdvocateAbility of student to refer patient access to appropriate resources to prevent disease and promote health and well-being. Ability of student to advance the health and well-being of individual patients, communities, and populations. [AFPC Relevant Outcomes (Advocate) - 5.2]

Guidelines for assessing performanceUnsatisfactory

Meets patient’s need for accurate and safe medication supply but displays minimal or little acknowledgement of professional responsibility to assist patients with their management of other health needs or with supporting their maintenance of health.

Is unaware of, provides minimum response to or inappropriately refers patients who face challenges gaining access to required resources.

Is unaware of, provides minimum response to or refuses patient groups’ request for guidance related to medication or health policies or practices.

Focuses on the distribution of medications and provision of only basic professional services required for safe dispensing of medications.

Is unaware of or minimizes their responsibility for promoting patient health and wellness.

Satisfactory Consistently provides accurate and clear guidance to patients regarding availability and

appropriate use of local health care services. Accurately and appropriately interpret health information for patients to support their decision-

making and access to health services. Appropriately respond to patient groups’ requests for guidance related to medication or health

policies or practices. Effectively support patient access to the health and associated resources that patients require to

prevent disease and promote their health and well-being. Routinely offers services to promote the health, reduce health risks and maintain the safety of

individual patients.Promote the health of individual patients, communities, and populations Facilitate patient’s interaction with the health care system through advice, education and/or

guidance. Support patient’s access to required health services by representing or speaking on behalf of

patients. Participate in health promotion activities, public health campaigns and patient safety initiatives

that are directed at disease prevention, risk factor reduction and/or harm minimization

Superior Have an appropriate understanding of the roles/responsibilities of a wide range of health care

providers and can appropriately refer patients to these providers. Actively seek opportunities to promote access to health and associated resources for patients,

proactively identifying their needs and independently implementing strategies to meet these needs.

Consistently seeks out connections and opportunities to develop a reference network to efficiently facilitate patient navigation through the health care system.


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Consistently seeks out current information on health promotion and patient safety initiatives, actively incorporating activities related to this information into daily practice.

ScholarAbility to apply the core knowledge and skills required to be a medication therapy expert, and are able to master, generate, interpret and disseminate pharmaceutical and pharmacy practice knowledge. [AFPC Relevant Outcomes (Scholar) - 6.1-6.3]

Guidelines for assessing performanceUnsatisfactory

Does not demonstrate the required depth or breadth of core knowledge or skills or are unable to apply this knowledge consistently and effectively while performing their professional roles.

Consistent or critical deficiencies in their core knowledge and are unable to provide accurate explanations or rationale for decisions/recommendations/solutions to medication-related issues.

Not conscious of deficiencies in their knowledge or skills, being unaware of the complexities of situations and/or their need to seek assistance.

Consistently rely on inappropriate literature to investigate and solve medication-related issues or drug information requests.

Does not check accuracy of information when there are questions or controversies.

Satisfactory Appropriately, consistently and confidently uses their professional judgment when making

evidence-based decisions, providing drug information and facilitating learning, relying aptly on a blend of their core knowledge, experience and critically-appraised, literature-based evidence.

Has a thorough understanding of core knowledge and an ability to apply this knowledge and associated skills to effectively manage medication-related issues.

Consistently and accurately rationalize their recommendations/solutions. Accurately and consistently identify when their knowledge or experience is insufficient to

manage a situation, and appropriately seek strategies to resolve the situation. Consistently recognize when a situation is deviating from an expected course (e.g., not going

according to plan) and appropriately seek assistance. Consistently use a systematic approach to accessing and reviewing appropriate literature,

integrating critical content and effectively formulate responses/recommendations or translating literature into practice.

Demonstrate a thorough understanding of the fundamental knowledge required of pharmacists and apply this knowledge in daily practice Rationalize their recommendations and decisions with appropriate, accurate explanations and

best evidence. Rely on professional experience to develop solutions to routine, previously encountered

problems. Utilize established decision-making frameworks when face with new situations to identify,

analyze and develop solutions to problems. Undertake and apply learning required to manage new problems.Provide drug information and recommendations


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Identify needs for information, recommendations and decisions on medications. Conduct a systematic search for evidence using a variety of search methods and tools. Critically analyze information including primary research articles. Determine plausible solutions and select the most appropriate recommendation. Communicate information/recommendations. Evaluate usefulness of the information provided. Document the information provided.Educate regarding medications and appropriate medication use, including the pharmacist’s role Identify learning needs of the audience. Select educational techniques appropriate for the learners. Select and organize content. Implement educational plans. Assess outcome for education

Superior Have a master of both core and a specialized area of proficiency. Routinely incorporate reflections on their quality of care provided and care processes followed

to detect deviations from expected outcomes, and openly seek opportunities and resources to improve this care and are processes.

Increasingly efficient in accessing and critically reviewing relevant literature, and is able to make appropriate recommendations related to ambiguous medication-related issues and those where evidence is limited or contradictory.


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Professional Student complies with legal and regulatory requirements of practice. Student fulfills the full range of roles required or a self-regulated professional. Student consistently acts in a professional manner. [AFPC relevant outcomes: Professional 7.1-7.4]


Unacceptable - Behaviors that will result in Immediate Dismissal Violate fundamental ethical principles related to professional accountability or patient

autonomy, confidentiality and non-abandonment. Violate confidentiality of site polices and procedures. Minimize responsibility for managing ethical dilemmas, either by inappropriately referring or

dismissing the dilemma. Undertake to complete only the minimum activities required of the clerkship. Resistant to feedback on their performance. Demonstrate a lack of commitment to the professional role of pharmacists, with focus on

maintaining status quo and limited involvement with professional activities and organizations. Unaware of the key issues facing the profession, with little or no capacity to plan for practice

change or improvement. Routinely demonstrate behaviors or attitudes that undermine intra and inter-professional

relationships. Are unclear or defensive when articulating their role relative to other health care providers. Student fails to identify themselves as a “student pharmacist” in patient and health care

provider interactions, as required by the College of Pharmacists of BC. Institution nametag and site identification (where appropriate) are not visible, as required by

the College of Pharmacists of BC and receiving agency. Disrespectful when communicating with others. Provide care or services beyond their scope of practice. Does not recognize patients who require referral, or refer patients to an inappropriate care

provider.

Acceptable Provide patient-centred care that is consistent with ethical guidelines governing the health

professions. Demonstrate acceptance of the need for their continual professional growth and learning. Adapt to change within the profession, being receptive to feedback on their performance and

accurately recognizing when additional development is required. Consistently determine appropriate strategies for achieving continual professional growth and

learning. Demonstrate a deep understanding of and commitment to the developing role of pharmacists in

the Canadian health system. Identify the key components of an effective practice advancement plan, with a focus on plans

that are rational and feasible, and based on managing important issues facing the profession.


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Demonstrate professionalism throughout patient encounters. Show respect for patients by acknowledging the patient as a person, listening actively and

considering their needs and expectations; Accept responsibility for recognizing and meeting patients’ medication therapy needs; Maintain patient confidentiality, and Maintain appropriate boundaries with patients. Practice in an ethical manner that assures primary accountability to the patient. Involve the patient in decision-making, respecting their right to make their own choices; Fulfill requirements for obtaining patient consent; Integrate patient preferences related to culture, beliefs and practices; Use professional judgment; Prioritize patient needs Ensure the continuity of patient care Accept responsibility for recognizing and meeting patients’ medication therapy needs; Maintain patient confidentiality, and: Maintain appropriate boundaries with patients. Recognize and manage situations presenting ethical dilemmas including conflicts of interest.Maintain their competence to practice through lifelong learning. Evaluate their practice to identify areas for continuing professional development; Acknowledge and reflect on errors, omissions and close calls to identify limitations in

competence / performance; Seek and accept feedback to identify limitations or strengths in competence / performance; Recognize their limits of competence and seek assistance; Plan and undertake learning activities to support maintenance of competence and professional

development; Incorporate learning into their practice; Practice in manner demonstrating professional accountability. Comply with the legal and regulatory requirements of practice; Respect and fulfill professional standards of practice; Be accessible to patients and other health care professionals; Fulfill their professional tasks and commitments to patients in a diligent, timely, reliable,

respectful manner; Accept responsibility for their decisions and recommendations with patients and colleagues; Use health care resources appropriately, including human and financial resources; Maintain a professional image, using appropriate language and demeanor; Maintain their professional composure even in difficult situations; Maintain appropriate professional boundaries; Effectively detect and efficiently resolve situations presenting ethical dilemmas; Strongly value the need for continual professional growth and the change within the profession,

actively seeking feedback on their performance and reflecting on when additional development is required;

Can develop new strategies to achieve required learning, depending on the professional development required;

Consistently participate in activities or with organizations that promote the profession, and Effectively reflect on practice and develop appropriate practice management plans to improve

practice.


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