Description:
Preceptor: Dean Van Loo, Pharm.D. Office: W-052
Hours: 8:00-5:00
Phone: (269)251-2990
Email: vanloo@bronsonhg.org
General Description:
Internal Medicine (IM) is a required, 4 week learning experience at Bronson Methodist Hospital. The resident will be assigned to the internal medicine rounding team for the selected month. The team will be composed of an attending physician, various medical residents, interns, and/or students. Other disciplines may consult with or round with the team, including, but not limited to pharmacists, pharmacy students, respiratory therapy, dietary, and nursing.
Disease States:
Common disease states in which the resident will be expected to gain proficiency through literature review, topic discussion, and/or direct patient care experience may include, but not limited to:
○ Cardiovascular Disease: HTN, Congestive heart failure, CAD
○ Infectious Disease: CAP, HCAP, UTIs
○ Endocrine Disorders: Diabetes mellitus, thyroid disorders
○ Gastrointestinal Disorders: Stress-ulcer prophylaxis, upper/lower GI bleeds, IBD
○ Hepatic Diseases: Acute alcoholic hepatitis and cirrhosis
○ Neurologic Disorders: stroke, seizure disorders
○ Renal Failures (acute/chronic)
○ Respiratory Disorders: Asthma and COPD
○ Acute alcohol withdrawal and substance abuse management
○ Pain management
○ Thromboembolic disorders: DVT and PE
Preceptor Interaction
Daily: 07:55 Check with preceptor for morning information/pre-rounds 08:00 Attend morning conference
09:00 Work-up patients 10:30 Round with team
14:00 Meet with preceptor for topic discussions, patient reviews, journal club, etc Day 1: Preceptor to review IM/AC learning activities, schedules, and expectations
Week 1: Resident to work up assigned patients and present to preceptor and students. Preceptor will participate in rounds (modeling the pharmacist's role in the healthcare team).
Week 2: Resident to work up assigned patients and present to preceptor and students. Preceptor may
attend/participate in team rounds (coaching the resident to take on more responsibility as a pharmacist on the team).
Week 3-4: Resident to work up assigned patients and present to preceptor and students. Preceptor may attend and observe the resident's participation in team rounds, and/or may expect a summary report from the resident regarding rounding activities and use of recommendations made by the resident. Preceptor will be available for questions and will follow patients independently to monitor resident skill development in all aspects of the learning experience (facilitating the resident as the pharmacist on the team).
[The length of time the preceptor spends in each of the phases of learning will depend BOTH on the resident's progressions in the current rotation and where the rotation occurs in the residency program]
Evaluation Strategy
The resident will receive on-going, regular formative verbal feedback throughout the rotation. At the completion of the rotation the resident and preceptor will independently complete the Summative Evaluation in PharmAcademic, then will meet and compare the evaluations prior to cosigning. The resident will also complete the Learning Experience Evaluation and a Preceptor Evaluation for each preceptor.
Expectation of Residents:
The resident is responsible for identifying and resolving medication therapy issues for patients and will work toward assuming care of assigned patients on the service throughout the learning experience. The resident will be responsible for assigning patients, drug information requests, topic reviews, and journal clubs. They will also be responsible for providing and documenting therapeutic drug monitoring services for patients on their team.
Residents will also be expected to lead patient discussions and in conjunction with the preceptor is ultimately
responsible for the patients on service.
The resident will personally or direct a student to talk with the patient/patient's family to clarify all medication related issues (e.g. allergies, doses, home medications, adherence, etc.)
All interventions will be documented in a timely manner by the resident, decentralized pharmacist, and/or
preceptor.
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Taught and Evaluated Objectives
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Activities
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Goal R1.1
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In collaboration with the health care team, provide safe and effective patient care to a diverse range of patients, including those with multiple co-morbidities, high-risk medication regimens, and multiple medications following a consistent patient care process
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OBJ R1.1.1
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(Applying) Interact effectively with health care teams to manage patients' medication therapy
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Log interventions detailing changes recommended to improve patients' pharmacotherapy.
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OBJ R1.1.2
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(Applying) Interact effectively with patients, family members, and caregivers
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Clarify with patients when necessary to ensure accurate allergy and medication information.
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OBJ R1.1.3
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(Analyzing) Collect information on which to base safe and effective medication therapy
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Collect pertinent data in preparation for presenting patient to preceptor.
Present a care plan to preceptor based on information available before rounding with the academic team.
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OBJ R1.1.4
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(Analyzing) Analyze and assess information on which to base safe and effective medication therapy
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Collect pertinent data in preparation for presenting patient to preceptor.
Evaluate patient specific data to make recommendations to optimize patient pharmacotherapy.
Present a care plan to preceptor based on information available before rounding with the academic team.
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OBJ R1.1.5
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(Creating) Design or redesign safe and effective patient- centered therapeutic regimens and monitoring plans (care plans)
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Evaluate patient specific data to make recommendations to optimize patient pharmacotherapy.
Present a care plan to preceptor based on information available before rounding with the academic team.
Sustain ownership of the patient by following them on a daily basis and providing detailed instructions to responsible parties when resident is unavailable.
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OBJ R1.1.6
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(Applying) Ensure implementation of therapeutic regimens and monitoring plans (care plans) by taking appropriate follow-up actions
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Sustain ownership of the patient by following them on a daily basis and providing detailed instructions to responsible parties when resident is unavailable.
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OBJ R1.1.7
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(Applying) Document direct patient care activities appropriately in the medical record or where appropriate
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Log interventions detailing changes recommended to improve patients' pharmacotherapy.
Sustain ownership of the patient by following them on a daily basis and providing detailed instructions to responsible parties when resident is unavailable.
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OBJ R1.1.8
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(Applying) Demonstrate responsibility to patients
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Clarify with patients when necessary to ensure accurate allergy and medication information.
Present a care plan to preceptor based on information available before rounding with the academic team.
Sustain ownership of the patient by following them on a daily basis and providing detailed instructions to responsible parties when resident is unavailable.
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Goal R4.1
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Provide effective medication and practice- related education to patients, caregivers, health care professionals, students, and the public (individuals and groups)
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OBJ R4.1.1
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(Applying) Design effective educational activities
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Lead a topic discussion with the pharmacy students, both formally and spontaneously on rounds.
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OBJ R4.1.2
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(Applying) Use effective presentation and teaching skills to deliver education
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Lead a topic discussion with the pharmacy students, both formally and spontaneously on rounds.
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OBJ R4.1.3
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(Applying) Use effective written communication to disseminate knowledge
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Lead a topic discussion with the pharmacy students, both formally and spontaneously on rounds.
Log interventions detailing changes recommended to improve patients' pharmacotherapy.
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OBJ R4.1.4
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(Applying) Appropriately assess effectiveness of education
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Lead a topic discussion with the pharmacy students, both formally and spontaneously on rounds.
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Goal R4.2
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Effectively employs appropriate preceptor roles when engaged in teaching students, pharmacy technicians or fellow health care professionals
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OBJ R4.2.1
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(Analyzing) When engaged in teaching, select a preceptor role that meets learners' educational needs
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Lead a topic discussion with the pharmacy students, both formally and spontaneously on rounds.
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OBJ R4.2.2
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(Applying) Effectively employ preceptor roles, as appropriate
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Lead a topic discussion with the pharmacy students, both formally and spontaneously on rounds.
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Evaluations:
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Evaluation
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Evaluator
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Evaluated
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Timing
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Summative Evaluation
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All Preceptors
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Each Resident Taking this Learning Experience
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Ending and Quarterly if Needed
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ASHP Learning Experience Evaluation
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Residents
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Learning Experience
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Ending and Quarterly if Needed
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ASHP Preceptor Evaluation
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Residents
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All Preceptors of this Learning Experience
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Ending and Quarterly if Needed
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Summative Evaluation
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Residents
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Each Resident Taking this Learning Experience
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Ending and Quarterly if Needed
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