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					                 Pharmacy 425
                  2011-2012



  Student Performance Assessment Booklet


              Institutional Rotation



Student’s Name: _______________________________

Institutional Site: _______________________________

Clinical Practice Area: ___________________________

Name Midpoint Evaluator: ______________________

Date Midpoint Evaluation: _______________________

Date Final Evaluation: ___________________________
Instructions for Preceptor Evaluation of Student
A formal midpoint and final assessment are required in addition to the daily feedback. The
student is responsible for providing the preceptor with a coil bound copy of the Student
Performance Assessment Booklet at the beginning of each rotation.


Assessment Scale Descriptions*
NEEDS IMPROVEMENT
Unprepared to Practice (1)
    Student not able to engage in activity or demonstrate skill(s) even with prompting and
       intervention from preceptor.
    Completes the activity incorrectly.
    Displays unsafe professional decision-making or behaviour in relation to the activity or
       skill(s) described.
Somewhat Prepared to Practice (2)
    Student completes activity or demonstrates skill(s) described with frequent prompting,
       intervention and support from the preceptor.

ACCEPTABLE
Prepared to Practice (3)
    Student completes activity or demonstrates skill(s) with minimal support or intervention
       from the preceptor.
    Makes safe choices with regard to patient care.
Well Prepared to Practice (4)
    Student completes activity or demonstrates skill(s) without prompting or intervention
       from the preceptor; usually at a level exceeding expectations for a 4th year pharmacy
       student.
    Is able to self-reflect on patient care experiences.
    Knows when to research further before providing information or advice.
Not Able to Assess (NA)
    Skill(s) described not applicable to this practice site.
       OR
    Student has not had an opportunity to demonstrate the skill(s) described.


*Adapted from rating scale used at Dalhousie University
Reference: Koenigsfeld CF, Tice AL, Organizing a Community Pharmacy Advanced Practice Experience. Amer J
Pharm Ed 2006;70(1) Article 22.




                                                   Pharmacy 425 – Student Performance Assessment || Page   2
Steps Involved in the Midpoint and Final Assessment

      Assessment of the evidence of the student’s performance based on the criteria outlined
       on the Student Performance Assessment
      Assignment of an overall mark of Needs Improvement (1 or 2) or Acceptable ( 3 or 4)
       for each major rotation objective at both the midpoint and final evaluation (Please only
       use whole number scores of 1, 2, 3 or 4)
      Ensure documentation of evidence supports the mark (strengths and areas for
       improvement)
      Discussion of the midpoint assessment with the student and implications for the
       balance of the rotation. Grades of 1 or 2 may indicate student is at risk of not passing
       the rotation – see steps below.
      Assignment of an overall mark (ie: Pass/Fail) for the rotation at the time of the Final
       Assessment.

Midpoint Assessment
The Midpoint assessment day/time should be scheduled at the beginning of the rotation and is
important to ensure the student is aware of his/her progress in the rotation as well as areas for
improvement. The preceptor is required to assess the student’s understanding and
performance of each of the objectives using the criteria outlined on the assessment forms. The
student may document in the performance assessment form the evidence of performance,
which he or she feels meets the course objectives. The student cannot assign their own mark
for their performance; the preceptor must do this. After discussing the midpoint evaluation,
goals for the balance of the rotation need to be finalized. Students are responsible to ensure
that all documents, which require review by the preceptor, have been provided in advance of
the assessment (midpoint or final) and all changes are incorporated by the deadline set by the
preceptor, which must be prior to the completion of the rotation.

Final Assessment – Rotation Mark
The final assessment involves assessment for each of the course outcomes and assignment of
an overall mark for the rotation. A rotation mark should not be provided until the preceptor has
reviewed all components of the portfolio and course requirements. The preceptor is
responsible for assigning a mark of Pass or Fail for the rotation. A recommendation of Pass
requires that the student achieve an overall mark of acceptable (a score of 3 or 4) for each
rotation objective.


Students who are Struggling and/or at Risk of Not Passing the Rotation

If at any point and in all cases in which there are concerns about the student’s performance
and/or ability to pass the rotation, the student and the Faculty must be informed of the
concerns. Faculty must be contacted to discuss the student’s situation at the earliest possible
time. This facilitates being able to tailor the rotation to meet the particular needs of the


                                              Pharmacy 425 – Student Performance Assessment || Page   3
student consistent with the course expectations. (Call, even if you are not sure that it is an
issue – it is much better than leaving it too late to help the student)

The following checklist based on AFPC outcomes, has been developed to assist students and
preceptors to identify situations that may require additional assistance and the need to
contact the Course Coordinator. Consider the student’s performance as early as after the first
week of the rotation. Please note this list is not all-inclusive, but a guide to consider.

I. Professional
         a. Timely completion of assignments
         b. Timely provision of specific patient care activities
         c. Attendance and/or participation
II. Care Provider
        a. Assessment of drug therapy and ability to identify significant drug related problems
        b. Adequate knowledge to deliver effective patient care
        c. Ability to set goals of therapy
        d. Ability to integrate patient specific factors into care plan
        e. Ability to document care
III. Communicator
        a. Communication with peers, preceptors and or other health care providers
        b. Communication with patients, family and or caregivers

Please contact Cheryl Cox if any questions or concerns. cheryl.cox@ualberta.ca 780 492-2110.

The Course Coordinator in collaboration with the student and the preceptor, will assess the
issues involved, document the areas in need of improvement, plan the steps to support
learning and improvement and set expectations and deadlines for the next assessment of the
student’s progress. At the time of the assessment, if a student demonstrates a level of
performance which is considered as “Unprepared for Practice” or “Somewhat prepared for
Practice”, a mark of 1 or 2 must be given for that objective. If by the end of the rotation, the
performance is not meeting the expectations of “Prepared for Practice” or “Well prepared for
Practice”, a mark 1 or 2 must be given for that objective and an overall mark of “Fail” for the
rotation.


Final Course Grade
Pharmacy 425 is a Credit/Non-Credit course. The final Course Grade is determined by the
Faculty Course Coordinator based on:

       1. the student’s performance assessment completed by the preceptor
       2. the quality of the contents in the portfolio
       3. attendance of mandatory orientation on-campus

The student’s performance assessment and the recommended rotation marks from the
preceptor are reviewed to ensure consistent application of Faculty standards.


                                              Pharmacy 425 – Student Performance Assessment || Page   4
The student may appeal a course grade of Fail at the Faculty level.
                                                                                      I. PROFESSIONAL
Performance Criteria

The student should be able to:

7.1    Demonstrate professionalism throughout               7.4     Practice in manner demonstrating professional
       patient encounters.                                          accountability.
7.2    Practice in an ethical manner which assures          7.5     Display a sense of pride in and commitment to
       primary accountability to the patient.                       the profession and its evolving role in the
7.3    Maintain their competence to practice through                health care system.
       life long learning.

Midpoint Assessment                                         Final Assessment
Record of Evidence:                                         Record of Evidence:
Examples of Performance (include both Strengths and Areas   Examples of Performance (include both Strengths and Areas
for Improvement)                                            for Improvement)




Midpoint Assessment Mark                                    Final Assessment Mark
Needs Improvement                                           Acceptable
1.    Unprepared for Practice                               3.    Prepared for Practice
2.    Somewhat Prepared for Practice                        4.     Well prepared for Practice
                                                                  “NA” Not able to Assess or Not Applicable


                                                     Pharmacy 425 – Student Performance Assessment || Page    5
Additional Criteria for Assessment of Professionalism
7.1 Demonstrate professionalism throughout patient encounters.
      7.1.1     show respect for patients by acknowledging the patient as a person, listening actively and
                considering their needs and expectations;
      7.1.2     accept responsibility for recognizing and meeting patients’ medication therapy needs;
      7.1.3     maintain patient confidentiality, and:
      7.1.4     maintain appropriate boundaries with patients.
7.2 Practice in an ethical manner which assures primary accountability to the patient.
      7.2.1     involve the patient in decision-making, respecting their right to make their own choices;
      7.2.2     fulfill requirements for obtaining patient consent;
      7.2.3     integrate patient preferences related to culture, beliefs and practices;
      7.2.4     use ethical frameworks as one component of professional judgment;
      7.2.5     prioritize patient needs, accepting inconvenience and subordinating their personal interests to
                those of their patients;
      7.2.6     ensure the continuity of patient care, abiding by the principle of non-abandonment, and:
      7.2.7     recognize and manage situations presenting ethical dilemmas including conflicts of interest.
7.3 Maintain their competence to practice through life long learning.
      7.3.1     adhere to regulatory requirements for maintenance of competence as consistent with the self-
                regulating status of a health professional;
      7.3.2     evaluate their practice to identify areas for continuing professional development;
      7.3.3     acknowledge and reflect on errors, omissions and close calls to identify limitations in competence /
                performance;
      7.3.4     seek and accept feedback to identify limitations or strengths in competence / performance;
      7.3.5     recognize their limits of competence and seek assistance;
      7.3.6     plan and undertake learning activities to support maintenance of competence and professional
                development;
      7.3.7     incorporate learning into their practice;
      7.3.8     assess the impact of learning on competence and practice performance, and:
      7.3.9     document their maintenance of competence.
7.4 Practice in manner demonstrating professional accountability.
      7.4.1     comply with the legal and regulatory requirements of practice;
      7.4.2     respect and fulfill professional standards of practice;
      7.4.3     be accessible to patients and other health care professionals;
      7.4.4     fulfill their professional tasks and commitments to patients in a diligent, timely, reliable, respectful
                manner;
      7.4.5     accept responsibility for their decisions and recommendations with patients and colleagues;
      7.4.6     use health care resources appropriately, including human and financial resources;
      7.4.7     maintain a professional image, using appropriate language and demeanour;
      7.4.8     maintain their professional composure even in difficult situations, and:
      7.4.9     maintain appropriate professional boundaries.
7.5 Display a sense of pride in and commitment to the profession and its evolving role in the health care system.
      7.5.1     participate in peer review and quality assurance processes;
      7.5.2     participate in education of future pharmacists by making practice-based learning opportunities
                available as a mentor / preceptor;
      7.5.3     adapt their practice to provide all professional services required according to pharmacist’s scope of
                practice;
      7.5.4     support the professional organizations in their efforts to advance the professional role of
                pharmacists, and:
      7.5.5     contribute to the planning for implementation of change including strategies to identify and
                overcome barriers, and to capitalize on facilitators.




                                                        Pharmacy 425 – Student Performance Assessment || Page         6
                                                                                                  II. Care Provider*
*(Patient medication reviews, Assessment and documentation of care for new Rx and refill Rx, OTC consults, medication reconciliation )

A.        Assess Patients – Performance Criteria

The student should be able to:
1.1    Develop and maintain professional, collaborative relationships required for patient care.
1.2    Elicit and complete an assessment of required information to determine the patient’s medication-related
       and other relevant health needs.
1.3    Assess if a patient’s medication-related needs are being met.
1.4    Determine if a patient has relevant, priority health and wellness needs.


Midpoint Assessment                                                   Final Assessment
Record of Evidence:                                                   Record of Evidence:
Examples of Performance (include both Strengths and Areas             Examples of Performance (include both Strengths and Areas
for Improvement)                                                      for Improvement)




Midpoint Assessment Mark                                              Final Assessment Mark
Needs Improvement                                                     Acceptable
1.    Unprepared for Practice                                         3.    Prepared for Practice
2.    Somewhat Prepared for Practice                                  4.     Well prepared for Practice
                                                                            “NA” Not able to Assess or Not Applicable

                                                              Pharmacy 425 – Student Performance Assessment || Page              7
B.       Plan Care - Performance Criteria

The student should be able to:
1.5    Refer patients for management of priority health and wellness needs that fall beyond the scope of
       practice of pharmacists.
1.6    Develop a care plan that addresses a patient’s medication-therapy problems and priority health and
       wellness needs.
1.7    Implement the care plan.
Note: Patient self-management care plan for drug therapy can include procurement, administration, monitoring,
documentation, and collaboration with health care professionals and caregivers.

Midpoint Assessment                                       Final Assessment
Record of Evidence:                                       Record of Evidence:
Examples of Performance (include both Strengths and       Examples of Performance (include both Strengths and Areas for
Areas for Improvement)                                    Improvement)




Midpoint Assessment Mark                                  Final Assessment Mark
Needs Improvement                                           Acceptable
1.    Unprepared for Practice                               3.   Prepared for Practice
2.    Somewhat Prepared for Practice                        4.    Well prepared for Practice
                                                                 “NA” Not able to Assess or Not Applicable




                                                      Pharmacy 425 – Student Performance Assessment || Page     8
C.       Follow-up and Evaluate - Performance Criteria
The student should be able to:

1.8 Elicit clinical and / or lab evidence of patient outcomes.

1.9 Assess and manage patients’ new medication-related needs.
Note: This includes planning for continuity of care for patients following the completion of your rotation.

Midpoint Assessment                                         Final Assessment
Record of Evidence:                                         Record of Evidence:
Examples of Performance (include both Strengths and         Examples of Performance (include both Strengths and Areas for
Areas for Improvement)                                      Improvement)




Midpoint Assessment Mark                                    Final Assessment Mark
Needs Improvement                                              Acceptable
1.   Unprepared for Practice                                   3.   Prepared for Practice
2.   Somewhat Prepared for Practice                            4.    Well prepared for Practice
                                                                    “NA” Not able to Assess or Not Applicable




                                                       Pharmacy 425 – Student Performance Assessment || Page     9
D.      Document - Performance Criteria
The student should be able to:

1.10 Support the continuity of patient care by documenting their patient care activities.
      1.10.1 document in a timely, retrievable, usable manner
      1.10.2 fulfill professional responsibilities for documentation
      1.10.3 report and document the reporting of adverse events and close calls

Midpoint Assessment                                   Final Assessment
Record of Evidence:                                   Record of Evidence:
Examples of Performance (include both Strengths and   Examples of Performance (include both Strengths and Areas for
Areas for Improvement)                                Improvement)




Midpoint Assessment Mark                              Final Assessment Mark
Needs Improvement                                        Acceptable
1.   Unprepared for Practice                             3.   Prepared for Practice
2.   Somewhat Prepared for Practice                      4.    Well prepared for Practice
                                                              “NA” Not able to Assess or Not Applicable
Care Provider - Care Plan Worksheet and Documentation Comments for Case #1
Comments should reflect your assessment of the entire process from 1st draft to final care provided.




Care Provider - Care Plan Worksheet and Documentation Comments for Case #2
Comments should reflect your assessment of the entire process from 1st draft to final care provided.




Total Number of patients assigned to the student across the rotation ______________



                                             Pharmacy 425 – Student Performance Assessment || Page   11
                                                                                  III. COMMUNICATOR
Performance Criteria
The student should be able to:
2.1. Communicate non-verbally and verbally with others.
2.2. Communicate in writing.
2.3. Present information. (*Note: group presentation)
2.4 Use communication technology.
Midpoint Assessment                                        Final Assessment
Record of Evidence:                                        Record of Evidence:
Examples of Performance (include both Strengths and        Examples of Performance (include both Strengths and Areas for
Areas for Improvement)                                     Improvement)




Midpoint Assessment Mark                                   Final Assessment Mark
Needs Improvement                                             Acceptable
1.   Unprepared for Practice                                  3.   Prepared for Practice
2.   Somewhat Prepared for Practice                           4.    Well prepared for Practice
                                                                   “NA” Not able to Assess or Not Applicable




                                                      Pharmacy 425 – Student Performance Assessment || Page    12
                                                                                 IV. COLLABORATOR
Performance Criteria
The student should be able to
3.1 Function as members of teams.
3.2 Support team-based care in a community setting with geographically distinct centres of care.
3.3 Work collaboratively with the patient and his/her health care professionals to provide care and services
    that facilitate management of the patient’s health needs.

Midpoint Assessment                                    Final Assessment
Record of Evidence:                                    Record of Evidence:
Examples of performance (include both Strengths and    Examples of Performance (include both Strengths and Areas for
Areas for Improvement)                                 Improvement)




Midpoint Assessment Mark                               Final Assessment Mark
Needs Improvement                                         Acceptable
1.   Unprepared for Practice                              3.   Prepared for Practice
2.   Somewhat Prepared for Practice                       4.    Well prepared for Practice
                                                               “NA” Not able to Assess or Not Applicable



                                                  Pharmacy 425 – Student Performance Assessment || Page     13
                                                                                                V. MANAGER
Performance Criteria
The student should be able to:
4.2 Manage the safe and efficient distribution of medications.
       4.2.3    identify the factors critical to safe and efficient medication distribution systems including pharmacy layout
                / design, workflow, technology and automation and;
       4.2.4    discuss human, environmental and medication distribution situations that place patients at risk.
4.3    Participate in quality assurance and improvement programs.



Midpoint Assessment                                          Final Assessment
Record of Evidence:                                          Record of Evidence:
Examples of promotion of patient medication safety           Examples of promotion of patient medication safety




Midpoint Assessment Mark                                     Final Assessment Mark
Needs Improvement                                              Acceptable
1.    Unprepared for Practice                                  3.   Prepared for Practice
2.    Somewhat Prepared for Practice                           4.    Well prepared for Practice
                                                                    “NA” Not able to Assess or Not Applicable




                                                      Pharmacy 425 – Student Performance Assessment || Page        14
                                                                                               VI. ADVOCATE
Performance Criteria

The student should be able to:

5.2    Promote the health of individual patients, communities, and populations.
5.3    Support the role of pharmacists in evolving health care systems.

Midpoint Assessment                                        Final Assessment
Record of Evidence:                                        Record of Evidence:
Examples of Performance (include both Strengths and        Examples of Performance (include both Strengths and Areas for
Areas for Improvement)                                     Improvement)




Midpoint Assessment Mark                                   Final Assessment Mark
Needs Improvement                                             Acceptable
1.    Unprepared for Practice                                 3.   Prepared for Practice
2.    Somewhat Prepared for Practice                          4.    Well prepared for Practice
                                                                   “NA” Not able to Assess or Not Applicable




                                                      Pharmacy 425 – Student Performance Assessment || Page    15
                                                                                              VII. SCHOLAR
Performance Criteria
The student should be able to:
6.1 Demonstrate a thorough understanding of the fundamental knowledge required of pharmacists and
      apply this knowledge in daily practice.
6.2 Provide drug information and recommendations.
6.3 Educate regarding medications and appropriate medication use, including the pharmacist’s role.
6.4 Apply principles of scientific inquiry and critical thinking while participating in practice-based research.


Midpoint Assessment                                    Midpoint Assessment
Record of Evidence: Examples of Performance (include   Record of Evidence: Examples of Performance (include both
both Strengths and Areas for Improvement)              Strengths and Areas for Improvement)




Midpoint Assessment Mark                               Final Assessment Mark
Needs Improvement                                          Acceptable
1.   Unprepared for Practice                               3.   Prepared for Practice
2.   Somewhat Prepared for Practice                        4.    Well prepared for Practice
                                                                “NA” Not able to Assess or Not Applicable



                                                  Pharmacy 425 – Student Performance Assessment || Page     16
                                                                     VIII. Final Mark for Rotation

 Site Name:

 Rotation Dates:


 Recommended Overall Rotation Mark for Student (Please insert Pass or Fail)


 Student's Name (Print)                                               _______

 Student’s Signature



 Primary Preceptor’s Name
                                           (Print)

 Preceptor’s Signature

 Preceptor E-mail                                                     _______




 Co-Primary pharmacist preceptors participating in this Assessment


         Name                              Signature                            E-mail       License #




This completed booklet must be signed by the primary preceptor and student, and mailed or
delivered to the Faculty within 1 week of completing this rotation.
Mailing address:

         Cheryl Cox
         c/o Alix Pearce
         Faculty of Pharmacy & Pharmaceutical Sciences
         3127 DP Building
         University of Alberta
         Edmonton AB T6G 2N8




                                                     Pharmacy 425 – Student Performance Assessment || Page   17

				
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