The Advanced Practice Ambulatory Medicine Experience

General Objectives

At the conclusion of the ambulatory medicine experience the student should be able to:

  1. Demonstrate an understanding of the pathophysiology and treatment of chronic diseases encountered during the experience and/or assigned by the instructor.
  2. Monitor the patient profile, the medical record and other available patient data to assist in drug-related problem identification and resolution.
  3. Contribute to the patient data base by taking medication histories, detecting and reporting adverse drug reactions, and encouraging the use of appropriate drug monitoring parameters.
  4. Develop, implement, and monitor a pharmacotherapeutic patient care plan for each patient assigned identifying: a) the pertinent therapeutic drug-related problems; b) the priority ranking of those problems within the patient; c) the plan for the drug-related treatment of those problems and the intervention strategies; and, d) the indices necessary to monitor the progress of the problem resolution.
  5. Individualize patient dosage regimens using appropriate monitoring parameters and pharmacokinetics when serum drug levels are available.
  6. Demonstrate effective patient communication techniques through direct communication, group learning sessions, and/or newsletters.
  7. Assess patient medication compliance and strategies for improving compliance.
  8. Evaluate patient's drug response using physical assessment skills, when indicated.
  9. Consult with other health professionals regarding drug selection, alternative therapies, cost-effective therapy, and drug information.
  10. Actively participate in medication counseling and patient education.
  11. Actively participate in drug utilization reviews and clinical drug investigations, where available.
  12. Assist in the labeling and delivery of medications where appropriate.
  13. Describe effective means to delivery clinical pharmacy services to the ambulatory patient.

Required Ambulatory Medicine Clerkship Forms

Those to return to the office

  1. End-of-Rotation Assessment - preceptor completes online
  2. Mid Rotation Self Assessment
  3. Personal Reflection - one copy goes to the preceptor, one copy goes to Purdue
  4. Clerkship Site/Instructor Evaluation Form (online)
  5. Affidavit of Experience- original goes to Purdue, copy goes in the student's portfolio
  6. Request for Absence Form (if applicable)

Those to place in student portfolio

Required
  1. Mid Rotation Self-Assessment
  2. End-of-Rotation Assessment
  3. Oral Presentation Evaluation Form(s)
  4. Skill-based Competency Sign Off sheets (place these in the front of the manual)
As Applicable
  1. All cases, handouts, and bibliographies from presentations
  2. End of Block Evaluation Form
  3. Articles and reports prepared by the student during rotations
  4. Other documents prepared during clerkship rotations evidencing relevant experiences and abilities

Potential Activities for the Ambulatory Medicine Rotation

  1. Counsel patients on new prescription medication, refill prescription medication, and over-the-counter medication.
  2. Detect drug-related problems in assigned patients (e.g. interactions, dosing, adverse reactions) and develop rational solutions to these problems.
  3. Research and answer any drug information questions from the assigned health care practitioner.
  4. Provide pharmacokinetic and nutritional consultations for assigned patients, as appropriate.
  5. Attend and participate in various committee meetings of the health care setting as available.
  6. Design and implement a brown bag service for the rotation site's patient population, where applicable.
  7. Design and implement a free blood pressure or blood glucose screening, where applicable.
  8. Design and deliver an inservice for the pharmacy staff or other ambulatory staff.
  9. Design and deliver a community health presentation to be given at a local retirement home, nursing home, pharmacy, or other community center.
  10. Design and implement a service to aid in the pharmacy or ambulatory site's dispensing routine.
  11. Develop educational brochures on disease state awareness, treatment, or other pertinent patient-related topics.
  12. Design a health awareness or informational newsletter for the patient population to aid in education and awareness of health issues, medication, and other pertinent patient-related topics.
  13. Develop marketing strategies and services to aid in community awareness of services provided.
  14. Develop programs to improve continuity of care for diabetes, tuberculosis, asthma, smoking cessation, etc.

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