Put everything that counts in the rotation manual

This next section of the manual provides information on the policies and expectations. In the first section, there are under hours you can see that it was made very clear to the students that they were expected to show up to the hospital

between 8 and 8:30 a.m. And I did not want them to leave the hospital

before 4:30 p.m. So I didn’t want them disappearing in the middle of the afternoon. This made it very clear, no misunderstanding. I also wanted the students to understand that they needed to attend every day of the rotation. And if they could not attend, they needed to

contact me between 8 and 8:15 or contact someone else in the pharmacy if they couldn’t reach me. This type of information is very important. You can’t assume that students know that when they should show up or when it’s appropriate to leave? What they should do if they don’t feel well and going to be absent that day? That type of information should be well spelled out and provided to the students so there are no misunderstanding. Next section of the manual that I like to illustrate are the learning outcomes. Naturally, if everything revolves around learning outcomes, it’s needed to provide those learning outcomes to the students.

Every major learning outcomes of rotation should be printed and provided to the students in the manual. You can see here on the first couple of learning outcomes. Right off the bat, we’re talking about the fact that students are going to need to identify patient monitoring parameters that relate to the patient’s problems list and/or drug list. They’re going to have to collect such data. Second, learning outcomes make it very clear that they’re going to have to be able to evaluate patients therapy and write a SOAP. So we’re clarifying what the student needs to be able to do. So when there’s any question about what students are going to be expected to accomplish during the rotation.

Preceptor can refer the student to a clear, defined list of learning outcomes. Now, in my rotations I always included clinical pharmacokinetics, so you can see number 8 down there toward the bottom of the slide. They were expected to perform a pharmacokinetic analysis to adjust the dosing of the patient. For drugs like an aminoglycoside, phenytoin, and theophylline. Back in 1982, just about every asthmatic was taking the theophylline, so there was a lot of pharmacokinetic dosing performed by pharmacist at that time. Not so much today. The next section of the manual involves clarifying responsibilities for the student. The student understands that one of the learning outcomes is for them to be able to monitor patients during the rotation.

They also need to understand what the expectations are. In terms of how they go about monitoring patients. But you can see here is. We’ve indicated to the students that they will be expected to closely monitor 3-5 patients at all times. That means if one of their patients discharged from the hospital, they would have 24 hours to pick up a new patient. We also provide information that tells them. They not only need to gather laboratory information and other relevant information about the patient by using a monitoring form. But they have to write a SOAP for the patient, a SOAP note. Now this provides for a consistency of information that were notifying the students about the learning outcomes.

Tell the student you do need to learn how to SOAP patient as part of patient monitoring. These responsibilities indicate to the students that part of their responsibility is to be able to soak 3-5 patients at all times. That’s the activity that they will be involved. We would also have an assessment form that would lists criteria that would be used to evaluate the student SOAPs. And lastly, in terms of the schedule on the calendar for the rotation. The student would know that on Thursdays, the SOAP would be evaluated. So they know they’ll have to turn the SOAP on Thursday. So students would know on Wednesday, you gonna have to make sure that you really have your SOAPs up-to-date.

For providing optimal information, it could guide the students to success. This portion of the manual includes the grading system that will be used. This is something students will certainly pay a great deal of attention to. This first part list all the items that will be graded. Now you can see that, not every aspect of the grading, includes the same number of points. And in this rotation patient monitoring was much more important. It was given higher priority, 275 points, which is much more than all the other items. Now there are many items on this in this rotation. I should emphasize that, in 1982, at the Medical College of Ohio, these were nine-week rotations.

It is even more reason to build a lot of structure into the rotation and provide a lot of information to the students. Because it would have been very draining as a preceptor. Over nine weeks to keep the students occupied if I didn’t have everything very carefully meticulously planned. Now the other thing to keep in mind is the back then as an individual preceptor, I was assigned 4-6 students at a time. So again, good planning was critically important. For my whole day would have been consumed overseeing the performance of students and I had many other responsibilities to the hospital. So it emphasizes the need for this type of planning and detail in designing a rotation.

The next element of grading and I’d like to emphasize. You can see above, all the elements that were graded. From a final exam that I mentioned in the session 2. All the other elements that were graded. You can see the variability of points and you can see that. For each of these, it would have been necessary to have an assessment form to make sure that student knew how they would be graded and what the criteria were for the evaluation. Section at the bottom is something that I would strongly recommend. It’s signs of penalty for late assignments. Students every once in a while have a tendency to turn in the assignments a little late.

That can be very disruptive within a rotation. When a preceptor is planning to be able to evaluate student performance  on a certain day if the student doesn’t turn it in on time. That delays processes that might interfere with preceptors other responsibilities. So I was very strict with students to make sure they understood it was important to turn things in on time. So I use a system of analyzing students for turning things late. It was very simple. Any assignment was one day late would be rated at only 70% of what the student actually earned. And every day thereafter that percentage would decrease from 70, 60, 50, 40, to 30 percent.

With this type of limitation of grading, students were very cautious to turn things in on time. They understood what the rationale was. It was important to me that they be reliable and turn it in on time. And they remain consistent to the planned schedule.