SUMMATIVE EVALUATION

AMBULATORY CARE ROTATION
Resident: / Date Completed:
Preceptor: / Time Period of Learning Experience:
  • This form documents resident attainment of goal areas formally taught in the learning experience. Evaluation of goal mastery is based on preceptor judgment of resident performance on the associated objectives listed below each goal.
  • There are two categories of evaluation. The first category is an evaluation of goals designated for formal evaluation. The second category is of goals selected to be formally taught in the learning experience, but not chosen for formal evaluation.
  • Preceptor will provide a narrative commentary for each goal in the first category of evaluation which is based on current resident performance level and reflects the aggregate resident activity during the rotation.

NI = Needs Improvement; SP = Satisfactory Progress; ACH = Achieved

Category 1: Goals Designated for Formal Evaluation
GOALS AND ASSOCIATED OBJECTIVES / DESCRIPTION OF REQUIREMENTS / NARRATIVE COMMENTARY / NI / SP / ACH
Goal S1:Take personal responsibility for attaining excellence in one’s own ability to provide pharmaceutical care.
OBJ S1.2(Characterization) Display initiative in preventing, identifying, and resolving pharmacy-related patient-care problems.
OBJ S1.3(Organization) Choose daily activities so that they reflect a priority on the delivery of direct patient care.
OBJ S1.4(Synthesis) Devise efficient
strategies for one’s own practice activitiesthat maximize the delivery of appropriate direct patient careto each patient within a limited time frame. / The resident is expected to prepare for clinic beforehand by printing and reviewing patients, preparing questions for interviews and for health care practitioners. Daily activity is directed toward improved patient outcomes and documentation of progress is expected. A written log of clinic activities is kept and reviewed at least every other day with the preceptor. Findings regarding medication problems, omissions, and needs are communicated to the health care team and the patient is educated appropriately. The resident shows progress in designing and managing their day for efficiency, and these activities are timely.
Goal S3:Demonstrate the characteristics of a
professional.
OBJ S3.1(Organization) Choose daily activities so that they reflect the pursuit of expertise in the development of direct patient-care problem-solving skills.
OBJ S3.4(Characterization) Consistently maintain personal self-control and professional decorum.
OBJ S3.5(Characterization) Demonstrate acceptance of one's professional responsibility toward colleagues and the health system through commitment to one's team..
OBJ S3.7 (Organization) Present pharmacy concerns, solutions, and interests in an assertive manner. / The resident meets dress code, is prepared with patient information, arrives on time, and participates as a respected professional vs. observer. The resident addresses the team with respect and tact as s/he presents information directed toward patient improvements. Actions in the clinics are presented without undue emotion and differences and conflicts are handled professionally, without patient involvement. The resident directs energy and goals to the good of the patient and the institution.
The resident is as assertive as necessary without alienating another member or pharmacy as a service.
Goal S9:Solve practice problems efficiently.
OBJ S9.1(Application) Demonstrate consistent use of a systematic approach to problem solving.
OBJ S9.2 (Application) Use consensus-building skills. / The resident demonstrates problem solving by reviewing possible causes, researching, weighing options and choosing based on patient factors and goals set. The resident further weighs the options of addressing the team, selecting strategy suitable for the players, and designed for the patient’s good.
Goal S19:Manage time effectively to fulfill practice responsibilities. / Residents will need to work with efficiency in the clinic, prepare on their own, at times, and pace themselves to prepare on time throughout the rotation. Missing clinic time is not an option unless agreed to by the preceptor. Follow up with team members on outstanding questions or issues are imperative.
Goal P1: Establish a collaborative working relationship with physicians and other healthcare providers in the health system. / Work to understand the motivations, requirements, needs and challenges of the medical team members to better support them and their patient related activities. Attempt to anticipate their needs and surpass them.
Goal P2:Design, recommend, monitor, and evaluate patient-specific therapeutic regimens that incorporate the principles of evidence-based medicine (the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients).
  • Reviewing patients with resident throughout rotation in a verbal fashion will assist with this part of the evaluation. Identify drug therapy/disease states and any potential problems. Determine goals and monitoring plan to achieve those goals
  • Formal Care Plan and CBA Evaluation Required (Attach to this Evaluation)
/ This objective is paramount to the residency rotation experience.
The resident is expected to prepare and maintain the appropriate database to know the needs of their patients, including texts, proper handbooks, and use of appropriate web sites. Evidence based therapeutic issues should be used as benchmarks. Preceptors are responsible to monitor the use of resources and help the resident reach a decision. The resident is expected to formulate, prepare, and present suggested changes in therapy to promote optimal outcomes.
Examples of this process will be formally evaluated using CBA.
Goal P3:Provide concise, applicable, comprehensive, and timely responses to requests for drug information from patients, health care providers, and the public. / Drug information questions, queries, analysis, etc, will be the responsibility of the resident with guidance by the preceptor. Forms for documentation are not only useful but required and completed forms should be part of the resident’s portfolio. Proper sources for answering questions are available in the clinics and should be used. Delivery of the answer to the question must be pertinent to the patient situation and to the practitioner.
Goal P4:Document direct patient-care activities appropriately. / Patient care activities should be recorded on the resident log sheet, in the portfolio, and in the institution medical record as appropriate. When in doubt ask the preceptor concerning the content, location for the entry, and procedure for doing so. Protocol should be used according to the clinic the resident is in at the time.
Goal P12:Understand a process for formulating and delivering programs that center on disease prevention and wellness promotion. / Disease prevention and wellness is a priority. The resident should understand the needs of patients by addressing educational abilities (sight, literacy, interests, needs, dependency on a partner in the home, etc.). The resident should collect and use teaching guides, expertise of others, and deliver education in the format the patient is most likely to learn (printed material, demonstration, modeling, etc.)
Goal M18:Provide instruction to pharmacy technicians, pharmacy students, pharmacy residents, and pharmacists. / The resident is not responsible for the teaching of other residents or undergraduate students in pharmacy or another discipline. However, sharing information, including others in their experiences, etc is expected, as is necessary for them to succeed.

Category 2: Goals Selected to Be Formally Taught But Not Formally Evaluated

GOALS AND ASSOCIATED OBJECTIVES / Description of Requirements / NEEDS ATTENTION
Goal S11:Display a caring attitude toward patients in all
aspects of job responsibilities. / The resident considers working with patients a privilege, and considers the patient and their companions guests in the institution. The resident works to assure the patient is as comfortable, as informed, and as cared for as possible. The resident shows the patient respect, and shows compassion and assurance as the patient attempts to succeed in caring for themselves.
Goal S12:Maintain confidentiality of patient and proprietary business information. / Patient information, business information, research information and the personal information of co-workers are to be protected. Verbal, electronic, written and implied communication of this information is not tolerated and jeopardizes the trust instilled in employees, and the trust built between practitioners and patients. Policy of the institution is to be read, and honored.
Goal M1:Identify a core library, including electronic media,
appropriate for a specific practice setting. / The resident will be given guidelines for developing a personal library. In ambulatory care, this library should be maintained, with emphasis on the patient situations encountered. Presentations attended, presented, and collected should be part of this.
OBJ S3.6(Synthesis) Develop and implement an effective system for assessing the quality and accuracy of one's own work. / Self evaluation should be a daily practice. The resident should consider the contribution s/he has made to the institution and to the staff and patients served, and reflect on methods to enhance this in the future. Journaling is encouraged and the journal should be part of the portfolio.

Overall Comments:

Areas of strength (required):

Areas to focus on for enhancement/improvement (required):

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Resident Signature Preceptor Signature Program Director Signature