To be completed online in E*Value by practice educator once per academic year.
Practice Educator’s Name (please print):
Practice Site: Date:
The information you provide will be used to review the Experiential Education Program. Your thoughtful ratings and constructive comments will be extremely valuable in making appropriate changes.
Please indicate whether the activities could be fulfilled at the site:
Activity / Were the activities able to be fulfilled at the site?- Provide Comprehensive Patient Care and Medication Review Services
- Assess 80 Patients with New Prescriptions and 80 Patients with Refill Prescriptions for Drug Therapy Problems (DTPs)
- Provide Pharmaceutical Care to Patients Requesting OTC Products from Different Categories (10 per week)
- Provide Follow-Up Care to 10 Patients per week
- Provide Drug Information x 2 questions per week
- Drug Category Presentations x 2 per week
- Discuss Pharmacy Practice Issues
- Participate in Inter-professional Education
- Complete Health Promotion Project
- Professional & Interpersonal Skill Development
Please give your reaction to the following statements by selecting the response that best corresponds to your opinion:
Program / Agree / Neutral / Disagree / Not Applicable1 / The Learner Introduction form was a good icebreaker at the start of the rotation in order to assure that mutual interests and needs could be met.
2 / The Learning Contract was helpful to understand what the learner hoped to gain from the rotation.
3 / The OEE provided the site with sufficient information on the required activities and learner to be placed.
4 / I understood the Faculty’s expectations, goals and objectives for the rotation experience.
5 / The Course Syllabi and required activities helped me guide the learner’s experience on the rotation.
6 / The Evaluation Forms were easy to use.
7 / I knew the Office of Experiential Education was available if I needed to discuss the learner’s clerkship or to clarify the activities.
Program / Agree / Neutral / Disagree / Not Applicable
8 / I contacted the Office of Experiential Education and found the staff to be polite and courteous.
9 / I met with or spoke to the Course Coordinator regarding the learner’s performance and was provided with appropriate guidance.
10 / The Coordinator visited my site, and I found the site visit to be helpful in clarifying the rotation activities and expectations.
11 / I found the OEE website useful.
12 / Overall, I am satisfied with the direction of the Experiential Program.
13 / In general, this practicum experience helped the learner practice the problem solving process and clinical judgment.
14 / In general, this practicum experience helped the learner understand the profession.
15 / In general, this practicum experience provided the learner with an opportunity to practice the roles of an early pharmacist practitioner.
16 / In general, this practicum experience helped the learner understand the major concepts and principles of pharmacy.
Have you participated as a preceptor for The University of British Columbia Faculty of Pharmaceutical Sciences before?
YESNO
Have you completed preceptor training? (If YES, please provide specific program name and date of completion)
YES, Program Name: NO
Date Completed:
Would you like the Coordinator to do a site visit?
YESNO
As a current pharmacy preceptor you are eligible to apply for a Campus Wide Login (CWL) account and UBC Card which provides you with full access to the UBC Library Database.
If you would like to apply for a UBC Card, Please provide us with your EMAIL so we can forward to you the appropriate administrative forms to get the process started. **Please note processing may take up to 4-6 weeks to complete. Thank you for your patience. **
EMAIL:
Please indicate any other specific comments and suggestions which you feel will be helpful to the Experiential Education Program.
Completed forms can be submitted along with the “Practice Educator Evaluation of the Student” in a sealed envelope.
Phar479 HandbookCopyright © 2012 UBC Faculty of Pharmaceutical Sciences / 1