Rotation Structure Worksheet – IPPE III Clinical
Company/Site: ________________________________________________________________________________________________________
Participant: __________________________________ E-mail: _____________________________ Contact #: ____________________________
Competency
Teaching Method
Assessment/Documentation
1 Develop a patient-specific problem
list
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
2 Assess prescription orders for
potential drug-related problems
(e.g. drug-drug and drug-disease
interactions)
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
3 Develop a plan when a prescription
order
presents a potential drug-related
problem
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
4 Discuss the risk of toxicity and the
signs and symptoms of toxicity of a
drug or drug class in relation to the
patient’s therapeutic regimen
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
5 List the patient factors that may
influence the selection of therapy,
to include, drug, dose, dosage form,
duration of therapy etc.
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
Status: IP – In Progress / TBD – To Be Developed
Activity
(How is it achieved?)
Time Frame: H1 – 1st half of rotation / H2 – 2nd half of rotation / ONG - Ongoing
Status
IP/TBD
Time
Frame
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Rotation Structure Worksheet – IPPE III Clinical
6 Discuss factors to consider when
determining therapeutic outcomes
for a patient
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
7 Design a therapeutic regimen to
achieve desired therapeutic
outcomes
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
8 Devise a plan to monitor the
regimen
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
9 Discuss the patient and lab
parameters that will measure the
achievement of the desired
outcome
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
10 Demonstrates judgment, initiative,
responsibility, and maturity.
Displays a cooperative attitude and
is receptive to feedback
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
11 Reports to rotation site, patient
care activities, group discussions,
and meetings on time
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
Status: IP – In Progress / TBD – To Be Developed
Time Frame: H1 – 1st half of rotation / H2 – 2nd half of rotation / ONG - Ongoing
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Rotation Structure Worksheet – IPPE III Clinical
12 Exhibits neatness and
professionalism in appearance and
work.
13 Demonstrates tact when dealing
with staff, patients, and other
health professionals
Status: IP – In Progress / TBD – To Be Developed
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
□ Lecture
□ Panel experts □ Video Tapes
□ Small Group □ Case Studies □ Guest Speaker
□ Project
□ Role Play
□ Observation
□ Group Discussion □ Guided Practical Experience
□ Other: __________________________________
Time Frame: H1 – 1st half of rotation / H2 – 2nd half of rotation / ONG - Ongoing
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ Test □ Quiz □ Research Paper □ Poster
□ Individual Project □ Group Project
□ Oral Presentation □ Other □ Homework
□ Observation
□ Lab exercise
□ Documentation____________
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
□ IP
□ TBD
□ 1st half
□ 2nd half
□ Ongoing
Page 3