ROTATION SYLLABUS
P2 FALL & SPRING
PHRM 6101 and 6201: Introductory Pharmacy Practice Experiences 2 and 3
Dialysis Clinic
Preceptor & Site Information
Course Coordinator / Preceptor
Lewis McKelvey, PharmD, RPh
Assistant Dean of Experiential Education, Assistant Professor of Pharmacy Practice
Office: 326
Phone extension: 3866
Cell: 864-200-5020
Email: lmckelvey@presby.edu
Office hours: M-F 10:00 – 12:00 noon, and 2:00 – 5:00 PM. Contact Mrs. Carbonneau for appointments.
Site Information
DaVita Dialysis clinics, located in either Clinton or Greenville, SC
American Renal Associates dialysis clinic, located in Greenville.
Assigned site contact information available in E-Value
Course Description PHRM 6101 and 6201, Introductory Pharmacy Practice Experience (IPPE) 2 and 3 – Dialysis Clinic
This introductory pharmacy practice experience familiarizes students to a pharmacists’ involvement in outpatient Dialysis Clinics.
Student will interact with other healthcare professionals (i.e. doctors, nurses, nursing techs, dieticians) and other members of the
care team (e.g. social workers) to provide care during dialysis and during transitions of care.
Course Meeting Times
- Each rotation segment meets 4 hours per week on a Tuesday or Thursday morning from 8:00 – 12 noon; each segment has a 6
week* duration, excluding the Week 7 reflection meeting.
- Week 1 – All students from both Tuesday and Thursday morning segments will meet together with Dr. McKelvey at 8:00 AM on
Thursday of that week. The specific time and classroom location will be announced prior to this meeting.
- Week 2 – Week 6 – All students report to their assigned clinic on their assigned day at 8:00 AM unless otherwise designated, and
will remain the full 4 hours.
- Week 7 – All students from both Tuesday and Thursday morning segments will meet together with Dr. McKelvey at 8:00 AM on
Tuesday of that week. The specific time and classroom location will be announced prior to this meeting. The purpose of this
meeting is to have a group reflection discussion and to administer a post -rotation quiz based on syllabus objectives.
Site Description
Dialysis Clinics treat patients with chronic kidney failure and end stage renal disease. These outpatient facilities improve patients'
quality of life by providing clinical care, and by offering integrated treatment plans, personalized care teams and convenient healthmanagement services.
Patient Populations To Whom Students Exposed
Ambulatory community patients consisting of, but not limited to:
African-American
Men
Caucasian
Women
Hispanic
Adults 20-55 years old
Seniors 55-80 years old
Course Credit Hours: 2
Site Requirements for Students
Students should complete all prerequisite requirements required by the site. These requirements are communicated to
all assigned students by the Office of Experiential Education (Mrs. Susi Carbonneau).
Course Prerequisite
Current status as second year student in good standing in the PCSP program.
Methods of Assessment
The student will be assessed by the Course Coordinator, to include significant input from the preceptor delegate at the
clinic site, on performance and professionalism via electronic IPPE evaluations on the E*Value rotation management
database. Students will receive a midpoint assessment, which will not be used in the calculation of the final grade. The
assessment feedback received at midpoint will be used for student self-reflection and to set goals for the remainder of
this rotation segment. Students will receive a Pass or Fail final grade on the last day of the IPPE.
Faculty Approved Grading Scale:
70-100%
<70%
Pass (S)
Fail (U)
Grade Appeals
Students who wish to appeal a rotation or rotation segment grade must do so within one week of the date of the
preceptor’s final grade submission on E*Value. Please refer to the Academic Affairs policy regarding grade challenges
and appeals.
Attendance Requirements
Students are required to contact Dr. McKelvey (not the site) via email at least 2 weeks before the start of any IPPE rotation.
It is the responsibility of the Student to notify both the Office of Experiential Education (OEE), the Preceptor (Dr.
McKelvey), and the site of any absence. Time missed during any experience must be made up at Preceptor’s
discretion. Failure to do so may result in an automatic unsatisfactory evaluation.
Dress Code, Rotation Etiquette & Professionalism
Students are expected to abide by the dress code requirements set forth in the PCSP
Bulletin:
http://pharmacy.presby.edu/wp-content/uploads/2014/07/Bulletin_2014-2015.pdf
Required minimum attire includes clean and pressed PCSP lab jacket and PCSP student name badge.
Professionalism, as detailed in the PCSP Code of Professional Conduct, is exemplified by student behavior at the
experiential site.
Failure to demonstrate the following characteristics of professional behavior can result in an automatic grade of
“Unsatisfactory” for the course.
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Reading assignments (including this course syllabus) should be completed by end of Day 1.
Students are expected to arrive at the assigned site at the scheduled time and remain until dismissed.
Students should avoid any behavior that interferes with the ability of others to hear and learn.
Cell phones and other electronics should be muted, turned to vibrate, or turned OFF during rotations.
ACTIVE student participation during all experiences is expected by the School and should be encouraged by the
Preceptor, Preceptor delegate, and their associates.
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Textbook
Required: NONE
Honor Code
The School of Pharmacy supports and enforces the Presbyterian College Honor System. Pharmacy Students are
expected to read, understand, and abide by the tenets of the PC Blue Book. Quizzes, tests, examinations, projects,
and papers to be graded or submitted should be accompanied by the pledge “ On my honor, I pledge that I have
neither given nor received any unacknowledged aid on this assignment,” followed by the Student’s signature.
Unacknowledged aid includes aid that is not allowed by the instructor. On some rotations, Students will be expected
to work in small groups on certain assignments or projects. When authorized by the Preceptor, these activities are
not Honor Code violations. However, the interpretation of data and the reporting of results and conclusions are,
unless stated otherwise by the Preceptor, individual responsibilities.
Course Assignment
After the initial 2 hour Day 1 classroom meeting with Dr. McKelvey, students must familiarize themselves with the tenets
of this syllabus. Students will all meet together again for another 2 hour classroom meeting at the conclusion of the 6week segment.
At the time of the midpoint assessment, the Preceptor (Dr. McKelvey) may assign a Drug Information topic assignment
to each group of students. The students would present their assignment to Dr. McKelvey (or to the Director of
Experiential Education, or to the site preceptor delegate) at a time to be determined, prior to the end of the rotation
segment.
At the completion of each 6-week rotation segment, all students will meet for a class discussion and review quiz/exam
during the following week (Week 7).
Dr. McKelvey serves as the Course Coordinator and Preceptor for this unique IPPE.
Most on-site interactions at the DaVita or ARA clinics will be with the Facility Administrator (FA) at each site, with Dr.
McKelvey overseeing the activities. Dr. McKelvey will communicate with the FA and other healthcare professionals at
the site to provide guidance and gather information about student performance for grades.
The SC Pharmacy Practice Act designates these dialysis facilities as non-dispensing pharmacies, but since they do not
dispense to the public, only a consultant pharmacist is required. Dr. McKelvey serves as a consultant pharmacist for
these facilities.
Much of the information pertaining to the listed objectives and activities has been covered in your fall MTP and
Kinetics courses. Relevant terminology and some laboratory have been covered last year in Pathophysiology. Other
topics relevant to CKD including additional lab value data will have been covered in Dr. Goodbar’s MTM II Renal
course in your spring P2 year.
Review notes from Dr. Goodbar’s MTP lectures, which discuss PTH/Ca++/Phos cascade and their roles in bone
mineralization.
During the Day 1 presentation with Dr. McKelvey, students will be provided insight to the patient care operations of a
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ACPE Goals for this IPPE: (adapted from ACPE Guidelines, Appendix C)
The primary goal of this experience will be to allow the student to participate in the any of the following:
 Process and dispense new/refill medication orders
 Create patient profiles using information obtained
 Respond to drug information inquiries
 Interact with other health care professionals
 Perform calculations required to compound, dispense, and administer medications
 Interact with pharmacy technicians in the delivery of pharmacy services
 Billing third parties for pharmacy services
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Conduct patient interviews to obtain patient information
Interpret and evaluate patient information
Evaluate appropriateness of medication dosing utilizing basic dosing principles
Prepare and compound extemporaneous preparations and sterile products
Participate in educational offerings designed to benefit the health of the general public
Triage and assess the need for treatment or referral
Identify patient-specific factors that affect health, pharmacotherapy, and/or disease state
Assess patient health literacy and compliance
 Administer medications
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Provide point-of-care and patient-centered services
Conduct physical assessments
Communicate with patients and other health care providers
Observe documentation of interventions in patient records
Present patient cases in an organized format covering patient information
Course Learning Outcomes
Upon completion of this IPPE segment, the student should be able to:
1.
Understand and explain the general concepts of dialysis, including:
i. Type of patients who require dialysis (Dr. Fox lecture & Dr. Pedigo’s general lab data presentation)
ii. Functions and set up of the dialysis machines (clinic lab techs)
iii. Healthcare professionals and other specialists are involved in the treatment team and their
specific roles in the therapy
2.
Accurately perform and record history and physicals with assessment, differential diagnosis and
plan under the guidance of the preceptor or FA (make certain that students are able to do participate in
monthly med checks and MD/NP rounds)
3.
Develop skills to assess kidney function (Dr. Goodbar’s spring CKD lecture)
4.
Define complications of Chronic Kidney Disease (CKD) and appropriate treatments, including:
i. Anemia of CKD
ii. Hypertension Management
Acid/base disorders covered by Dr.
iii. Renal Osteodystrophy
Goodbar. Other topics can be discussed via
iv. Electrolyte Abnormalities
v. Fluid and Electrolyte Balance
MD/NP queries during rounds.
vi. Acid/Base Disorders
vii. Missed dialysis
5.
Effectively communicate with healthcare professionals and patients
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Learning Objective
Understand and explain
the general concepts of
dialysis
Accurately perform and
record history and physicals
with assessment,
differential diagnosis and
plan under the guidance of
the preceptor or FA
Develop skills to
assess kidney function
Activities/Assignments
Student
Completed
Successfully
(date)
 List types of patients who require dialysis and identify those
patients at the site
 Discuss treatment outcomes options for patients, to include
which patients would make good candidates for kidney
transplant.
 Understand the pathology, diagnosis and treatment of the
conditions being managed
 Define and understand terminology and
Terminology
disease states related to CKD patients
discussed in
and dialysis, including:
pathophysiology.
 Oliguria/Anuria
 Pre renal azotemia
Glomerular
 Acute kidney injury (AKI)
diseases discussed
 AKI on chronic kidney disease
in Dr. Goodbar’s
 End stage renal disease (ESRD)
CKD lecture
 Hematuria
 Proteinuria
 Pyuria
 Glomerular diseases (patho?)
 Renal disease in pregnancy
 Practice adjustment of medications and avoidance of renal
toxic agents in CKD (discuss on MD/NP rounds and apply
objective to monthly patient medication checks)
 Recognize urgent (i.e. acute) and emergent (e.g. chronically
developing) indications for hemodialysis
 Review and examine different filter sizes (discuss with RN
manager and/or Anemia Manager)
 Identify how the filter sizes affect drug therapy management
and identify specific medications that must be monitored or
changed due to filter size
 Meet and interact with the healthcare team
 Differentiate and discuss differences between ESRD treatment
options (peritoneal vs hemo vs and home training), and
hemodialysis access options (CVC vs Graft vs Fistula).
 Obtain accurate and comprehensive patient history (including
drug allergies, a description of allergic reactions, drugs being
taken, doses being used, over the counter medications being
taken, herbal/natural products begin used, self-care behaviors
and adherence)
 Classify patients with regard to CKD
 Prioritize patient problems and diagnoses, and outline
interventions needed (discuss with Social Worker)
 Make general recommendations regarding long term plans for
ESRD treatment (discuss with Social Worker)
 Recognize limitations of different methods to assess GFR
(kinetics lecture)
 Correctly interpret urinalysis, urine electrolytes and urine
protein/creatinine
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Learning Objective
Define complications of
Chronic Kidney Disease
(CKD) and appropriate
treatments, including:
i . Anemia of CKD
ii. Hypertension Management
iii. Renal Osteodystrophy
iv. Electrolyte Abnormalities
v. Fluid & Electrolyte Balance
vi. Acid/Base Disorders
vii. Missed dialysis
Activities/Assignments
 Explain the use of iron and ESAs
 List risks and benefits of erythropoeitic agents
 Recognize when to refer patients for dialysis access
placement (renal function degradation to the point of
CKD and ESRD; know lab diagnosis lab parameters)
 Participate in therapy management with the dietician
 Define and understand hypertension management for CKD
patients – benign, accelerated, malignant, essential and
secondary (apply relevant info discussed in MTM
sequences)
 Describe the use of vitamin D supplements and calcimetic
drugs
 Define renal osteodystrophy and hyperparathyroidism
 Identify the place in therapy of phosphate binders
 Define the treatments for fluid and electrolyte balance
 Outline the effects and treatments for missed dialysis
treatments
Student
Completed
Successfully
(date)
Effectively communicate with  Communicate appropriately with healthcare team during
medical rounds (emphasize opportunities for patient
healthcare professionals and
interactions)
patients
 Demonstrate effective communication skills (verbal,
nonverbal and written) with patients and families using
suitable language and avoiding jargon and medical
terminology
 Provide patient and caregiver self-management education
(discuss with SW possible roadblocks to effective outcomes)
 Accurately respond to drug information questions (MD inquiry
or being quizzed by practitioner)
 Explain CODE procedure for clinic facility
 Participate in discussions and activities that promote health
and wellness and the use of preventive care measures
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