SPEP 2
Manual
Structured Practical Experiential Program
Kelly Brink
Nancy Kleiman
2015
SPEP 2
2015
1
Table of Contents
Acknowledgements ................................................................................................................. 3
Overview ................................................................................................................................. 4
Course Information.................................................................................................................. 5
Course Requirements .............................................................................................................. 6
SPEP 2 Executive Summary - Institution.......................................................................... 10
Suggested Learning Activities - Institution .......................................................................... 11
Day 1 ..................................................................................................................................... 11
Day 2 ..................................................................................................................................... 12
Day 3 ..................................................................................................................................... 13
Day 4 ..................................................................................................................................... 13
Day 5 ..................................................................................................................................... 14
SPEP 2 Executive Summary - Community ........................................................................... 15
Community Pharmacy - Suggested Learning Activities ....................................................... 16
Day 1 ..................................................................................................................................... 16
Day 2 ..................................................................................................................................... 17
Day 3 ..................................................................................................................................... 18
Day 4 ..................................................................................................................................... 19
Day 5 ..................................................................................................................................... 19
Example Optional Activities ................................................................................................. 20
SPEP 2 OTC Quiz ................................................................................................................. 21
Topics covered in Clinical Pharmacy 1 & PSL 2 .................................................................. 22
Tool Kit - Table of Contents ................................................................................................. 23
SPEP 2
2015
2
Acknowledgements
On behalf of the College of Pharmacy I would like to thank all of the preceptors who invest
their time and effort training the next generation of pharmacists. It is an exciting time in the
profession of pharmacy and change is always challenging.
Thank you to all of the students and preceptors for your feedback. It is instrumental in the
continual development and improvement of our experiential program.
Thank you to Nancy Kleiman for her advice and guidance in coordinating the experiential
program and we wouldn’t be able to keep up with everything without the help and hard
work of Christine Laqui our College’s pharmacy technician.
Kelly Brink
Structured Practical Experiential Program Coordinator
SPEP 2
2015
3
Overview
The general objective of the Structured Practice Experiential Program (SPEP) is to provide students
with an opportunity to enhance their classroom learning with “real world” experience. The specific
objectives for this course are designed to complement the material students would have covered to
this point in their academic career. This course focuses on the development of the various
professional practice skills that include introduction to the drug distribution, development of
professionalism, communication with patients and healthcare professionals, patient self-care
education and providing drug information.
This manual serves as a guide for students and preceptors outlining their responsibilities. It consists
of two main sections. The first section represents a general description of the course, including its
general objectives and course policies and the expectations placed on students and preceptors. The
second section outlines the specific learning objectives for both community and hospital practice
experiences. All of the learning objectives will be introduced and evaluated according to a list of
suggested learning activities. If time permits, preceptors may add additional relevant activities.
Students and preceptors are advised to review the learning objectives and learning activities together
in order to get a better understanding of the degree of complexity of each and how they might be
best approached.
In addition to the manual described above, there is a toolkit containing reference information
related to the course. Both can be found in RxPreceptor in the Document Library. (tab on the left
side of the screen) see below:
**New this year** Students will complete their evaluation forms online (RxPreceptor) by the end of
the rotation. (under the Evaluations tab on the left side of the screen)
SPEP 2
2015
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Course Information
Course:
Coordinator:
Office:
Telephone:
Manitoba)
FAX:
E-mail:
SPEP 2, PHRM 2700
Ms. Kelly Brink
Room 117
(204) 474-6282 or cell 204-223-6658 or 1.800.432.1960, ext 6282 (in
(204) 789-3744
kelly.brink@umanitoba.ca
Structured Practical Experiential Program 2 (SPEP 2) is a practical experience course for which the
student receives academic credit. It consists of a 2 week (2 – 1 week blocks) clerkship designed to
provide pharmacy undergraduate students with an early exposure to a variety of pharmacy sites (e.g.
community and institutional pharmacy practice). The student will practice under the close
supervision of selected pharmacists and technicians.
The aim is to have the student experience the broadest possible exposure to pharmacy practice in the
course of the rotation. The level and depth of exposure and activities will depend upon the students
prior experiences. This experience may therefore be the student’s first significant exposure to
community/hospital pharmacy practice. Therefore; (s)he will probably need:
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guidance and/or a structured format to follow while observing and participating
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detailed explanations of tasks, responsibilities, expectations, etc.
·
the opportunity to observe prior to attempting to perform a task
·
close supervision
Please see the summary of academic courses students have completed in the toolkit (in the
Document Library in RxPreceptor or online: http://umanitoba.ca/pharmacy/students/spep.html.)
Students’ experiences will vary according to the practice site assigned, the particular types of
pharmacy services provided at the site, the types of patients who frequent the site, the professional
activities within the pharmacy, the ideas/opinions of the preceptor and pharmacy staff relating to
pharmacy practice, and the individual student’s initiative and interactions. Each student should view
his/her experience as unique and strive to benefit from observation and discussion and interaction
with their preceptor, other pharmacy staff and patients.
SPEP 2
2015
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Course Requirements
Schedule
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The experiential rotation occurs in a two week period after the 2nd academic term of the 2nd
year of the pharmacy program. The exact dates will be announced early in the academic
year.
The rotation consists of two - 1 week blocks, requiring a minimum of 40 hours at each
site.
Students are required to adhere to the schedule established by the practice site. Schedules are
prepared by the primary preceptors at each site.
Attendance
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Attendance at the orientation sessions, debriefing session and at the practice site is
mandatory for credit to be received.
Students must request special permission from the SPEP Coordinator, Ms. Kelly Brink, for
any changes to their rotation schedule.
Students are expected to be punctual and be present at the rotation site according to the
schedule arranged with your preceptor.
If for any reason a student is going to be absent, the preceptor and SPEP Coordinator
must be contacted in advance. In the event that the preceptor cannot be reached directly, it
is important to leave a message for the preceptor and to contact the SPEP Coordinator.
Excused absences include legitimate illness or family emergency or sanctioned Faculty
events. In the event of a legitimate illness or family emergency resulting in an absence
greater than 1 day, written documentation must be provided to the SPEP Coordinator.
Specific request for time away from practice rotation (e.g. a job interview) must be arranged
prior to the event and with mutual agreement of the SPEP Coordinator, preceptor and
student.
All other reasons for not reporting to the rotation site as scheduled will be considered
unapproved absences, unless prior approval was obtained and arrangements were made with
the SPEP Coordinator and the practice site preceptor.
To fulfill the experiential program requirements, students must make up absences, excused
or otherwise.
In the event of inclement weather, the student should contact his/her preceptor to determine
the need for reporting to the site.
Students may NOT take any other courses or attend classes during the weeks of the SPEP 2
rotation, without prior approval of the SPEP Coordinator.
Evaluation
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The student’s standing in the course is based primarily on the primary preceptor’s evaluation of
the student’s performance during the rotation, but is also based on the satisfactory completion
and submission of all required assignments to the SPEP Coordinator and is based on attendance
at both the orientation and debriefing sessions. Preceptors will evaluate the ability of the
students to complete the identified tasks that were developed in accordance to the specific
objectives stated for community and hospital practice.
The course is graded on a PASS/FAIL basis. All tasks must be completed satisfactorily in
order for the student to pass the course.
If a student fails to achieve a grade of PASS in SPEP 2, the SPEP Coordinator, in consultation
with the preceptor will determine whether or not the rotation must be repeated or extended and
in some circumstances if the entire course must be repeated.
SPEP 2
2015
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The final course grade will be determined by the SPEP Coordinator.
A student can be removed from the rotation because of unsatisfactory behavior or if the student
poses a risk to patients or to the operation of the pharmacy. In such cases the student will be
assigned a grade of FAIL.
Pledge of Confidentiality
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All students are required to sign a Pledge of Confidentiality in their first year in the College (see
a copy of the form in the toolkit).
The pledge is required for compliance with the Personal Health Information Act and to respect
the right of the pharmacy practice site to confidentiality concerning its business practices.
Professional Standards
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Students are expected to behave in a professional manner and in accordance with the Standards
of Practice for Professional Students at all times during the course of their rotation.
Students are also expected to wear appropriate, professional attire suitable to their experiential
site.
Compensation
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Students may not receive any form of monetary compensation for his/her participation in the
experiential program.
Students are responsible for all transportation, housing, food, and any other personal expenses
associated with their rotations.
Practice Site Allocation
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Site allocations for experiential rotations will be influenced primarily by the availability of
pharmacies which are willing to participate in the program and which meet the standards
required by the College.
Students may indicate a preference for a practice site in a particular geographic area. This should
be done early in the academic year to allow for the time required to solicit an appropriate site.
Although the College will endeavor to accommodate the students’ preferences, there is
absolutely NO guarantee that a student will be placed in their area of choice.
Students wanting to train at a site where they have been previously employed in any fashion or
have served as an intern must obtain approval from the SPEP Coordinator.
In the event that there are a limited number of suitable training sites available, students will be
preferentially assigned to sites in the geographic area of their permanent address, as indicated in
their registration.
Immunization
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All students are to complete all required immunizations before participating in SPEP 2.
The immunization status of each student will be assessed by the Bannatyne Immune Status
Program and any student who lacks adequate history of immunization must be immunized.
Students who have not submitted an immunization record or medical exemption will not
be assigned a practice site for their SPEP 2 rotation
Employment or extracurricular activities
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SPEP 2
2015
Work schedules must be adjusted to accommodate the SPEP 2 rotation requirements,
including orientation and debriefing sessions.
Employment conflicts will not be considered a legitimate reason for excusing a student
from the practice site or debriefing sessions.
Participation in extracurricular activities such as sporting events, including those associated
with the University, will not be considered a legitimate reason for excusing a student from
the practice site.
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Résumé
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A résumé is to be completed by each student and submitted to the primary preceptor via
RxPreceptor one to two weeks in advance of rotations for community pharmacies and
hospitals outside of Winnipeg only. Institutional rotations require the resume to be brought
with you on the first day (unless otherwise specified).
Liability Insurance
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The University has a policy of general liability insurance which insures the pharmacy
students while acting within the scope of their duties during the SPEP 2 rotations.
Under The Workers Compensation Act (Manitoba), students of the University of Manitoba
who are engaged in a field practicum as a required part of their program are generally
covered for injuries sustained in the course of and arising out of the practicum in accordance
with and subject to the provisions of The Workers Compensation Act. However, where the
practicum takes place outside of Manitoba, and the student is not a Manitoba resident,
workers compensation coverage may not be extended, based on the provisions of The
Workers Compensation Act. The Workers Compensation Board will not make advance
rulings in these types of cases.
Therefore, students who are not Manitoba residents and are trying to arrange a practicum
outside Manitoba may experience difficulties or be denied a placement because the
University is not able to guarantee that workers compensation coverage will be extended.
Alternative arrangements can sometimes be made to accommodate such practicums, but
will have to be done on a case by case basis. Students are encouraged to contact the SPEP
Coordinator at the earliest opportunity to determine if any such alternative arrangements are
possible.
Concerns during the rotation
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Any difficulties experienced at your site, either with your rotation or preceptor should be
first discussed with your preceptor (however you can contact the SPEP Coordinator for
guidance at any time).
If you are unable to resolve the problem or wish to discuss the matter further, you should
contact the SPEP Coordinator at the earliest possible time. Any concerns brought to the
coordinator’s attention will be dealt with in confidence. It is expected that the student and
the coordinator will develop a mutually agreeable plan for resolving the difficulties before
any action is taken. (See conflict resolution document in the toolkit)
SPEP 2 Manual
Students are responsible for all of the content outlined in the SPEP 2 Manual. This manual will
assist students and preceptors to understand the activities required during this rotation, their
professional responsibilities and the evaluation procedures by which they will be assessed.
Documentation of Activities
The student is required to submit some documentation of their rotation to the SPEP Coordinator.
Do not include any information that might identify a patient in any
material you submit to the Faculty.
Assessment of the Rotation/Site & Preceptor
The student will be required to complete an assessment of their preceptor, the rotation and the site.
This practice is designed to provide the College with constructive feedback from the student about
their rotation, the practice site and the instruction they received from assigned preceptors.
SPEP 2
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Submission of Evaluation Forms and Assignments
Preceptors
Preceptors are to complete and submit all necessary evaluation forms online via RxPreceptor on the
last day of the rotation.
Students
Students are to complete and submit all necessary evaluation forms online via RxPreceptor on the
last day of your rotation.
Plagiarism and Cheating
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SPEP 2
2015
In keeping with the University of Manitoba’s policy on the Responsibilities Of Academic
Staff With Regard To Students (ROASS), instructors are required to inform students that the
academic community considers plagiarism and/or cheating a serious offense, subject to
academic penalty.
For more on this topic, see the discussion of plagiarism and cheating in the section
“Academic Regulations and Policies” of the University of Manitoba General Calendar.
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SPEP 2
Executive Summary - Institution
LEARNING
OBJECTIVES
Drug preparation and
Distribution (primary objective)
√
SUGGESTED LEARNED ACTIVITIES
 Unit dose packaging
 Wardstock/Pyxis maintenance
Demonstrates an enhanced
 Compounding (e.g. creams/ointments, capsules)
understanding of what is involved
 Basic calculations (eg. w/v, mmoles, meQ)
in the preparation, distribution
and monitoring of pharmaceutical  Jurisprudence of narcotic and controlled drug distribution
agents
 Purchasing/receiving
 Inventory control
 Observes medication order review and computerized medication
order entry
 Hospital formulary management
 Observe IV admixture (optional)
Professionalism and
Interpersonal Skills
Demonstrates motivation to
engage in self-directed learning.
Consistently demonstrates
professional and responsible
conduct
 Displays professionalism in interactions with preceptor, patients
and/or other health care professionals
 Student is punctual (scheduled meetings and appointments)
 Completes assigned tasks
 Observes legal and ethical guidelines for safeguarding the
confidentiality of patient and business information (PHIA)
 Maintains a professional appearance
 Shows interest in rotation and learning
 Maximizes learning opportunities
Communication
Consistently demonstrates
effective written, verbal and nonverbal communication
Optional activities
SPEP 2
2015
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Interacts confidently with preceptors, other
pharmacy staff and other health care professionals
 Asks pertinent and relevant questions for obtaining
unknown information from colleagues and other health care
professionals.
 perform medication reconciliation with supervision
 answering basic drug information questions
 observing interactions with pharmacists and physicians or other health
care professionals
 attend patient care rounds (eg. Discharge planning rounds, medical team
rounds)
 observing additional pharmacist-patient interactions
 observe and/or perform basic IV admixture using aseptic technique
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Suggested Learning Activities - Institution
The listed activities are presented as a guideline representing the minimum number of topics the
student is expected to cover during their practicum. Time permitting, the student and preceptor are
free to investigate other areas relevant to the practice site. Likewise, the activities which follow are
meant to be a guide rather than a rigid schedule.
Example Scenarios
Each day’s learning activities are followed by a short “scenario”. These scenarios are fictional
anecdotes which are meant to illustrate some of the things pharmacists may face in day-to-day
practice. They are used here as another teaching tool and are meant to stimulate discussion between
student and preceptor. Preceptors are encouraged to share their own experiences with the student to
help the student apply his/her knowledge to practice and develop more effective communication
skills.
Example template of a student’s daily activities
Note: The activities listed below to help both the preceptor and student organize the suggested
learned activities. This may be adapted to suit the needs of specific practice sites.
Day 1
On the first day of the hospital practicum, the student should meet with the primary preceptor to
discuss their expectations, the course objectives, and outline a preliminary schedule for the rotation.
An orientation to the pharmacy would be appropriate at this time. It may include:
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a tour of the pharmacy to familiarize the student with the general layout
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an introduction to all relevant employees
·
an introduction to the pharmacy’s method of drug distribution and the steps in the
medication administration cycle (e.g. Cart exchange, pyxis etc)
Suggested Learning Activities
Observe and assist in unit dose drug packaging. What does unit dose mean? What are the
advantages of packaging medications this way? What information is placed on the packaging?
What procedures are followed to ensure quality and accuracy?
Inventory control: rotating stock, checking expiry dates.
Example Scenario:
A nurse phones down from the ward stating, “I was in the pyxis machine getting out Mr.
Smith’s furosemide 20 mg tablet, but there are furosemide 40 mg tablets mixed in the
drawer”. How would this drug error be investigated and handled?
SPEP 2
2015
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Day 2
Suggested Learning Activities
Drug distribution:
How does this pharmacy distribute medications to the patients on the ward? Observe then assist in
this drug distribution function. Does the pharmacy provide wardstock, do they use an automated
unit dose system (Pyxis), or do a cart exchange?
Select a minimum of 2-3 drugs each day with which you assisted in the dispensing process and
determine the following:
 therapeutic class (loop diuretics)
 how does it work? (increase excretion of water, sodium, potassium, calcium, and
chloride; decrease uric acid secretion.)
 indication(s) of the drug (CHF)
 What is a common dose in an ambulatory setting and what is the best time of the day the drug
should be given? ( 40-80mg/day in the morning , generally given earlier in the day
to prevent nocturia)
 One-two other brands of the drug available at your practice site (lasix, Apo-furosemide)
 One common side-effect (orthostatic hypotension),
 What advice would you give the patient to prevent/manage the potential side-effect, (getting
up slowly from a lying position)
 One significant drug interaction: drug-drug, drug-disease, drug-food ( furosemide causes
sodium depletion which can lead to a decrease lithium excretion)
 How can the drug-interaction be managed? (Given the interaction has a delayed onset
of action and considered moderate- plan is to inform doctor and patient of the
nature of the interaction and suggest monitoring for lithium toxicity)
 What are the patient -specific monitoring parameter(s )for:
 desired outcome ( decrease shortness of breath, decrease swelling in the
ankles, feet)
 lack of response (no change or worsening of the above symptoms after
the 2-5days of taking the medication)
 undesirable or potentially adverse drug reactions (sulphonamide-type
hypersensitivity).
 Is there any non-pharmacological advice that can be offered to this individual? ( sodium
restriction)
Purchasing and receiving: Who is responsible for purchasing and receiving medications for this
pharmacy?
Example Scenario:
The pharmacist receives an order for a medication which is apparently “manufacturer short”. What
does this mean? How would you handle this situation?
SPEP 2
2015
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Day 3
Suggested Learning Activities
Identify common products compounded at your site and usual ingredients on hand in the
dispensary. Participate in compounding activities as part of the normal activities in the
dispensary.
Observe the distribution of narcotics and controlled drugs. What are the special requirements
when dispensing these drugs? Where are these medications stored in this pharmacy? How does
this differ from distribution of narcotics and controlled drugs in a community pharmacy?
Continue researching 2-3 drugs per day.
Example Scenario:
A patient is leaving the hospital on a 24 hour pass receives morphine every 6 hours. What are the
proper procedures the pharmacy must follow to dispense the morphine to the patient?
Day 4
Suggested Learning Activities
Medication order review/order entry: (from CSHP Standards of Practice 1995)
Check the medication order for:
 the patient’s name, hospital number and location
 signature of authorized prescriber
 the name of the medication and formulary status
 dose, form, and strength
 route and frequency of administration
 duration of treatment, if limited
 complete directions for appropriate use
 date and time order was written
 for verbal or telephone orders, the name and signature of the person who received
the order and the name of the prescriber
Review and update the medication profile for the detection of:
 duplication of therapeutically similar medications
 potential allergic or adverse drug reactions
 possible drug-disease incompatibilities
 significant drug-drug interactions
 correct dosage and dosage interval
 appropriate dosage form and route of administration
 problems related to intravenous administration including potential
incompatibilities, drug stability, volume of intravenous fluid for medication
administration, and rate of administration
 appropriate length of therapy
SPEP 2
2015
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Hospital formulary management: what is a hospital formulary? What is its role?
Continue researching 2-3 drugs per day.
Example Scenario:
A nurse phones down from the ward wondering if she can mix potassium chloride with morphine.
What questions do you need to ask him or her before you can look up the answer? What are a few of
the main information resources used for IV compatibility?
Day 5
Suggested Learning Activities
Observe a pharmacist performing a patient interview (eg: medication history, discharge
counseling, etc.)
Continue researching 2-3 drugs per day.
While observing the pharmacist performing medication order review, you receive an order for a
patient for an ACE Inhibitor that is not on the hospital formulary. What is the pharmacist’s
approach to handling this matter?
You receive an order for IV Cefuroxime for a patient, but when starting to enter the order you see
that the patient has a penicillin allergy on their pharmacy profile. What do you do?
SPEP 2
2015
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SPEP 2 Executive Summary - Community
LEARNING OBJECTIVES
SUGGESTED LEARNED ACTIVITIES
Drug Distribution
(primary objective)
Demonstrate the basic
knowledge/skills/attitudes needed to
prepare and distribute
pharmaceutical agents in a process
that ensures safety, accuracy and
quality of the product.
 Compounding using appropriate ingredients, calculations
and procedures and dispensing a professional appearing
final product
 Identify the relevant legislation which governs the various
steps in the dispensing process.
 Review the procedures for narcotic and controlled drugs
(before filling and after filling prescriptions – perpetual
inventory, receiving of narcotics, and multiple
prescriptions)
 Review 3rd party prescriptions-troubleshooting, coverage
under Pharmacare and NIHB coverage
 Inventory control (site specific)
Professionalism
Students will:
 Demonstrate
professionalism during all
activities
 Demonstrate skills of selfreflection, self-assessment
and self-improvement
 Demonstrate selfmotivation and initiative

Communication
Students will communicate
effectively and appropriately with
their preceptor, patients, their peers
and other health care professionals
 Interacts confidently with preceptors, other pharmacy staff,
other health care professionals and patients
 Accurately transfers prescription(s) from/to another
pharmacy (under direct supervision of a pharmacist)
 Accurately receives prescriptions from another pharmacy
and/or another health professional (under the direct
supervision of a pharmacist) (can be either directly or via
voice mail –site specific)
 Offers assistance to patients in an appropriate manner (looks
for opportunities to assist patients)
 Uses a systematic approach during information gathering
before recommending a product (patients’ medical
conditions, current medications, OTC’s, herbals, vitamins
and any drug allergies)
 Selects a suitable non-prescription product (under direct
supervision of a pharmacist and with their input)
 Provides appropriate information (Name of product chosen,
directions for use, max/day, information required for
correct use, how long to use before seeking medical
attention )
 Suggests non-pharmacological measures as appropriate
 Minor ailments prescribing activity **New**
 Complete and document 1 drug information request from
preceptor, patient or other health care professional using the
form provided (in RxPreceptor document library) or form
provided by site
Patient self-care & minor
ailments counseling
The student is able to select and
provide information to patients
and/or caregivers on selected
categories of drug products to
encourage appropriate drug use
and to promote health
Drug Information
Students will provide accurate,
evidence-based, timely and
appropriate drug information that
meets patient care needs
√
Displays professionalism in interactions with preceptor,
patients and/or other health care professionals
 Student is punctual
 Completes assigned tasks in a timely manner
 Observes legal and ethical guidelines for safeguarding the
confidentiality of patient and business information(PHIA)
 Maintains a professional appearance
 Shows interest in rotation and learning
 Maximizes learning opportunities
**Note: The above learning activities are intended only as a guide to ensure that the student
meets the objectives of SPEP 2. The above activities may be tailored to meet the relevant
practice needs at each specific site.
SPEP 2
2015
15
Community Pharmacy - Suggested Learning Activities
The activities listed below are presented as a guideline representing the minimum number of topics
the student is expected to cover during their practicum. Time permitting, the student and preceptor
are free to investigate other areas relevant to the practice site. Likewise, the activities which follow
are meant to be a guide rather than a rigid schedule.
Example Scenarios
Each day’s learning activities are followed by short “scenarios”. These scenarios are fictional
anecdotes which are meant to illustrate some of the things pharmacists may face in day-to-day
practice. They are used here as another teaching tool and are meant to stimulate discussion between
student and preceptor. Preceptors are encouraged to share their own experiences with the student to
help the student apply his/her knowledge to practice and develop more effective communication
skills.
Example template of a student’s daily activities
Note: The activities listed below are to help both the preceptor and student organize the
suggested learned activities. This may be adapted to suit the needs of specific practice sites.
Day 1
On the first day of the community rotation, the student should meet with the preceptor to discuss
each of their expectations, the objectives of the rotation, and outline a preliminary schedule for the
rotation (including duration of breaks, shift times etc). An orientation of the pharmacy would be
appropriate at this time. It may include:
SPEP Day 1 Orientation Checklist for Preceptors
Tour the site and introduce the student to the pharmacy team. Let the student know if you will be
their primary preceptor or if other members of the pharmacy team will be involved and what their role will
be. Provide the student a list of staff members and a description of their roles and responsibilities.
General logistics: Site policies and rules, parking availability, storage of personal items, access to
washroom/lunch room, hours/schedule (including breaks), absence policy, dress code, designated student
workspace, computer access.
Review the suggested learning goals and activities of the rotation, the student’s expectations of the
rotation, your expectations of the student for the rotation i.e. what you are comfortable with the student
doing (based on the students’ level of experience and your own comfort level with students).
Review when and how feedback will be provided to the student and when the final evaluation will
take place.
Have the student to become familiar with the prescription filling process/workflow, answering
phones, location of drug information resources, where medications are kept and general operation of the
pharmacy.
Review the patient care process, documentation, follow-up, scheduling procedures etc for these
services
SPEP 2
2015
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Suggested Learning Activities
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Familiarize yourself with the pharmacy layout, how products are organized (brand name,
generics, eye drops)
Assist in selection of products for prescriptions being filled
Observe the pharmacy technician or pharmacists receiving prescriptions, gathering
appropriate patient information as well as billing information (drug plan information)
Learn the procedures involved in filling a prescription through observation
Review 2 sections in the non-prescription medication area and observe how the products are
displayed. Compare different products and determine which ones contain similar
ingredients
If time permits have your preceptor or pharmacist discuss the products with you and learn
what they recommend and why
Example Scenarios:
A patient approaches the pharmacy with a new prescription from her doctor. She is an
older person and seems very confused about all the medications she is taking and keeps
saying she doesn’t know why she needs all these pills. The technician takes the
prescription, tells the person it will be 20 minutes and turns to answer the phone. The
patient is still standing at the counter and looks very upset and confused. How could this
situation have been handled differently and how would you help this patient?
A young man approaches the counter with a new prescription for Advair 250 Diskus. He is
covered under NIHB and does not expect to pay for his medication. What is required for
this prescription to be covered on his plan and how would this plan be entered into the
computer?
Discuss with your preceptor or the technician(s) some challenges faced with 3rd party plans.
Day 2
Suggested Learning Activities
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SPEP 2
2015
Practice filling prescriptions
Review patients profile and gather further information if required before filling the
prescription
Enter the prescription information correctly and generate a label, ensuring the correct
information is on the label (always consult a pharmacist before over-riding any allergies or
drug interaction screens)
Selection of appropriate medication for filling (checking and comparing DIN’s to
prescription label), choose appropriate container size, affix label in a professional manner
and choose correct auxiliary labels
Observe while the pharmacist counsels on prescriptions, paying close attention to how the
interaction is handled, information given and how the patient receives the information.
Review 2 more sections in the non-prescription medication area and observe how the
products are displayed. Compare different products and determine which ones contain
similar ingredients
If time permits have your preceptor or pharmacist discuss the products with you and learn
what they recommend and why
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Research 2 to 3 drugs that you are not familiar with, and learn what they are used for,
common doses prescribed and dosage forms available
Example Scenarios:
A patient phones and wants to talk to the pharmacist because an error in his medication has been
made. The pharmacist checks the original prescription and finds that the directions on the label for
the patient are the same as what the doctor wrote and the drug is correct (The prescription is written
for Gliclazide 80 mg BID). The patient insists the drug is different and that he takes his pills once a
day only. What questions would you ask for more information and how would you solve this
problem?
Discuss with your preceptor different PHIA issues that have occurred in the pharmacy.
Day 3
Suggested Learning Activities
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Continue to practice filling prescriptions
Continue the review of the non-prescription medication sections that have not been done and
if possible participate in counseling non-prescription medication(s) with your preceptor or
pharmacist observing
Watch for an opportunity for minor ailment prescribing (if one does not arise during the
week ask preceptor to provide you with a scenario to document).
Observe or take prescriptions from doctors (either on a phone system if available at the store
or directly from the doctor with your preceptor listening in)
Transfer prescriptions to other pharmacists (be sure to identify yourself as a student and who
your pharmacist on duty is)
Prepare compounds (if possible) under the supervision of a pharmacist
Learn the distribution of narcotic and controlled drugs. What are the requirements for
dispensing and receiving this class of drugs? How are they received at this store?
Continue to research drugs that may be unique to that site or that you are not familiar with
Example Scenarios:
A woman comes into your pharmacy looking for a product that “burns carbs”. What products are
available to the public that advertise this and discuss/research if they really do what they advertise.
A man comes into the pharmacy looking for herbal product for cold relief or prevention. Research
the different herbal and OTC products available and then discuss with your preceptor or another
pharmacist which ones they would recommend if any.
Discuss with your preceptor any forgeries that the site has had and how they were managed.
SPEP 2
2015
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Day 4
Suggested Learning Activities
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Continue to practice filling prescriptions and take the process from the beginning to the end
when you either counsel or observe counseling of the prescription
Practice checking prescriptions if preceptor approves
Continue the review of the non-prescription medication sections that you have not yet
completed and if possible participate in counseling non-prescription medication(s) with your
preceptor or pharmacist observing
Minor ailments activity: complete your documentation and submit via RxPreceptor for your
preceptor to review
Continue to research 2 – 3 drugs that you are not familiar with and learn what they are used
for, common doses prescribed and dosage forms available
Example Scenarios:
A mother comes into the pharmacy to purchase cough and cold medication for her 6 year old. The
child has a stuffy nose and a hacking cough that is keeping them both up at night. She wants
everything in one bottle as the child does not like to take medicine at all and she wants something
that tastes good. Research and decide which product (s), if any would be suitable for her to
purchase.
Discuss with your preceptor how they manage “difficult” or challenging situations.
Day 5
Suggested Learning Activities
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Continue practicing what you have learned during the week
Continue either observing or counseling (with supervision) non-prescription medications
Review the evaluation form with your preceptor and review areas of growth
Example Scenarios:
A woman comes to your pharmacy complaining of an “itchy scalp”. What line of questioning
would you use to determine the cause and what products are available? What are the possible
causes of an “itchy” scalp?
A young man comes into the pharmacy looking for something for his “eye infection”. What
questions do you ask to distinguish between an eye infection, allergies or irritated eye and what
would your recommendations be for each condition?
Discuss with your preceptor any ethical situations they may have experienced during their career
SPEP 2
2015
19
Example Optional Activities
If all of the above activities are completed satisfactorily and if time permits, other activities the
student may participate in include:
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SPEP 2
2015
Observe how PHIA is handled at this location. What does the store do well and consider
how you might improve the existing methods
Learn the NIHB Prior Approval procedure at this location and research what drugs at this
site require this to be done
Demonstrate (under supervision) how to use adherence devices that you have learned about
during your labs or other devices that may be site specific
Review the schedule II products section and determine why they are kept behind the counter
(some stores keep other products behind the counter that do not legally have to be thereWhy?)
Observe your preceptor or pharmacist while they do a medication review/education or
counseling session with a patient
Learn the regulations governing the methadone program and how the site manages this
program (billing, storage, mixing etc)
Become involved in site specific projects/learn about medications that are site specific
Interact with other health care professionals whenever possible
Organize an information session on OTC’s for patients
Prepare a pamphlet for the store on certain OTC products
OTC Quiz – see below
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SPEP 2 OTC Quiz
1.
What products are available at this site that contains pseudoephedrine as one of its ingredients?
2.
Where are the iron products kept and why? What are the different formulations available at this
site?
3.
List the different multivitamins that are available for children at this site
4.
Name the different acne products at this site that contain benzoyl peroxide and in what strengths
and formulations?
5.
How many different formulations of acetaminophen, ASA, Naproxen and ibuprofen are available at
this site? (tablets, capsules, etc)
6.
What eye drops can be used to treat allergic reactions of the eye? Which ones are compatible with
contact lenses?
7.
Determine which antihistamines are available at this site and when you would recommend
them?(children, adults, allergic conditions, non-drowsy, existing medical conditions, colds etc)
8.
What products are available that contains stimulant laxatives?
9.
What products are available to treat dry skin or eczema and where are they kept?
10. What herbal or alternative products can be recommended for colds?
11. What exempted codeine products are available at this site and where are they kept?
12. What products are available to treat vaginal/foot fungal infections?
SPEP 2
2015
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Topics covered in Clinical Pharmacy 1 &
Pharmacy Skills Lab 2
The students have completed the following subjects in their 2 nd year courses:
 Acne
 Allergic Rhinitis
 Infant care, pre & post-natal care
 Constipation
 Contraception (barrier & hormonal)
 Cough & cold
 Cutaneous Fungal Infections (Athletes foot, Jock Itch – Rx & OTC products)
 Dermatitis (Dry Skin, Eczema, Psoriasis, Seborrhea, Dandruff, Contact dermatitis and diaper
dermatitis)
 Diabetes (Type 2 – Introduction- does not include blood glucose monitoring)
 Diarrhea
 Dyspepsia/GERD
 Ear & Eye Disorders (Infections, Glaucoma)
 Emergency Contraception (ECP)
 Fever & Pain
 Foot care (Corns, Calluses, Warts)
 Glaucoma
 Hemorrhoids
 Influenza
 Insect bites/Anaphylaxis
 Insomnia
 Lice & Scabies
 Nausea & Vomiting
 Pain (Acute & Chronic)
 Pinworms
 Pregnancy & Lactation (Drug use in)
 Premenstrual syndrome & Dysmenorrhea
 Psychiatry (Introduction)
 Smoking Cessation
 Sunscreens/Burns (1st year skills lab)
 Vaccines
 Vaginal Infections/Barrier methods
 Oral conditions
The students have had practice in Skills Lab counseling or working with the following:
 Allergic Rhinitis, Cough & cold
 Antibiotic Suspensions
 Hormonal Contraception
 Drug Information (utilizing tertiary resources), including MB formulary
 Introduction to minor wound care
 Dyspepsia, nausea & vomiting (OTC only)
 Hemorrhoids & Constipation
 Cutaneous Fungal Infections (Athletes foot, Jock Itch, etc.)
 Dermatitis (Dry Skin, Eczema, Psoriasis, Seborrhea, Dandruff)
 Emergency Contraception (ECP)
 Eye/Ear Drops (Rx & OTC)
 Handling Medication Errors
 Vaginal Candidiasis
 Lice & Scabies
 Pinworms
 Sleep Aids (prescription & non-prescrption)
 Smoking Cessation
 Basic pharmaceutical calculations
 Managing & preventing ADR & DI’s
 Minor ailments prescribing lab
SPEP 2
2015
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Tool Kit - Table of Contents
Contents available in document library in RxPreceptor and
SPEP webpage: http://umanitoba.ca/pharmacy/students/spep.html
Conflict Resolution (Faculty of Pharmacy)
2
The Role of the Preceptor (Rehana Durocher)
4
Standards of Conduct for Professional Pharmacy Students (Rehana Durocher)
5
Pledge of Confidentiality for Pharmacy Students
9
(Faculty of Pharmacy)
Summary of Academic Courses
10
Detailed Systematic Approach to Self-Care Counseling
11
Drug Plans
12
(Nancy Kleiman)
Drug Information Response Form (example)
14
Preceptor Resources
16
Debriefing session (Rehana Durocher)
18
Optional activity – OTC Quiz (Nancy Kleiman)
19
SPEP 2
2015
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