Site Information
Publix Super Markets, Inc.
Corporate Office
Pharmacy Operations
3300 Airport Rd.
Lakeland, FL 33811
(P) 863-688-1188
(F) 863-499-8553
Primary Preceptor:
Jennifer Pytlarz, PharmD
Clinical Coordinator
(863) 688-1188 x 54610 jennifer.pytlarz@publix.com
Additional Preceptors:
Robin Sistrunk, PharmD
Manager of Integrated Care
(863) 688-1188 x 52004 robin.sistrunk@publix.com
Dale Houston, BSPharm
Manager of Managed Care
(863) 688-1188 x 52364 dale.houston@publix.com
Schedule: Monday – Friday
9am – 4pm
Subject to change
Chris Hewell, PharmD
Manager of Procurement
(863) 688-1188 x 52416 chris.hewell@publix.com
Debbi Damkjer
Manager of Technology
(863) 688-1188 x 52407 debbi.damkjer@publix.com
Jillanne Smith
Manager of Recruiting, Training and Development
(863) 688-1188 x 58004 jillanne.smith@publix.com
Updated 3/15/11

Course Description
This Administrative Community Pharmacy Practice experience is designed to expose the 4 th year Doctor of
Pharmacy candidate to the operations of managing a supermarket pharmacy chain. Development, implementation and management of clinical programs will be the primary focus of this rotation. In addition, this rotation is designed to further develop the student’s knowledge and understanding of the activities, processes, procedures and skills necessary to provide, supervise and manage all pharmacy services within the Publix Super Markets, Inc. pharmacy chain. The student will be exposed to various elements of pharmacy operations which include but are not limited to: 1) clinical services; 2) purchasing/inventory control; 3) staff training/recruitment; and 4) managed care .
The student will begin to understand the skills necessary to supervise and manage a community pharmacy on a global scale from a corporate perspective. The student will be assigned a primary preceptor to provide oversight and guidance although he/she will also work with other pharmacy operations personnel in order to gain insight of the various departments within Publix Pharmacy Operations.
The student is responsible for being familiar with their school’s policies, procedures and requirements for this rotation. It is also the student’s responsibility to inform the preceptor of these policies, procedures and requirements if they differ from this syllabus to ensure they are being met. This syllabus is to serve as a guide to the student.
Prerequisites
Satisfactory completion of a community pharmacy experience is preferred.
Ability Based Outcomes
The following are outcomes which the student will be expected to accomplish during the rotation experience; however, the individual items identified with letters (A, B, C, D etc.) are used as a guide. The student may or may not be exposed to these specific items. If the school has goals/objectives which differ from the following, the preceptor and student will incorporate school-specific requirements.
1.
The student should be able to understand the purpose of and develop the following skills related to the management of global pharmacy operations:
A.
Development, implementation and management of clinical pharmacy services
B.
Federal & state regulations regarding community pharmacy practice
C.
Procurement process

Generic & brand purchasing process

Inventory management

Pricing
D.
Personnel recruitment, training and management
E.
Quality improvement procedures
F.
Fiscal management

Third party contracting

Store enrollment

Plan set-up

Billing and payment processing

Basic overview of third party programs
G.
Marketing
H.
Physical space and workflow design/management
I.
Management structure
J.
Technology processes
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2.
The student should be able to evaluate, review or develop, implement and monitor clinical pharmacy services/programs conducted within a community pharmacy chain.
A.
Become familiar with existing point-of-care clinical services including cholesterol screening, bone density screening and immunization delivery.
B.
Understand the structure and process of existing Medication Therapy Management (MTM) programs.
C.
Understand the necessary steps taken when developing new clinical services/programs including SWOT analysis, federal and state regulations, provider training, marketing and clinical materials, implementation and continuous quality improvement (CQI).
D.
Identify and review resources to support clinical patient care services to ensure adequate and appropriate provider training.
E.
Develop materials to support clinical initiatives including documentation, marketing and educational pieces.
F.
Apply critical review skills to analyze new and existing clinical services/programs for expansion and improvement opportunities.
G.
Understand the DUR process which occurs during the course of dispensing.
H.
Identify opportunities for drug product-related interventions, disease-related interventions and wellness/prevention-related interventions to be implemented in community pharmacy.
I.
Understand the importance of evaluation of clinical program outcomes.
3.
The student should be able to identify and utilize drug information services in order to facilitate their role as a drug-information specialist for other health care professionals and patients to achieve positive therapeutic outcomes.
A.
Interact appropriately with other members of the health care team.
B.
Know and use the sources of drug information.
C.
Apply drug information to obtain positive outcomes for patients.
D.
Serve as drug information specialists for patients and other health care professionals.
E.
Understand the responsibility and reporting mechanism for adverse drug reactions.
F.
Use language appropriate for the intended audience.
4. The student should be able to develop oral or written presentations on pharmacy-related topics to other health care professionals.
A.
Effectively communicate in verbal and/or written form, in a concise and organized fashion, a critical evaluation of drug products, pharmacy services or elements of the profession.
B.
Develop presentation skills for variable audiences for interdisciplinary education.
Required Activities
During this administrative community practice rotation the student will be involved in the following activities and any additional requirements as noted by the school. Students will complete assignments/projects during the working day as time permits; however, they should be prepared to complete assignments/projects at home on their own time in order to meet deadlines.
1.
Interact with health care providers verbally and in writing when necessary.
2.
Prepare and present oral 30-minute presentation using visual aids and handouts to be presented to
3.
pharmacy operations staff during the fourth week of the rotation (exact date to be determined by the preceptor). The topic must be timely and related to community pharmacy practice or pharmacy management. The student may choose the topic within the first 2 weeks of the rotation (as approved by the preceptor) or it may be assigned as requested by pharmacy personnel. The student will serve as the expert on the topic presented.
Conduct MTM services with proper documentation (as the need arises during the rotation). Critically review patient medication profiles and apply current clinical practice guidelines when making recommendations to changes in therapy.
Updated 3/15/11

4.
5.
6.
Prepare and present 1-2 patient case reports as time permits during the rotation, likely during the second and/or fourth weeks of the rotation. Case reports will be a result of providing MTM services (see Appendix
A for patient history template).
Draft an article for publication in the monthly pharmacy newsletter and provide content for additional pharmacy publications as needed.
The student will prepare and present 1-2 journal club assignments as time permits during the rotation, likely during the second and/or fourth weeks of the rotation. The journal article must be relevant to pharmacy operations or clinical programs for community pharmacy practice and approved by the preceptor
(see Appendix B for format).
Optional Activities
The following list provides ideas for additional learning opportunities. During this rotation, the student may choose to complete any of the following activities with guidance provided by the preceptor as time and availability permits.
1. Plan and conduct a health screening or educational event at a Publix Pharmacy. Develop a plan for topic,
2. logistics and marketing the program.
Ride along with a Pharmacy Supervisor for exposure to various community pharmacy practice settings
3.



 and introduction to community pharmacy management.
Critique various forms of direct-to-consumer advertising (i.e. print media, internet, TV, radio ads) or

 current medical news topic. Questions to consider:
Who is the intended audience?
What message is being conveyed?
Do you think the message is successful?
Is the message misleading?
What types of advertising techniques were used?
How would you counsel a patient who presents this message and has questions?
4. Observe and participate in call center/mail order activities for exposure to telephonic patient communication, including the provision of medication therapy management (MTM).
5.
Identify specific needs of pharmacy operations and develop/design a plan to satisfy those needs using available resources.
6.
7.
8.
Engage in communication with pharmacy staff, customers, health care professionals and pharmaceutical industry representatives.
Assist preceptors in the implementation of a project or pilot of a new pharmacy service.
Observe and participate in clinical pharmacy training programs.
Final Project Activities
The student may select and complete at least one of the following by the end of the rotation (unless otherwise instructed by the school):
1.
Prepare a project proposal outlining the expansion of clinical services. This should include data on need, feasibility, legalities, expense, profitability and time to implement. This could be an expansion of existing services or a new service to be instituted.
2.
Prepare an analysis of a current clinical service for evaluation purposes. This may include patient subjective evaluation, health care professional subjective evaluation, cost justification or impact on patient studies.
3.
Participate in expanding the clinical services of the pharmacy as outlined by a previous student.
4.
Prepare one review article covering a timely therapeutic topic, new drug, innovative community pharmacy intervention or other topic as determined by student and preceptor. A detailed outline (1-2 pages) of the article should be submitted to the preceptor within the first two weeks of the rotation; the first complete draft is due shortly after the mid-point and the final project due the last week of the rotation (exact due dates to be determined by the preceptor).
5.
Other projects as appropriate to the site and agreed upon by the student and preceptor.
Updated 3/15/11

Required Readings
1.
Rodis JL, Ahrens-Thomas R. Stepwise Approach to Developing Point-of-Care Testing Services in the
Community/Ambulatory Pharmacy Setting. J Am Pharm Assoc . 2006;46(5):594-604.
2.
Lee JK, Grace KA, Taylor AJ. Effect of a Pharmacy Care Program on Medication Adherence and Persistence,
Blood Pressure, and Low-Density Lipoprotein Cholesterol. JAMA . 2006;296(21): 2563-2571.
3.
Touchette DR, Burns AL, Bough MA et al. J Am Pharm Assoc . 2006;46(6):683-691.
4.
Boyd ST, Boyd LC, Zillich AJ. Medication Therapy Management Survey of the Prescription Drug Plans. J Am
Pharm Assoc . 2006;46(6):692-699.
5.
Hansen RA, Roth MT, Brouwe ES et al. Medication Therapy Management Services in North Carolina
Community Pharmacies: Current Practice Patterns and Projected Demand. J Am Pharm Assoc .
2006;46(6):700-706.
6.
Medication Therapy Management in Pharmacy Practice: Core Elements of an MTM Service Model. V2.0.
APhA, NACDS Foundation. March 2008.
7. Any additional readings required by the school or those which the site preceptor recommends.
A.
B.
C.
Orientation
During the first week of the rotation, the student should be oriented to the pharmacy operations department and pertinent policies and procedures. HIPAA training will be conducted if needed. The following is a recommended orientation process:
Participate in a guided tour of the corporate office, identifying location of pertinent areas.
Be introduced to each preceptor and adjunct personnel in pharmacy operations.
Discuss pertinent policies and procedures of the department with preceptor. The following points should be addressed:
 Confidentiality of information
 Manner and appropriate dress
 Lines of authority as it involves the student


Telephone and computer rules
Scheduling of student’s hours, absences and tardiness
 Daily routines of the work environment (opening/closing, housekeeping, security etc.)
Rotation Outline
Day 1 – Follow Orientation Outline
Days 2-19 – Advanced Practice Experience Training
Day 10 – Mid Point Evaluation (the SUCCESS website may be utilized)
Day 20 – The instructor should complete the student's post evaluation via the SUCCESS web site. The instructor should go over the student's Post Evaluation with the student. The student is responsible for completing the instructor evaluation as it relates to school policy.
Student Responsibilities

Demonstrate the ability to use basic word processing, spreadsheet and PowerPoint software.

Demonstrate effective communication (verbal and written) with employees, customers and other health care providers.

Make ethical decisions and exhibit professional behavior.

Perform self-assessments.

Be self-directed.

Complete all readings and assignments in a timely fashion.
Updated 3/15/11

Attendance
The student is expected to be on time with respect to arrival, returning from lunch and any off-site events scheduled during the rotation. Students are required to be at the rotation site a minimum of 35 hours per week. Rotation hours will likely mimic a typical workday although variations may occur. The student will be allowed a 30-minute lunch break which is provided free of charge in the corporate cafeteria. The primary preceptor is to be notified immediately if the student is to be absent or late for any reason. If sickness or other problems require the student's absence during rotation time, those lost hours must be rescheduled as soon as possible. Failure to participate in the assigned number of hours will result in an "Incomplete" grade for the course.
If you are unable to attend rotation, contact the primary preceptor and notify the school per school policy.
Absences will be dealt with in the following manner:
Excused – Each excused absence will be made up at the discretion of the preceptor. Absences may be excused secondary to health or family issues (personal illness, dependent’s illness, Dr.’s appointment, family crisis, etc.), professional issues (interview for position, educational meeting, etc.) or at the discretion of the preceptor for other reasons not listed here. Absences that are planned require notification prior to the day of the absence. A minimum of 1-week notice regarding planned absences is expected. Educational meetings are an important part of being a professional. Attendance will be encouraged, but not required.
Unexcused – Each unexcused absence will result in a deficiency in that competency area in the SUCCESS program. Each absence must be made up at the convenience of the preceptor. Failure to notify at the time of the absence in the case of unexpected situations will result in an unexcused absence. Failure to notify in advance of planned activities will result in an unexcused absence. More than 1 unexcused absence is grounds for dismissal from the experience.
Tardiness – Two unexcused tardies will be the same as one unexcused absence. The definition of tardy will be left up to the preceptor.
Dress Code
Students are expected to dress professionally Monday through Thursday (unless otherwise indicated). Casual attire including jeans and sneakers are permitted to be worn on Fridays although students are encouraged to maintain a professional appearance. All students must display their school ID and Publix guest pass at all times. This dress code is specific for the Publix Corporate office; however, the student is expected to adhere to their school’s dress code policy if more stringent.
Confidentiality
The student is expected to maintain confidentiality of all patient and proprietary business information at all times.
The student will read and sign the Publix Super Markets, Inc. Release Agreement and Standard Non-Disclosure
Agreement. The student is expected to have completed HIPAA training prior to starting this rotation; however, if training is needed the preceptor will provide HIPAA training during rotation orientation. The student will abide by
HIPAA guidelines at all times.
Evaluation & Grading
There will be two formal evaluations during the rotation (unless otherwise specified by the school): a midterm evaluation and a final evaluation. Additional feedback may be provided either verbally or in writing as deemed appropriate by the preceptor and/or student. A verbal or written mid-point evaluation is recommended at the end of the second week of the rotation. The mid-point evaluation provides the preceptor an opportunity to evaluate and provide feedback to the student in regards to their performance up to that point. The student is also encouraged to provide the preceptor with feedback regarding their personal objectives. The student is encouraged to conduct a
Updated 3/15/11

self-evaluation at the mid-point to help him/her identify strengths and weaknesses which may be addressed during the remaining time on rotation.
Final evaluations will occur via the SUCCESS online evaluation system. The system and the tutorial for the system are located at www.cop.ufl.edu/success . Below is a list of the competencies and sub-competencies for the
SUCCESS program and the respective weights which are applicable to this experience. Students will be evaluated as Excellent, Competent, or Deficient. Definitions of Excellent, Competent and Deficient for each sub-competency are available in the SUCCESS program. Sub-competencies noted with “*” are considered “Critical”. Critical deficiencies are indicative of a major deficit in the student’s skill set. This is reflected in the grade calculation.
(0) Competency #1 Drug Distribution Systems
(5) Competency #2 Disease State Knowledge a.
Discusses pathophysiology of disease(s). b.
Synthesizes basic science and clinical information to appropriately identify patient problems.* c.
Applies knowledge of the pathophysiology of a specific disease to prevent medicationrelated problems. d.
Uses appropriate critical pathways, clinical practice guidelines, and disease management protocols in the delivery of pharmaceutical care.* e.
Assesses the needs of the target population relative to disease prevention/detection. f.
Selects and implements an appropriate strategy to prevent (i.e. immunizations) or detect (i.e. blood cholesterol screening) disease in the target population.
(5) Competency #3 Drug Therapy Evaluation and Development (if opportunity exists) a.
Synthesizes complete patient history and laboratory and physical exam data to identify problems. b.
Identifies and prioritizes both actual and potential drug related problems stating rationale.* c.
Identifies problems that require emergency medical attention.* d.
Designs and evaluates treatment regimens for optimal outcomes using pharmacokinetic data and drug formulation data.* e.
Designs and evaluates treatment regimens for optimal outcomes using disease states and previous or current drug therapy as well as including psycho-social, ethical-legal and financial data.* f.
Develops backup plans based on what problems are likely to occur from/with the primary plan. g.
Provides written documentation of the pharmaceutical care plan that is clear, complete and concise.
(0) Competency #4 Monitoring for Endpoints
(5) Competency #5 Patient Case Presentations (if opportunity exists)
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(5) Competency #6 Patient Interviews (if opportunity exists) a.
Introduces self as student form College of Pharmacy.* b.
Optimizes environment for the interview. c.
Clarifies the purpose and structure of the interview. d.
Verifies patient name and correct pronunciation and demographic data.* e.
Explains how patient will benefit from interview. f.
Employs vocabulary, question structure, question complexity and invited feedback to insure patient understanding.* g.
Implements the interview in an organized fashion. h.
Answers patient questions providing appropriate and correct data.*
(5) Competency #7 Patient Education/Counseling (if opportunity exists) a.
Speaks clearly using proper enunciation, volume and rate.* b.
Uses terminology specific to the understanding of the patient. c.
Uses appropriate non-verbal communication. d.
Provides accurate and pertinent information in appropriate detail.* e.
Includes information required for the patient’s social and financial needs. f.
Provides feedback to patient questions/concerns. g.
Determines patient level of understanding by asking questions. h.
Demonstrates empathy. i.
Shows concern for patient well-being. j.
Retrieves and evaluates new information for the purpose of responding to patient questions.
(5) Competency #8 Drug Information a.
Selects the best available resource for answering a drug related request. b.
Demonstrates the ability to use other information resources (this includes poison control centers, pharmaceutical companies and federal agencies). c.
Generates correct answers to questions in a timely and systematic manner.* d.
Can define primary, secondary and tertiary references. e.
Is able to discuss the organization and operation of the Pharmacy and Therapeutics Committee
(or its equivalent depending on the site). (Specific responsibilities would include formulary management and drug usage evaluation process). f.
Demonstrates the ability to interpret descriptive statistics and inferential statistical tests using assessment tools commonly reported in medical and pharmaceutical literature. g.
Critically analyzes the design, methodology, results, and conclusions of a given published study h.
Compares and contrasts the approaches to clinical practice guideline (CPG) development and the concept of evidence-based medicine (EBM)
(15) Competency #9 Formal Oral Presentations a.
Provides list of references that support an adequate review of the literature. b.
Delivers a content correct presentation based on the assignment parameters.* c.
Communicates correct information that is understood and useable by the audience.* d.
Uses appropriate verbal and non-verbal communication skills (inclusive of body language). e.
Utilizes audiovisual aids and technology that enhance delivery and understanding of the presentation. f.
Utilizes time allotted for presentation efficiently and effectively. g.
Generates feedback from the audience by asking questions.
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h.
Demonstrates a knowledge base sufficient for the topic of discussion. i.
Correctly synthesizes enthusiasm, verbal skills, non-verbal skills, and audiovisual aids to produce a presentation, which gains and keeps the audience's attention.
(15) Competency #10 Formal Written Presentations a.
Facts about the topic are correct.* b.
Presentation of the topic is organized. c.
Presentation format and length adheres to the parameters established by the preceptor. d.
Written document contains review of primary literature from reputable sources.*
(25) Competency #11 Professional Team Interaction a.
Dresses appropriately for the setting. b.
Demonstrates sensitivity for patients and families during team activities.* c.
Demonstrates respect for other health care professionals. d.
Uses interpersonal communication skills to facilitate team interactions. e.
Actively participates in team activities. f.
Assists team members in establishing therapeutic and/or diagnostic objectives. g.
Uses documentation, persuasion, and alternative suggestions to resolve therapeutic disagreements. h.
Provides accurate, organized, and pertinent information relevant to the team's current or future tasks.* i.
Follows up on questions asked by the team in a timely fashion. j.
Interactions with the team are conducted with an appropriate level of confidence. k.
Retrieves and evaluates new information for the purpose of responding to professional questions.
(10) Competency #12 Professionalism/Motivation a.
Identifies and respects the values of others. b.
Demonstrates knowledge and understanding of the pharmacist "code of ethics."* c.
Defends ethical decisions through analysis of ethical principles. d.
Demonstrates sensitivity to confidentiality issues.* e.
Attends and participates in all activities according to attendance policies.* f.
Is punctual for all activities. g.
Completes assigned responsibilities (including patient care responsibilities) on time. h.
Accommodates to change in workflow without disruption of work schedule. i.
Initiates additional learning opportunities. j.
Synthesizes new information in order to draw conclusions, hypothesizes, or decides a course of action.
(5) Competency #13 Cultural Sensitivity a.
Assesses the religious and socio-economic value systems that affect need and adherence. b.
Possesses the knowledge, skills and behaviors required to identify communication tools to accommodate a culturally diverse population. c.
Identifies cultural differences that will potentially affect professional interactions. d.
Identifies appropriate alternative measures to improve verbal and non-verbal interactions between patient and pharmacist.
Updated 3/15/11

Appendix A – MTM Documentation
PATIENT INFORMATION
Name Birthdate Age
Sex □ Male □ Female Ethnicity □ Caucasian □ Asian □ Native American □ Black □ Hispanic □ Other
Address Phone
Primary Care Provider
Health Plan
Alt Phone
Phone
ID #
SOCIAL HISTORY
Exercise: _______ minutes _______ times per week
Tobacco: □ Never □ Current □ Past
Packs _______ Years _______
Alcohol: _______ drinks per week
Illicit drug use: _____________________________
PAST MEDICAL HISTORY
□ Asthma □ High cholesterol
FAMILY HISTORY (parents, siblings, grandparents)
□ High blood pressure
□ Heart attack
□
Depression
□
Diabetes
□ Ulcers (stomach/intestine)
□ Stroke
□ Cancer
□
High cholesterol
□
Kidney disease
□
Other _____________________________________
□ Other _____________________________________
SURGICAL HISTORY
1. __________________________
□ Irregular heartbeat □ Cancer
□
Anxiety
□ Thyroid disease
□
High blood pressure
□
Stroke
2. __________________________
3. __________________________
□
COPD
□
Heart attack
□
Other
________________
4. __________________________
□
Diabetes
□
Insomnia
□
Other
________________
□
Depression
□
GERD
□
Other
________________
5. __________________________
CURRENT MEDICATIONS (name, dosage, frequency)
Including prescription, nonprescription, herbal and dietary supplements
1. _______________________________ 5. _______________________________ 9. ______________________________
2. _______________________________ 6. _______________________________ 10. _____________________________
3. _______________________________ 7. _______________________________ 11. _____________________________
4. _______________________________ 8. _______________________________ 12. _____________________________
ALLERGIES (including reactions)
1. _____________________ 4. ____________________
2. _____________________ 5. ____________________
Patient Concern(s):
3. ____________________ 6. ____________________
IMMUNIZATION HISTORY (including year)
□ Influenza __________ □ Pneumococcal __________
□ Zostavax __________ □ Tetanus or Tdap __________
Updated 3/15/11

OBJECTIVE INFORMATION
Height _________ BP _________ TC _________ Other _________
Weight _________ Fasting BG _________ TRG _________ Other _________
BMI _________
Waist circum _________
ASSESSMENT (problems identified)
Comments
HgA1c _________ LDL _________
HDL _________
1. ________________________________________________ 5. _________________________________________________
2. ________________________________________________ 6. _________________________________________________
3. ________________________________________________ 7. _________________________________________________
4. ________________________________________________ 8. _________________________________________________
PLAN (recommendations)
1. ________________________________________________ 5. _________________________________________________
2. ________________________________________________ 6. _________________________________________________
3. ________________________________________________ 7. _________________________________________________
4. ________________________________________________ 8. _________________________________________________
Comments
Prescribing Provider contacted?
□ Yes □ No
EDUCATION Place rx label here.
MTM Pharmacist Name: _________________________________________________________ Date: _____________________
MTM Pharmacist Signature: _______________________________________________________
Updated 3/15/11

Appendix B – Journal Club Format
TITLE
Cite the journal article here (including title, journal, year, volume, page numbers)
BACKGROUND
Give a brief overview of the topic in discussion. Explain the importance/relevance of this particular article to the subject in discussion. What is the author’s rationale for conducting the study? Relate its relevance to
Publix Pharmacy.
OBJECTIVE
Explain what the article is attempting to find/explore through its research
METHODS
Design – Explain the study design (i.e. double-blind placebo controlled). Is the design appropriate to address the study rationale?
Inclusion Criteria – List all inclusion criteria
Exclusion Criteria – List all exclusion criteria
Were all the patients who entered the trial properly accounted for and attributed at its conclusion?
Were the groups similar at the start of the trial?
Aside from the experimental intervention, were the groups treated equally?
Case and Control Assignment – Explain how the different study groups were assigned to that designation
(i.e. computer-generated randomization) and define important concepts/terms
Analysis – List any analyses that were discussed. List how they controlled for confounders, if any.
Give odds ratios (if any) and mention the confidence interval(s) and p value(s). How large was the treatment effect?
Endpoints – List the various endpoints of the study
RESULTS
Discuss the results of the study
DISCUSSION
Explain the findings of the study
CRITIQUE
Does the article add significantly to the body of knowledge of medicine?
Can the results be applied to my patient care?
Were all clinically important outcomes considered?
Are the likely benefits worth the potential harms and costs?
Give your personal/professional opinions of the study and list any apparent flaws
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