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B.Pharm Professional Practice Experience

Introduction
The aim of this procedure is to make sure that the students of DPC get adequate experience in various pharmacy practice settings such as, Community Pharmacies, Pharmaceutical Industries and Hospitals, in order to achieve mission of the College.

Professional Practice Experience (PPE) in pharmacy education is rapidly gaining recognition as it enriches undergraduate curriculum and bridges theory to application.

This procedure applies to all the fourth year students, Student's Professional Practice Experience Unit, comprising of a Head, Members, Administrative Staff and the Staff in Community, Pharmaceutical Industry and various Hospitals who are responsible for the implementation of this procedure.

Definitions

PPE001:

Introductory Professional Practice Experience in Community for 200 hours during summer vacations in second and third year of B.Pharm.

PPE002:

Professional Practice Experience in Pharmaceutical Industry for 100 hours during fourth year of B. Pharm.

PPE003:

Professional Practice Experience in Hospitals for 600 hours during fourth year of B. Pharm.

Logbook:

Supplied by the College to the students, which is an instructional manual with queries regarding Professional Practice Experience in different pharmacy practice settings.

PPE003:

Professional Practice Experience in Hospitals for 600 hours during fourth year of B. Pharm.

Process:

As the pharmacy profession has moved from the traditional product to patient orientation, curricula within the schools and colleges of pharmacy have evolved to introduce more experiential course work to foster this patient orientation. This change has been supported by the philosophy of pharmaceutical care that encourages pharmacists to assume a patient advocacy role in optimizing a patient's drug therapy while minimizing the adverse effects of the medication.
The role of experiential education is to hasten and enhance the development of the student's ability to provide pharmaceutical care.
Professional  Practice Experience, being an integral part of DPC education program, has been  given more emphasis to improve its implementation  in the present curriculum and the number of  hours have been rescheduled  to 900 to be distributed as follows:
  1. Professional Practice Experience (PPE 001) in Community Pharmacy for not less than 200 hrs.
  2. Professional  Practice Experience (PPE 002) in   Pharmaceutical Industry for not less  than 100hrs (2 credit hours)
  3. Professional Practice Experience (PPE 003) in Hospitals for not less than 600hrs (12 credit hours).


Professional Practice Experience Test (PPET)


After the  completion of PPE, students will be evaluated with structured evaluation  checklists and oral examinations for PPE 01 and PPE 03, and written test for  PPE 02 in coordination with the training staffs. It will be useful to assess  their knowledge and training outcomes taking into consideration the  accomplishment of output of the training goals.

Evaluation of PPE
At the end of each of  PPE001, PPE002 & PPE003 the students must answer a questionnaire. College  Supervisor will collect these questionnaires and co-ordinate the results. The  results of this study will be discussed in the College Academic Council Meeting  and the Advisory Committee for any improvements in Professional Practice in  Community, Hospitals and Pharmaceutical Industry, if considered necessary.

Logbooks
  • Each student will be provided with a Logbook at the start of each PPE.
  • The main objective of the Logbook is to achieve the goals of PPE. 
  • Logbook is a manual designed by Dubai Pharmacy College, which is to be filled by the student during Professional Practice. 
  • Every Student should have her own "Log Book" to write down daily activities, during the PPE. 
  • College Supervisor will provide the student with the procedure for filling the Logbook. 
  • The student should submit the Logbook to the College supervisor at the end of her Professional Practice.

Student's Responsibility:
The student must be informed before each PPE about her responsibilities which are as follows:  

  1. She must exhibit a professional appearance in manner and dress and adhere at all times to the standards of dress behavior. 
  2. She must wear her name badge at all time during PPE. 
  3. She must regard all information and activities relating to the pharmacy, the medical community and customers to be confidential and, under no circumstances will such knowledge be revealed to anyone. 
  4. She must keep in mind that the primary aim of PPE is learning. Learning is not a passive process, but requires a continuous, active commitment. 
  5. She should recognize that the best learning environment is one that fosters mutual respect and courtesy between the trainee and preceptor. 
  6. She should never question the advice or directions of the preceptor in public, personnel, but rather accept it as a means of learning.  
  7. She should never be hesitant to admit that something is not known to her and should seek help whenever needed. 
  8. She should be aware of all laws and rules which govern her practice, and should seek clarification of any points which are not clear.  
  9. If she is regularly asked to violate laws or has knowledge that the pharmacy where she is employed violates such laws, she should immediately report and ask for change of PPE site or the preceptor. She shall report within five days after the end of each PPE to PPE Coordinator.

I) Professional Practice Experience in Community Pharmacy (Introductory PPE 001)

It is taken by the students in one or more Community Pharmacies selected by PPE coordinator during yearly summer vacations in the second and third years of B. Pharm. under course heading PPE001.

Introductory practice experiences are intended to introduce the student to pharmaceutical care. Service learning and shadowing are two types of experiences that accomplish this goal.

Service learning allows students to participate in service projects that meet the needs of the community, foster a sense of caring for others, and lead to student learning through communication and professionalism. Therefore, there are reciprocal benefits for both the community and pharmacy students. The development of caring relationships during service learning prepares students for establishing conventional patient caring relationships.

Shadowing, another type of introductory practice experience, involves the student in observing practitioners conducting pharmaceutical services in the community pharmacy.

Regular  visits, at least once, will be done by the faculty member of DPC to monitor the  students training and have discussions with preceptors and students

Learning Outcomes

On completion of the of Introductory Professional Practice Experience in  one or more Community Pharmacies, the students will be able to

LO1 Identify main  pharmacy locations and distribution of medicines in community pharmacy.
LO2 Distinguish the prescription and non-prescription medications and pharmaceutical products available in the market.
LO3 Recognize the minor to moderate medical cases that can be managed by the pharmacist.
LO4 Recognize the standard information required in a prescription.
LO5 Review the prescription for proper product selection, proper dose, proper frequency, proper duration, drug interaction, drug disease interaction to ensure effective, safe and economic patient care.
LO6 Apply calculations required for compounding, dispensing and administering medications with proper conversions between metric, and apothecary system of weights and measures.
LO7 Practice proper prescription checking, pricing, preparing, and labelling.
LO8 Apply, modify or recommend modifications in prescriptions to ensure effective, safe and economical patient care.
LO9 Resolve prescription problems.
LO10 Record prescription using files and / or computer.
LO11 Identify policy to inventory control (including purchase of medicines, expired medications and return of patients to suppliers).
LO12 Recognise good storage practice in Community pharmacy.
LO13 Apply IT skills for gaining professional information and literature.
LO14 Communicate with Health professionals for effective resolution of drug related problems.
LO15 Communicate with preceptors for reviewing cases, diseases or drugs.
LO16 Operate the professional experience in patient counseling and monitoring.
LO17 Communicate with patients for taking patient history, selecting, recommending self therapy or OTC drugs.
LO18 Develop the concepts for rational use of different pharmaceutical dosage forms.

Supervision of PPE001
Introductory  PPE is carried out under the supervision of the College supervisor  (Member of Student Professional Practice  Experience Unit) and a preceptor at PPE site who plays positive role model for  students and who possess the following characteristics.


Preceptor's characteristics

The Preceptor or the Pharmacist should:

  1. Have minimum of one  year of professional experience.
  2. Be involved in  professional organizations.
  3. Be competent in the  area of practice.
  4. Take personal  responsibility for patient outcomes.
  5. Utilize clinical  and scientific knowledge in clinical care decision – making.
  6. Demonstrate the  ability of having latest scientific knowledge in Pharmaceutical field.
  7. Demonstrate a  desire and an aptitude for teaching.
  8. Demonstrate the  ability to assess and document student performance.
  9. Practice continuous  professional development and collaborate with other healthcare professionals as  a member of a team.
  10. Demonstrate a  commitment to his/ her organization, professional society and community.


Role of Preceptor

  1. To train the students as per the objectives of PPE.
  2. To evaluate students for their performance during PPE in  developing and demonstrating the explicit skills mentioned for each PPE.
  3. To ensure the recording of all data in the log book.
  4. To supply the College supervisor a certificate indicating PPE  completion of the student in the pharmacy.
  5. To report to the College  supervisor after completion of PPE.


Steps for Introductory PPE 001

  1. PPE co-ordinator asks all students to suggest at least two community pharmacies of their choice with the name and qualification of the pharmacists working in these pharmacies. 
  2. The coordinator collects all the students before PPE and gives them the Log Book. 
  3. PPE coordinator explains the objectives of PPE001 and student's responsibility during PPE and also provide information to each student about the selected preceptor. 
  4. Each student receives a letter signed by PPE001 coordinator and the Dean for the preceptor which has the starting date and completion date of PPE.  
  5. After completion of PPE001 the Coordinator receives Preceptor's reports and Evaluation sheets and send them to Evaluation and Examination Unit.

Evaluation of students receiving PPE 001
Total marks for evaluation of PPE001 are 100, which are distributed as:
 
S.No. Particulars Marks Allotted
1. Practical Performance (*)    50
2. Log  book submission20
3. Attitude5
4. Attendance5
5. Oral exam20
 Total
Note: the student should achieve at least 70% marks  to be considered mandatory pass in PPE001
100
(*) Practical performance includes the following :-
Distribution of Medication in CP (Community Pharmacy)
      Storage in CP
      Purchasing Methods in CP
      Dispensing of Prescriptions
      Calculation and preparation of  Prescriptions
      Dealing with Expired Medicines in CP
      Preceptor and Physician Interaction
      Dealing with OTC
      Dispensing of Controlled Drugs in CP

(**) Logbooks:-
      Each student will be provided with a Logbook at the start of each PPE.
      The main objective of the Logbook is to achieve the goals of PPE.
      Logbook is a manual designed by Dubai Pharmacy College, which is to be filled by the student during Professional Practice.
      Every Student should have her own "Log Book" to write down daily activities, during the PPE.
      College Supervisor will provide the student with the procedure for filling the Logbook.
      The student should submit the Logbook to the College supervisor at the end of her  Professional Practice.
     


II) Professional Practice Experience in Pharmaceutical Industry (PPE 002)

It is taken by the students during the second semester of B. Pharm. 4th year in Drug manufacturing industries of U.A.E., which should meet the following requirements:
  1. Should apply GMP. 
  2. Should have manufacturing capacity of all types of pharmaceutical products, a well-developed R & D. section, a good Quality Control department and well-arranged storage facilities. 
  3. Should have a licensed MOH Pharmacist in Production and Quality Control department. 
  4. Should be functional and operative.


Learning  objectives of the Professional Practice in Pharmaceutical Industry are
LO1 Identify the design and set up of a Pharmaceutical Industry.
LO2 Identify the design and set up of a Pharmaceutical Industry.
LO3 Identify basics in Good Manufacturing Practice.
LO4 Organize purchase and analysis of the raw materials used in the  manufacturing of different pharmaceutical products.
LO5 Show experience in various Production Units involved in the manufacturing of solid, liquid, semisolid, and sterile dosage forms, etc.
LO6 Identify the packaging and storage of manufactured pharmaceutical  products.
LO7 Show knowledge about quality control, quality assurance and validation  of manufactured pharmaceutical products.
LO8 Show an experience of working in quality control laboratories having  sophisticated instruments like HPLC, GC, and Mass Spectrophotometer etc.
LO9 Describe the product and development work going on in R & D labs of  the Industry.


Supervisors for Professional Practice in Pharmaceutical Industry
Professional Practice in the Pharmaceutical Industry is monitored under supervision of:

  1. College  Supervisor: one of  the members of Students Professional Practice Experience Unit.
  2. Industry Supervisor: in the drug manufacturing  industry.


Responsibilities of Industrial PPE Supervisors

a. College Supervisor

To prepare a list of students eligible for Professional Practice.
To send the list of students to the Industry Supervisor.
To co-ordinate with the Industry Supervisor for:
  1. Student’s transportation from  College and hostels to Industry and back.
  2. Monitoring the Professional Practice  program.
  3. Solving any problem hindering proper  Professional Practice.
To  prepare a monthly report about Professional Practice of students for review by  the College Academic Council.
To  evaluate students PPE depending on professional reports supplied by them.

b. Industry Supervisor:

To receive a list of students sponsored for Professional Practice.
Send a list of enrolled students to the College Supervisor.
To prepare a Professional Practice program meeting the following requirements,

  1. To identify the Units in the Industry where Professional Practice will take place as per the prescribed schedule
  2. To identify the person responsible for marking the attendance of students during Professional Practice.
  3. To determine the mode of Professional Practice and appoint the person responsible for monitoring the program.
  4. Fulfillment of 100 hours Professional Practice in the Industry.
  5. To give each student a copy of Professional Practice program.
To submit a report to the College Supervisor about the students' attendance.
To submit a report on students assessment to the College Supervisor at the end of Professional Practice in Pharmaceutical Industry.

Evaluation of students receiving Industrial PPE 002
Total marks for evaluation of Industrial PPE002 are 50, which are distributed as:

 
S.No. Particulars Marks Allotted
1. Experience of stores for raw materials and finished products    05
2. Production for solid, semi solid, liquid and sterile dosage form. 05
3. Quality control and Quality assurance 05
4. Attendance 5
5. Professional report supplied about student 10
6. Written test 20
 Total 50

III) Professional Practice in Hospitals (Advanced PPE 003)

It is taken by students in 2nd semester of B.Pharm. 4th year and under course heading PPE003. Hospital training is taken in different hospitals of Dubai Health Authority (DHA) and primary health care centers. The hospitals are selected by the PPE Coordinator and it should meet the following requirements:

  1. Ministry of Health, U.A.E. or, Dubai should have approved the hospital.
  2. Pharmacy in the hospital should also be approved by Ministry of Health and Department of Health.
  3. The hospital pharmacy should have at least five licensed (MOH / DOHMS) pharmacists under its employment.
  4. All activities related to patients, drugs and dispensing in the pharmacy must be computerized.

Learning Outcomes of Advance Professional Practice Experience (PPE003)

LO1 Identify basic steps of proper outpatient, inpatient care and proper medication processing according to current standards of care unique to hospitals and health care systems.
LO2 Evaluate prescription drug order for completeness, accuracy of dosing, route of administration, drug-drug interaction and drug-disease interaction.
LO3 Apply calculations required for compounding, dispensing and administering medications with proper conversions between metric, and apothecary system of weights and measures.
LO4 Practice proper prescription checking, pricing, preparing, labelling, and storage.
LO5 Identify all functions of dispensing and labelling modules in electronic pharmacy system.
LO6 Apply guidelines and standards of practice for preparation, storage, in process quality control, and administration of sterile dosage forms and parenteral nutrition products in various pharmacy practice settings.
LO7 Resolve prescription problems regarding questionable or unclear medication orders and explain any medication errors such as missed doses, incorrect doses, or incorrect drugs.
LO8 Detect and report medication errors, adverse drug reactions and drug interactions.
LO9 Recognize Drug distribution systems and policy of dispensing special orders in hospitals: Out-patient and in-patient dispensing.
LO10 Analyze and resolve problems associated with patient drug therapy.
LO11 Recognize hospital guidelines and policy for ordering, recording and dispensing narcotics in both inpatient and outpatient settings.
LO12 Recognize hospital guidelines and policy for proper inventory control .
LO13 Communicate effectively with patients and provide proper patient counselling with appropriate terminology .
LO14 Establish a prospective therapeutic management plan that includes therapeutic endpoints, monitoring parameters, individualization of dosages, and patient counselling.
LO15 Assess patient medication needs on discharge solving the problems such as drug and dosage discrepancies, where prescriptions should be filled, and when prescriptions are needed.
LO16 Communicate effectively with other members of the health care team on topics such as therapeutics, drug information, policies and procedures, and patient planning needs.


Student activities during the round

Review patient medication therapy regularly before rounds in terms of indication, dosage, route, duration, efficacy and toxicity.
Obtain information to update and correct the medication profile.
Formulate and documents a list of problems for new or existing patients seen by the service. The list should focus on disease, drug, or socioeconomic factors.
Attend work rounds on a consistent basis and communicate to other on rounds the following information:

  1. Patient's current medication use.
  2. Observed subjective or objective signs of efficacy or toxicity.
  3. Drug distribution problems (non-formulary status or medication not ordered for a newly admitted patient)
  4. Prospective therapeutic management plans for patient problems (i.e., change of therapy, discontinuance of medication, change of pain medication, use of prophylactic antibiotics, and identification of therapeutic alternatives).
Attend work rounds and gather the following information:
  1. Subjective and objective data for monitoring a patient's medication therapy.
  2. Changes in patient status (condition improved or worsened), discharge date, surgery, diagnostic procedures and results of procedures.
  3. Changes in nondrug therapy (i.e., dietary changes, socioeconomic conditions, or physical therapy.
  4. Patient's understanding of medication, name strength and expected benefits and toxicities.
  5. Projected discharge needs including any special counseling.
Communicate developments to the unit pharmacist if he or she is unable to attend all or part of rounds.
At the end of the day, the students and their supervisors can have a lecture regarding the cases they faced during the daily round to discuss any modification or to clarify any doubt.


Evaluation of student's performance:
Preceptor  from Dubai Pharmacy College (DPC) will be guiding the students throughout their  training. Weekly visit will be done by the faculty member of DPC to monitor the  students training and have discussions with preceptors and students separately.  During a rotation, the preceptor will assess the student's performance and  provide feedback about the strengths and areas for improvement. The preceptors  will make these assessments using evaluation forms and performance criteria  that are based on goals and objectives out lined in the rotation syllabus or  manual. Therefore, before the rotation begins, the preceptor and the student  should meet and review the rotation goals and objectives, students’ performance  expectations and criteria to measure performance.

The  rotation goals and objectives are statements that communicate the level of  performance and activity of the students which are expected from them to  demonstrate. Typically, rotation goals and objectives communicate that the  students is expected to provide patient care successfully in the clinical  setting.

This figure describes four levels of ability that a student must achieve  to provide patient care. The lowest level of this triangle is "knows"  this tier infers that a student can recall knowledge gained during classroom  courses and the rotations. Goals and objectives describing this level will be  statement such as "The student can describe symptoms, pathophysiology,  laboratory tests, physical examination, prognosis and diagnosis of acute and  chronic diseases. The other verbs that could be used in this statement to  describe how to use the knowledge gained during class rooms


Evaluation of students receiving PPE003
Total marks for evaluation of PPE003 are 200, which are distributed as:

 
S.No. Particulars Marks Allotted
1. Out - patient Internship 35
2. In - patient internship. 35
3.Floor Stock Supply and Inspection 25
4.I.V admixtures / TPN services and chemotherapeutic admixtures. 25
5.Patient care rounds including25
6.Patient counseling including20
7.Attitude 10
8. Attendance    10
9.Oral exam15
 Total 200

Overall Evaluation of PPE

 
S.No. Particulars Marks Allotted
1. Introductory PPE001100
2. Industrial PPE00250
3. Advanced PPE003200
 Total 350
 
  

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