Rotation Manual

• Policies and Expectations
• Required Rotations (803 Series)
• Elective Rotations (810 Series)
• Elective Rotations (815 Series)
• Forms
• Experiential Main
• Longitudinal DI Manual

Policies and Expectations

This manual is a guide for preceptors, faculty, and students involved in professional practice experiences fulfilling curricular requirements of the Univerisity of Arizona College of Pharmacy.  To maintain this manual as a useful resource, suggestions regarding its content and structure are vey much appreciated.     

Feel free to contact us with comments or suggestions.

Professional experience rotations are designed to complete pharmacy students' education through supervised participation in pharmacy practice in a variety of settings.  In accordance with Accreditation Council for Pharmacy Education (ACPE) standards, these experiences include introductory pharmacy practice experiences (IPPE) and advanced pharmacy practice experiences (APPE) rotations.  IPPE rotations begin in the spring of the first year of the curriculum, enhancing the students' didactic learning by providing opportunities to apply the knowledge they are gaining.  APPE rotations are completed after the students' didactic courses are completed, with an exception for students particpating in rural rotations.  These students will have one APPE rotation between the second and third year of curriculum.  Through IPPE and APPE  rotations, students develop technical and clinical skills needed to become competent pharmacists.  Students receive both academic credit and intern hour credit to be reported to the Arizona State Board of Pharmacy for work done on IPPE and APPE rotations.

Students perform rotation activities under the supervision of assigned preceptors.  Preceptors are full or affiliate members of the faculty of the College of Pharmacy who  show students how to apply knowledge learned in the classroom to daily practice and evaluate students' progress.

The liaisons between the College of Pharmacy, the student, and the preceptor are the Director and Coordinators of Experiential Education.  Their function is to recruit and maintain rotation sites and preceptor relationships, make student assignments to rotation sites/preceptors, and support preceptors and students throughout the experiential education process.

Goals and Objectives for IPPE rotations are under development. 

Goals and objectives for APPE rotations are available in this online rotation manual to serve as a guide to the preceptor and the student in planning the rotation experience.  Students starting a new rotation should download the applicable Rotations Task Checklist (available for PhPr 803 series required APPE rotations) and the checklist for all rotations. The preceptor and student should review these together to plan rotation activities.  As guidelines, these may be tailored to the expertiseprevious experience and goals of the student as well as the unique characteristics of a rotation site.  The tasklists are in a checklist format if the student/preceptor wishes to use them as such.

The following expectations are addressed in the checklist for all rotations.  Students should download this at the beginning of each rotation, to use in conjunction with the rotation specific goals and objectives. 

1. Students are to comply with site specific requirements regarding nametags, orientation procedures, health screening/infectious disease prevention, and work schedules.  Students must adhere to the dress codes set by the College of Pharmacy.
2. Early in the rotation, the student and preceptor should discuss rotation goals and objectives and expectations of the student.
3. The preceptor is encouraged to have the student work with other pharmacists and pharmacy personnel to provide exposure to different functions within the pharmacy department. 
4. When possible, students are encouraged to attend departmental meetings, in-services, and other pertinent activities at the site.  These may occur outside normally scheduled hours.   If a student is scheduled to be at a rotation site on a Saturday or Sunday in order to enhance the learning experience, arrangements can be made for equivalent time off during the one of the weeks the student is at that site. 
5. The preceptor and the student should meet frequently for discussion of topics related to rotation goals.  The recommended minimum for this interaction is five hours per week, but may be distributed through the day/week to accomodate the preceptor's schedule or workflow at the site.  Students should be prepared participate fully in these discussions. 
6. It is highly recommended that the student does a project during each rotation that will benefit pharmacy services at the site.  The project should be selected within the first two weeks of the rotation. 
7. It is highly recommended that the student give at least one formal presentation during each rotation. The audience and topic should be decided upon with during the first two weeks of the rotation.  Invitations to pharmacy staff or other interested individuals should be made.  Through the rotation year, students should gain experience with formal patient presentations as well as presentation of topics.  The type of presentation and requirements regarding use of audio/visual media and handouts are at the discretion of the preceptor and resources available at the rotation site.
8. Students are responsible for ensuring that Longitudinal Drug Information course requirements are satisfied.  Preceptors are asked to grade assignments completed by students under their supervision.  The Longitudinal DI Manual is online and contains a complete description of the requirements and formats for submission.  The formats are suggestions, and may be altered at the discretion of the preceptor.
9. Preceptors should evaluate students at the rotation midpoint and end.  Final evaluations and grades may  be submitted online.  Student evaluations of the site and preceptor may also be submitted online. 
   https://www1.ems-webs.com/Arizona
10. The report of intern hours needs to be signed by the preceptor and submitted to the Director of Experiential Education.
    
    
    

For further information, please refer to above Expectations for All Rotations, Information for Students, and Grading Policies below.  Click here for information regarding becoming a preceptor.

1. Assignments  Before assignments are made, preceptors may specify available rotation dates and numbers of students that may be accommodated.  Any additional requirements a preceptor may have for accepting students must be communicated to the Director/Coordinator of Experiential Education.  Preceptors may view student names and dates of assignment online in the rotation website
   https://www1.ems-webs.com/Arizona.
2. Rotation Checklists The Checklist for All Rotations and specific Rotation Task Checklists (for PhPr 803 series required rotations) should be obtained at the beginning of the rotation and used as a guide for planning rotation activties. 
3. Optimizing the Learning Experience
• Students should take initiative in finding opportunities to learn and practice professional communication skills when interacting with all types of persons encountered at a rotation site.  Preceptors should provide appropriate oversight of student activities and provide guidance regarding effective communication to patients and other health care providers.
• Students should gain experience in making professional decisions involved in pharmacy practice (e.g. evaluating prescriptions/medication orders, therapeutic decisions, counseling/education activities, nonprescription drug advice, etc.).  Preceptors should provide guidance regarding these judgments and oversight of actions taken pursuant to decisions made.
• When possible, students should gain experience in writing notes in patient charts.  Students are to adhere to institutional policies regarding student-written chart notes.
• Preceptors should provide constructive feedback regarding students' professional interactions and performance.  When possible, students should be given opportunities to incorporate the feedback into their activities at the site.
• Students should not publicly question advice or directions of the preceptor.  Disagreements should be discussed privately and resolved with discussion between the parties involved.  The Director of Experiential Education may be contacted if needed.
4. Preceptor conferences with students  Preceptors should schedule regular opportunities for conferences with students to discuss student progress as well as topics pertinent to the practice site.  It is recommended that five hours per week be allowed for these meetings.  Students should be fully prepared to participate in these discussions.
5. Evaluations of Students  See Rotation Grading Policies below.  Preceptors are to complete a mid-point and final evaluation of each student.  The midpoint evaluation should facilitate discussion between the student and preceptor regarding areas in which the student needs more practice and to determine what rotation goals still need to be met.  The rotation grade will be assigned by the preceptor with the final evaluation.  The preceptor should discuss the final evaluation and grade with the student.  Midpoint and final evaluations may be sumitted online at https://www1.ems-webs.com/Arizona or downloaded and faxed/mailed to the Director of Experiential Education.  A sample form may be viewed under the Forms menu.  Rotation task checklists for PhPr 803 series rotations may also be sent to the Director of Experiential Programs. 
6. Reporting Intern Hours  Students are responsible for completing the Report of Intern Hours.  This must be verified and signed by the preceptor, and then submitted to the Director of Experiential Education.

Please refer to above Expectations for All Rotations for further information.

1. Assignments 
   • First year IPPE students will be assigned to longitudinal and short term experiences, which will be outlined in the specific course syllabi. 
   • Second year IPPE students will be assigned to semester long rotations. 
   • APPE students will be assigned to seven six week rotations at various practice sites with different preceptors.  Each student is required to do a community, institutional, ambulatory care, and adult acute care rotations.  The remaining three rotations are electives.  Follow this link to access the rotation selection schematic.
   • Students are expected to contact their assigned preceptors two weeks prior to the beginning of the rotation to make arrangements such as the initial meeting time/place, parking, and any required paperwork or check-in procedures at the site.  Students are responsible for parking fees when applicable.
     
2. Compensation  Students may not be compensated monetarily for experiential training on rotations. Students receive academic credit from the College of Pharmacy and intern hour credit from the Arizona State Board of Pharmacy after successful completion each rotation.  In order to recieve intern hour credit for an out of state rotation, the student must have a valid intern license in the state where the rotation was completed.  Students will not receive intern hour credit for international rotations.
   
3. Insurance 
   • The College of Pharmacy is enrolled in a malpractice insurance policy that covers students during their participation in the experiential program. This policy only covers the student for professional liability as a pharmacy intern while doing rotations assigned by the College of Pharmacy.  If the student is involved in activities beyond the scope of pharmacy practice and their level of training, they will not be covered by this policy.  This policy does not cover students performing intern activities outside the College of Pharmacy experiential program.
   • The College of Pharmacy does not provide health insurance coverage should the student become sick or injured while at the site. Students that are not covered under a health insurance plan of a spouse or parent/legal guardian are strongly encouraged to obtain personal accident and sickness insurance through the Campus Health Service or another source.
     
4. Pharmacy Intern Registration  
   • Each student must be a registered pharmacy intern. A copy of the student's intern license must be submitted to the Director of Experiential Programs prior to the start of rotations. Each student must comply with the Pharmacy Rules and Regulations (see R4-23-301 through R4-23-305 of the Arizona Pharmacy Rules and Regulations) including notifying the Arizona State Board of Pharmacy of change of mailing address within ten days.
   • Students completing rotations out of state must obtain required registration in that state and comply with intern regulations of that state.
     
5. Fingerprinting and Background Checks
   • Students admitted to the College of Pharmacy prior to 2008 are required to obtain Arizona Department of Public Safety (AZ DPS) fingerprint clearance cards prior to starting rotations. 
   • Beginning with the Fall 2008 incoming class, students are required to obtain AZ DPS fingerprint clearance upon admission to the College of Pharmacy.
   • When applying for AZ DPS fingerprint clearance, students should designate themselves as a "volunteer" and as a "Health Science Student and Clinical Assistant (ARS15-1881)."  For current fees and information, students are referred to the AZ DPS website.
   • Offenses that preclude someone from obtaining a clearance card may be found in A.R.S. 41-1758.03. More information regarding fingerprinting of Health Sciences students is available in A.R.S 15-1881.
   • Students should be aware that some rotation facilities may require additional background checks and/or urine drug screening. Unless paid for by the rotation facility, students will bear the expense of such screening. Neither The University of Arizona nor the College of Pharmacy pays or reimburses for the expenses related to background checks, drug screening, or fingerprint clearance.
   • Students who do not submit to fingerprinting and/or receive appropriate clearance may be unable to fulfill their academic requirements at the College of Pharmacy, and therefore may not be able to complete their educational program.
   • Should a criminal background check be required, a variety of sources are available.  Students should check with the institution requiring the background check before choosing a vendor. Select link for more information Criminal background checks.
     
6. Infectious Disease Prevention 
   • Students must observe the infectious disease prevention policies of the rotation site as well as Universal Precautions to prevent contact with blood and other potentially infectious materials.  Prior to rotations, students must complete Blood Borne Pathogen safety training presented by the University of Arizona Department of Risk Management. Students also receive an "AHSC Prompt Medical Attention Card" with instructions to follow in the event of a blood/bodily fluid exposures.
   • All students are required to show proof of immunity to hepatitis B, Varicella, Rubella, and Rubeola.  Documentation of vaccination and follow-up antibody titers confirming immunity should be provided.  Vaccination waivers are allowed for students with medical contraindications to vaccination.  Students should also have an up to date Tetatus booster.   Students must regularly obtain Tuberculin Skin Tests (PPD) such that a negative result is on file within the 12 month period before the start of each rotation assignment.  If a student has a history of a positive PPD or received BCG Vaccine, students should submit a recent chest x-ray and TB symptom questionnaire showing the absence of active disease. To download a summary of health screening requirements, follow this link.
     Health Screening Requirements
   • Students enrolled in the program prior to the Class of 2012 must  submit documentation of the above requirements to the Director of Experiential Programs prior to the start of the first rotation.  These documents should be submitted with the Health Screening Requirements Form COP .  Students are responsible for costs incurred in having these tests done. 
   • Beginning with the Class of 2012, students are to submit documentation of health screening items to Campus Health Services in order to obtain health screening clearance.  Documentation of health screening items obtained from sources other than Campus Health may be submitted with the Health Screening Requirements Form.  Students that do not have health screening clearance will be prevented from registering for courses beginning with the spring semester of their first year in the program. 
   • Students with health screening clearance needing to provide such documentation to a rotation site may obtain records online at www.health.arizona.edu.   Click on the patient link, enter UA net ID, choose Immunizations (or billing), and click on print.
     
7. Cardiopulmonary Resuscitation (CPR) Training  All students must have CPR certification in accordance with the curriculum of the American Heart Association for Healthcare Providers.    Documentation must be provided to the Director of Experiential Programs before the start of the first rotation, and maintained current throughout participation in IPPE and APPE rotation experiences.
   
8. HIPAA Certification  All students must have certification regarding application of the Health Insurance Portability and Accountability Act.  Courses are arranged by the College for students preparing for IPPE and APPE rotations each year.
   
9. Attendance/Absence Policy 
   • Attendance is essential if academic credit is to be received and intern hours accrued.
   • The student is responsible for adhering to the rotation schedule agreed upon with the preceptor, including meetings and other activities that may occur outside usual business hours. 
   • In case of sickness or other emergency causing the student to be absent from or late to a rotation site, the preceptor should be notified by telephone as early as possible. Failure to do so will constitute unexcused absence. If an absence will is more than two consecutive days, the Director of Experiential Programs must be notified.
   • Students who cannot reasonably get to their rotation site due to inclement weather must notify their preceptor as soon as they realize that they will not be able to attend. Failure to do so will constitute an unexcused absence. Rotation time missed due to weather must be made up.
   • Professional leave from rotations may be granted to APPE rotation students.  This must be requested using the Professional Leave Form no later than the first day of rotation in which the absence will occur.  Professional leave includes College functions/meetings, professional meetings, and residency/job interviews. Professional leave must be approved by both the preceptor and the Director of Experiential Programs prior to the leave dates.  Each student may use a maximum of four professional leave days per rotation not to exceed a total of ten days for the APPE rotation year.  Students do not accrue intern hours while away from the rotation site for professional leave.
   • Excused absences of more than 2 days per rotation must be made up. At the discretion of the preceptor, making up time may include additional hours at the site or completion of additional projects for the site.
   • Unexcused absences must be made up on hour per hour basis.
   • Absences of any type may decrease any student's ability to achieve all the objectives of the rotations, and this may be reflected in their rotation grade.
   • Students may lose 1 letter grade for each unexcused absence. Unexcused absences include failure to contact the preceptor (or site) in case of illness and failure to contact the preceptor (or site) if for any reason the student is unable to arrive at the site at the time agreed upon with the preceptor.  Absences resulting from failure to obtain health screening or other rotation requirements is unexcused.
     
10. Evaluation of Site/Preceptor  Students are to complete an evaluation of their rotation experience on the last day of a rotation. This may be done online at https://www1.ems-webs.com/Arizona.  Students are not expected to show this evaluation to the preceptor.  These evaluations will be kept confidential until the class graduates from the program.  Following graduation, a cumulative summary student evaluations reflecting the APPE year that doesn't include student names will be provided to preceptors.
    
11. Evaluations and Grade  See Rotation Grading Policies below.  Preceptors are to complete a mid-point and final evaluation of each student.  The midpoint evaluation should facilitate discussion between the student and preceptor regarding areas in which the student needs more practice and to determine what rotation goals still need to be met.  The rotation grade will be assigned by the preceptor with the final evaluation.  The preceptor should discuss the final evaluation and grade with the student.  Midpoint and final evaluations may be sumitted online at https://www1.ems-webs.com/Arizona or downloaded and faxed/mailed to the Director of Experiential Education.  A sample form may be viewed under the Forms menu.  Rotation task checklists for PhPr 803 series rotations may also be sent to the Director of Experiential Programs. 
    
12. Course Units and Internship Credit
    • Hour requirements for IPPE rotations will be outlined in the individual syllabi for IPPE courses.
    • Five academic credit units are awarded for each completed APPE rotation.
    • In APPE rotations, students are expected to function as full-time (40 hours/week) workers at their assigned rotation sites.  In consideration of University holidays, approved professional leave, and sites that may have shorter operating hours, a minumum of 200 hours is required to earn academic credit for a six week APPE rotation.  Absences in excess of two days from a rotation are to be made up at the preceptor's discretion, and in a manner that will achieve the minumum requirements.  A rotation grade will not be recorded until the preceptor notifies the Director of Experiential Programs that the appropriate time has been made up.
    • At the end of each IPPE or APPE rotation, students must submit a completed Report of Intern Hours to the Director of Experiential Education.  Based on these reports, Quarterly Reports of Intern Training will be generated by the Director of Experiential Education and submitted to the Arizona State Board of Pharmacy. 
    • In order for the Director of Experiential Education to report hours from rotations outside of Arizona to the Arizona Board of Pharmacy, the student must have an intern license in the state where the rotation was completed.
    • If a student is submitting intern hours to other state boards of pharmacy for credit for licensure in that state, it is that student's responsibility to find out the reporting procedures and regulations for intern hours set forth by that state board of pharmacy.  Students requesting assistance from the Director of Experiential Education in submitting hours to other states need to provide such information along with their request.
    • Submission of an inaccurate Report of Intern Hours is a form of academic dishonesty. 
      
    
    

In their interactions with patients and other health care professionals, students represent the College of Pharmacy as well as the practice site.  In this capacity, students must maintain professional decorum at all times. The student should understand that his/her conduct and actions reflect may be seen as reflective of the College of Pharmacy as a whole, and that his/her actions may impact the relationship between the College and the preceptor and rotation site long after the completion of the rotation.

1. Dress Code

                    IPPE Students:

• All students must wear neat, clean, white laboratory jackets unless otherwise directed by the preceptors.  Nametags from places of employment should not be worn at a rotation site.
• All students must wear a College of Pharmacy polo shirt or a plain red or navy polo shirt.
• Male students must wear navy, black, or khaki slacks with close-toed shoes (no athletic shoes).
• Female students may wear navy, black, or khaki slacks or skirts with appropriate hosiery and close-toed shoes.

                    APPE Students:

• All students must wear neat, clean, white laboratory jackets unless otherwise directed by the preceptors.  Nametags from places of employment should not be worn at a rotation site.
• Female students may wear skirts, dresses or dress slacks with appropriate hosiery and shoes.
• Male students must wear dress slacks, collared shirts, ties, socks and appropriate shoes.
• Jeans, shorts, mini-skirts, thong sandals, T-shirts, etc., are inappropriate dress and are NOT allowed.

      All Students:

• All students must maintain good personal hygiene.
• Students may be asked to leave a rotation site dress code violations. This absence is unexcused.

2. Confidentiality 

• All confidential/proprietory information revealed during a rotation assignment such as pharmacy records, fee systems, professional policies, etc. are to be kept confidential.
• All patient personal/health information must be kept confidential, according to principals of HIPAA.
  

3. Optimizing the Learning Experience
• Students should take initiative in finding opportunities to learn and practice professional communication skills when interacting with all types of persons encountered at a rotation site.  This includes pharmacists, other pharmacy or rotation site employees, physicians, other health care professionals, and patients.  Students should seek advice regarding appropriate methods of communication for different types of encounters.
• Students should gain experience in making professional decisions involved in pharmacy practice (e.g. evaluating prescriptions/medication orders, therapeutic decisions, counseling/education activities, nonprescription drug advice, etc.).  Students are to follow the advice of the preceptor regarding review/oversight of these professional judgments and their pursuant actions. 
• When possible, students should gain experience in writing notes in patient charts.  However, some institutions do not allow pharmacy students to write progress notes.  Students should discuss policies regarding progress notes with their preceptor.  Because charts are legal documents, notes should be carefully written under the guidance of preceptors to ensure appropriate content.
• Preceptors should provide constructive feedback regarding students' professional interactions and performance.  Students should view this a means of learning and seek opportunities to incorporate the feedback into their rotation activities.
• Students should not publicly question advice or directions of the preceptor.  Disagreements should be discussed privately and resolved with discussion between the parties involved.  The Director of Experiential Education may be contacted if needed.
  

4. Legal Responsibility  The student should constantly be alert to and obey the laws and regulations that govern pharmacy practice.  Students should seek clarification of any points that are not clear. Students are not to perform medical procedures or otherwise act outside the scope of pharmacy practice.

At the end of each rotation, the preceptor will evaluate the student and assign a grade using the form available online at https://www1.ems-webs.com/Arizona.   The evaluation and grade may be submitted online, or downloaded and faxed/mailed to the Director of Experiential Education.  An example form may be viewed under the forms menu.  Rotation task checklists for 803 series rotations may also be sent to the Director of Experiential Programs. 

For PhPr 803 series required rotations, the extent to which students accomplish the goals/objectives on the rotation task checklist is reflected in the first two items (Knowledge/Application) of the evaluation form.  For PhPr 810 and 815 series elective rotations, these evaluation items should reflect the extent of accomplishment of goals and objectives established by the preceptor and student at the beginning of the rotation.  The remaining items of the evaluation reflect the student's ability to communicate effectively, manage time and resources to accomplish tasks, professionalism, and ethics. Expectations of the student with respect to grading should be made clear, and preceptors should maintain documentation to justify a final grade.

At the end of the evaluation, the preceptor assigns a grade as follows.

S: Superior (no grade point value)	Performance was exceptional and noteworthy for a student of this level
P: Pass (no grade point value)	Performance was appropriate and acceptable for  a student of this level
C: grade point value = 2	Although performance was below that expected for a student of this level, student showed improvement over time
D: grade point value = 1	Significantly, repeatedly performs below expectations without showing improvement
E: grade point value = 0	Fails to complete rotation

The preceptor should discuss the final evaluation and grade at the end of the rotation.  Grade appeals will follow the procedure outlined in the University of Arizona Academic Catalog.

Procedures for Dealing with Sexual Harassment
Equal Opportunity and Affirmative Action Office
http://equity.arizona.edu/non-discrimination_anti-harassment

Code of Academic Integrity
http://dos.web.arizona.edu/uapolicies/

Grade Appeal Policy
http://catalog.arizona.edu/2009-10/policies/gradappeal.htm

The University of Arizona Statement on Drug Free Schools and Campuses
http://www.hr.arizona.edu/09_rel/drugstmt.php

This a collection of reference information for students.  It includes guides for evaluating patients and drug therapies and compliance.  It is hoped that by practicing using these concepts, students will develop a basic thought process for identifying and solving patient problems.  Also included are guidelines to assist students preparing for formal and informal patient presentations.  Much of this material has been presented in previous coursework. 

Preceptors are welcome to use any of this material for teaching purposes.  The content may be adapted to the unique characteristics of a practice site or expertise of a preceptor.

Download Back to Basics.