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Learning Experiences

Required Learning Experiences

  • Orientation (variable)
    • The resident will learn both the distributive and clinical functions of a pharmacist. The resident will gain knowledge in profiling prescriber orders, filling orders, checking orders, making/checking intravenous medication, clinical protocols, writing SOAP notes, documentation, and communication with prescribers, nursing, and other health care professionals. The resident will also gain knowledge of the organizations policies and procedures. Throughout orientation, the resident will complete clinical competencies and meet with various pharmacy personnel.
  • Mini-rotation (2 weeks)
    • This is an experience that takes place before regularly scheduled rotations begin. The mini-rotation learning experience is designed to help the resident become more comfortable with some of the clinical services provided at the hospital, provide a glimpse of a practice area that they may npt have been able to get a full rotation in, and transition from orientation to more formal rotations.
  • Internal Medicine (5 weeks)
    • Internal medicine is intended to provide the resident with an understanding of the pharmaceutical management of adult internal medicine patients. Residents will learn to develop and monitor a pharmaceutical care plan for a patient, provide consultation to other health care professionals, and assume the responsibility of drug therapy for the patient. The ultimate goal is to become valued as a drug expert on the health care team. Residents will also gain experience in providing consultative services such as pharmacokinetic dosing, as well as patient education and discharge counseling.
  • Antimicrobial Stewardship (5 weeks)
    • The antimicrobial stewardship service addresses all patients on antimicrobial therapy within the institution. The Antimicrobial Stewardship learning experience will involve the resident prospectively reviewing patients on antimicrobial therapy within the institution, meeting with an ID physician to determine appropriate therapy, and communicating these recommendations to other prescribers. This rotation is intended to provide the resident with an understanding of antimicrobial therapy and antimicrobial stewardship practices. Residents will learn how to assess for appropriate antimicrobial therapy, ways to streamline therapy, and develop effective communication techniques. Residents will also gain an understanding of appropriate antibiotic formulary management and an understanding of the role and functioning of the Antibiotic Subcommittee and Infection Control Committee.
  • Leadership and Practice Management (5 weeks)
    • The resident will meet with the pharmacy manager or the medication safety program manager in the inpatient pharmacy office on a daily basis. Each morning, the pharmacy manager or med safety program manager will delegate to the resident what their responsibilities will be for that day, whether it be to continue on a project or begin a new assignment or project. During the Leadership and Practice Management rotation, the resident will develop an understanding of core operational, financial and leadership techniques used as a pharmacy manager. The resident will participate and complete management projects, including medication safety initiatives. The resident will have the opportunity to participate in both the facility budgetary process and the system process.
  • Teaching Rotation (5 weeks)
    • For this rotation, the resident will act as the preceptor to a 4th year APPE student in a rotation of interest. The resident will be responsible for assigning the student a patient load, projects, leading topic discussions, and giving feedback to the student. While being a preceptor for a student, the resident will also have their own patient load to give them experience of being a clinical pharmacist while teaching. The resident’s preceptor will be more of a mentor than a preceptor during this rotation.
  • Adult Critical Care of your choice (5 weeks)
    • One of three choices: medical ICU, cardiac ICU, or neuro ICU
  • Transitions of Care (Longitudinal)
    • Transitions of Care is designed to expose the resident to the different roles that pharmacists can play in transitioning patients home, or to different levels of care. This rotation will focus on caring for and counseling patients hospitalized with heart failure and/or coronary artery disease. This service takes place on the third floor telemetry units of WMC. The primary responsibilities of the resident will be evaluating patients' heart failure therapy, and counseling the patient on their medications, the disease process, and lifestyle interventions. The resident may also communicate with outpatient providers when appropriate. Patients are identified by examining the census and running a report of patients admitted with elevated B-type natriuretic peptide levels. With the help of the preceptor, the resident will select patients from this list that may benefit from focused education. Other responsibilities will include performing educational presentations and participating in topic discussions throughout the year.
  • Formulary Management (Longitudinal)
    • Formulary Management is designed to provide the resident with training and skills of formulary management including drug monographs, drug class reviews and MUE. Residents will learn to understand the philosophy of formulary management in a health system and prepare and disseminate written drug information related to formulary and MUE results. Also, they will participate in the health system's formulary process to include drug monograph development, drug class reviews and medication use evaluations. This rotation is designed to instill in the resident an appreciation for how pharmacists may be involved in managing both pharmacoeconomic and quality of patient care in the acute care setting, relating to formulary.
  • Staffing (Longitudinal)
    • The resident will staff once every 3rd weekend as well as one major holiday. The staffing requirement covers multiple locations within the hospital. The resident could be assigned to the main pharmacy where they will be responsible for checking medications, answering questions, verifying orders, as well as some clinical consults. The resident may also be assigned to one of the decentralized pharmacies where they would be more heavily involved in clinical services.
  • Community Outreach/Career Development (Longitudinal)
    • The resident will gain experience with public health initiatives by participating in local events in the community. The purpose of this rotation is to facilitate organization and leadership skills and to prepare the resident to be a well-rounded, community and patient focused professional. Each resident will act as the outreach coordinator for at least one service event and is responsible for organizing participation, educating participants, and updating education materials for each local event assigned to the resident. The other component of this rotation is career development. Residents will meet with the preceptor monthly to discuss a variety of career development topics including, interview preparation, and CV/ cover letter reviews in order to prepare the resident for his or her career after residency.

Elective Learning Experiences

  • Cardiology Critical Care (5 weeks)
    • The service will include Cardiovascular Intensive Care Unit (CVICU) patients being followed by the intensivist service. Typically, the critical care rounding team will be responsible for anywhere from 10-12 patients.) Residents are responsible for rounding daily with their assigned multidisciplinary team as well as provision of clinical pharmacy services to the patients and health care practitioners (nurses, physicians, etc.) in the critical care units.
  • Medical Critical Care (5 weeks)
    • The primary area for rounding will include adult critical care units made up of the CCU (Cardiac/Coronary Care Unit) and MSCU (Medical/Surgical Intensive Care Unit). Residents are responsible for rounding daily with their assigned multidisciplinary team as well as provision of clinical pharmacy services to the patients and health care practitioners (nurses, physicians, etc.) in the critical care units. This Critical Care rotation allows residents to follow patients admitted from a variety of services including cardiology, neurology, pulmonary, surgery, and medicine. Common disease states encountered include: sepsis, pneumonia, acute respiratory distress syndrome (ARDS), myocardial infarction/cardiac arrest, heart failure, cirrhosis/acute liver injury, and substance withdrawal. Residents will also get the opportunity to work closely with the clinical dietician on writing parenteral nutrition orders, and understanding of enteral nutrition requirements.
  • Neuro Critical Care (5 weeks)
    • Residents are responsible for rounding daily with their assigned intensivist team as well as provision of clinical services to the patients and health care practitioners. This rotation allows residents to follow patients admitted with various neurological and neurosurgical conditions. Common disease states include head injury and poly trauma, hemorrhagic and embolic strokes, seizure disorders, and substance withdrawal.
  • NICU/Pediatrics (5 weeks)
    • The goal of this rotation is to learn about care of a neonate and pediatric patient in a hospital setting. The resident will round daily with the neonatologist, nurse practitioner, and dietician in the NICU. There will also be opportunities to round with the pediatricians and medical residents on the pediatric floor. The resident will also spend time with various members of the pediatric/NICU teams such as the NICU dietitian, the ketogenic diet dietician, respiratory therapist, lactation consultant, and nurses. The resident will be able to watch circumcisions, eye exam, and deliveries if desired. Throughout the rotation, the resident will be required to participate in daily rounds, maintain clinical documentation in EPIC, and document adverse drug reactions/medication errors appropriately in the risk reporting system. The resident will attend pediatric, Ob/Gyn, and neonatology meetings as able.
  • Anticoagulation (5 weeks)
    • The anticoagulation service will follow adult patients on full anticoagulation or any consults requested by physicians. Patients can be located on any area within the hospital except for pediatric units. The anticoagulation rotation will expose the resident to the complexity of caring for a patient treated for thromboemoblic diseases. Through active involvement in education, therapy monitoring and adverse event monitoring, the resident will gain understanding of a system approach to improve current practice and patient safety. The completion of this rotation will allow the resident to apply principles learned, as well as contribute to patient care. The resident will have an opportunity to attend anticoagulation committee meeting and work on policy related work to improve safety of anticoagulation use around the system.
  • Emergency Department (5 weeks)
    • PGY1 residents selecting this learning experience can expect immersion in all aspects of the ED. In addition to transitions of care, residents will be involved in acute care experiences, such as code strokes, and response to traumas, and cardiac/respiratory arrests. Residents will be expected to engage in direct interaction with patients and other healthcare providers to ensure the best possible patient outcomes. Residents will also gain significant experience in staff management by working alongside pharmacy technicians and ED staff on a daily basis. Good communication skills, self-initiative, and effective time management will enable residents to get the most out of this experience.
  • Neurology (5 weeks)
    • This rotation will be primarily focusing on patients on the neurology consult list and patients located on the neurology floor. A typical day will consist of rounding with the advanced practice providers on any new consults or required follow-up consults followed by time to provide patient education or complete medication reconciliations and attend discharge rounds. Residents are responsible for identifying new patients who would benefit from a medication reconciliation or patients who would benefit from medication education. Residents will be responsible for chart reviewing all patients on the service daily and then making necessary recommendations to the neurologists (or their advanced practice providers) or other attendings. Other required learning experiences will include preparing provider specific in-services and working on longitudinal neurology-related projects. Elective experiences may include watching procedures such as mechanical thrombectomy, electroencephalogram (EEG), or electromyography (nerve conduction studies) as available and participating in academia-related activities. During this rotation, residents will have direct patient care interactions and the opportunity to interact with a multidisciplinary treatment team on a daily basis. The rotation experience can be tailored to the resident's individual interests as able while maintaining consistent patient care.
  • Inpatient Psychiatry (5 weeks)
    • During this rotation, residents will provide direct patient care while serving as a member of a multidisciplinary treatment team. On a typical day, the resident will follow a panel of patients and be responsible for providing evidence-based pharmaceutical care, including identifying and resolving errors on medication reconciliation, managing drug-drug interactions, interpreting therapeutic drug monitoring results, and exploring other opportunities to optimize therapy. Prior to the interdisciplinary "lightning rounds" each morning, the resident will work up their panel of patients and interview patients as needed to obtain necessary medication-related information and perform medication reconciliation. The resident will participate in rounds and make medication-related recommendations. The resident will serve as a liaison between BHS and the pharmacy department and address any medication-related concerns that may arise. Other required learning experiences will include providing discharge medication counseling, educating BHS staff, reporting medication errors, and leading topic discussions on key psychopharmacology subjects. Other experiences may include leading patient medication education groups, shadowing with the electroconvulsive therapy team, opportunities in academia, co-precepting IPPE/APPE students (as available), and demoing long-acting injectable antipsychotic preparation and administration. The rotation experience will be tailored to the resident's individual interests and educational needs.

Practice Experiences

  • Rounding with interdisciplinary healthcare professional teams
  • Medication therapy management
  • Education of pharmacy students and healthcare professionals
  • Participation in departmental and committee meetings
  • Involved in medication safety practices
  • Providing community service

Additional Learning Experiences

  • Research project
  • Medication Utilization Evaluations
  • Manuscript writing
  • Formal presentations
  • Staffing every third weekend and 1 major holiday
  • ACLS/BLS certification
  • Journal Club
  • Career Development

Teaching Opportunities

  • Precept a 4th year pharmacy student on rotation
  • Provide didactic lectures to pharmacy students
  • Shenandoah University Pharmacy Residency Teaching and Learning Curriculum Program
  • Provide a continuing education to pharmacists