Following is a brief description of the various nontraditional clerkships. Orientation time has been reduced to the absolute minimum to make the clerkships more accessible, yet maintain academic integrity. Please understand that, although done infrequently, individual faculty can alter the requirements of the clerkship to ensure that you meet the "academic" standard. For example, if the faculty members feel that you need the benefit of more orientation time within the clerkship; they can, at their discretion, extend that time. By the same token, if you feel you need more orientation exposure to the clerkship you may request it of the preceptors.

These nontraditional clerkships utilize the same preceptors, the same outcome statements, the same competency statements, and the same behaviorally anchored grading forms that are used for traditional students. Although the process is different, the outcomes are expected to be the same.

REQUIRED CLERKSHIP (either Ambulatory Care/Family Practice or Adult Medicine)

Ambulatory Care/Family Practice 6623. This course is designed to integrate basic pharmacy-related concepts and patient care normally addressed in an ambulatory setting. This is accomplished through the pharmacist's involvement in patient care, case studies, written and oral presentations, pharmacotherapeutic discussions and selected exercises. In this process, problem-solving skills will be stressed. The clerkship involves three phases: an orientation phase, a self directed professional practice period, and an evaluation phase. The orientation period includes getting to know the preceptor, required readings, and spending several full days with the preceptor. The orientation period can vary from an estimated 5 days to 4 weeks depending upon the skills and experience of the pharmacist. Typically, five is required. The self-directed practice period includes developing 9 case studies from 56 commonly found pathophysiological states in ambulatory care from the pharmacist's community. In these exercises, problem-solving skills with opportunities to contribute to pharmaceutical care will be stressed. These case studies shall be presented to the faculty from one to three at a time, preferably in person. For the pharmacist for whom this would be impractical and at the preceptor's discretion, these may be conducted over the phone. These case studies are intended to be highly developed. The last phase involves the evaluation of the pharmacist. The preceptor must have enough contact with the pharmacist to fairly grade them based on behavioral skills.

Adult Medicine 6613. This course is designed to integrate pharmacy-related concepts and patient care normally addressed in an acute care setting. This is accomplished through the pharmacist's involvement in patient care, case studies, written and oral presentations, pharmacotherapeutic discussions, literature evaluations, and selected exercises. Like the Ambulatory Care Clerkship, this clerkship involves three phases: an orientation phase, a self directed professional practice period and an evaluation phase. During the orientation phase the pharmacist will review a number of selected articles followed by spending (typically) five consecutive days with the preceptor. Local pharmacists are expected to continue to monitor selected patients they followed during the orientation for the duration of the patient's confinement. Pharmacists may have this waived if distance would impose a hardship, but additional emphasis will be placed on the self-study portion of their clerkship. During the self-study portion of the clerkship, conducted in the pharmacist's community, the pharmacist shall develop in considerable detail six case studies of patients from six different disease domains and present them to the preceptor. In these exercises problem-solving skills with opportunities to contribute pharmaceutically will be stressed.

SELECTIVE CLERKSHIPS

Adult Medicine 6613 (same as Adult Medicine above but with a different preceptor)

Ambulatory Care/Family Practice 6623 (same as Ambulatory Care/Family Practice above but with a different preceptor)

Adult Medicine with an emphasis in Nutrition, Oncology, Cardiology, Nephrology, or Infectious Disease. These courses are organized like the required Adult Medicine clerkship, except all case studies are done within the selected disease domain. Prior to patient rounding with the preceptor, the pharmacist may be required to work through the respective ACCP clinical module.

Community Clinical 6663. The Community Clinical Clerkship is designed to allow non-traditional students the opportunity to use their personal patient database in the provision of more clinically based care of patients. Pharmacists enrolled in this rotation are expected to demonstrate competency in community pharmacy practice, provide clinical pharmacy services in the community setting, understand community pharmacy management, and develop community pharmacy projects and case presentations. Pharmacists are given assignments which must be completed before the rotation requirements are satisfied. Assignments include: a pharmacy site assessment, a mock Board of Pharmacy Inspection Report, a library evaluation of their clerkship site, two over-the-counter mini-case presentations, one at-risk patient presentation and an in-store project. In addition, didactic material on subjects such as OBRA '90, otitis media, and drugs in pregnancy are offered to refresh the pharmacist's memory on these subjects. This rotation is intended to give pharmacists an opportunity to study the information, then incorporate it in their practice and reap the benefits thereafter.

Geriatrics 6633. As the aging of America occurs, and the knowledge of the aging process expands, the need for appropriate geriatric prescribing and monitoring grows proportionally. The goal of the Geriatrics rotation is to acquaint the pharmacist with special issues relating to the older patient. The pharmacist is expected to meet with the preceptor for at least 5 days at the beginning of the rotation. During this period, the pharmacist will become familiar with the common physical changes of aging, with dosage modifications for the elderly, and with significant drug-drug and drug disease interactions. During the rotation, the pharmacist will attend 5 ward rounds with the preceptor, and attend at least one interdisciplinary staffing conference. The pharmacist is expected to prepare 9 case studies during the self-directed practice period. These cases will be on common pathophysiological states found in the elderly, and must meet the approval of the preceptor. The pharmacist is expected to prepare an inservice on a topic related to Geriatrics during this rotation.

ELECTIVE CLERKSHIPS:

Drug Information 6653. The Drug Information Rotation is designed to prepare the pharmacist to become an effective provider of drug information. This is accomplished through the pharmacist's utilization of reference materials available at their primary place of employment as well as those located at UAMS. In this process, the skills of information retrieval, evaluation, communication, and application are stressed. The course consists of an orientation phase, a self-directed practice period, and evaluation phase. Orientation will be at the drug information center and usually requires from one to three days. The distance pharmacist is recommended to spend at least two days at the center where they can take advantage of a University level library and conduct some of their major research before returning to their home communities. The self-directed professional practice period consists of several reading assignments, documentation of 15 requests for drug information and an evaluation of those responses from the pharmacists practice site, journal club participation, literature evaluation, drug monograph generation, and a research paper. The evaluation phase will consist of evaluation of the self-directed exercises as well as an evaluation of a verbal presentation of the pharmacist's research paper.

Nursing Home Consultant 6633. The rotation will acquaint the pharmacist with the aging process and the physiological changes relating to this patient population. In addition, the psychological and pharmacological considerations will be discussed. The pharmacist will become acquainted with the OBRA 90/93 guidelines directing the consultant pharmacist responsibilities with the long-term care patient. The information presented and experience gained will equip the pharmacist to perform the consultant pharmacist responsibilities in providing services to long-term care and related facilities.

Pharmacy Informatics 6693. The Informatics clerkship is designed to address five areas of computer applications in pharmacy practice and every day life. First, a general knowledge of computer terms, rudimentary knowledge of Windows 95, and file management is ensured. Secondly, electronic communications and information retrieval are developed via the Internet, Internet searches, Internet CE, and E-mail. Third, the pharmacist learns to use word processing and spreadsheet programs. Fourth, the pharmacist must select two projects from the options of: statistical software, kinetics software, graphic presentations, clinical documentation systems, homepage construction, or a special project. Fifth, pharmacists will evaluate a number of Pharmacy (non-distributive) computer systems. An estimated two days of orientation are required.

Home Infusion 6693. The Home Infusion Pharmacy Practice clerkship is designed to integrate basic home IV compounding procedures, distribution systems, patient IV administration equipment, pharmacy related concepts, and patient care normally addressed in a home infusion setting. The pharmacist must work with the preceptor to obtain a solid understanding of the practice environment in a home infusion setting by hands on experience. The preceptor and pharmacist mutually agree upon time spent within the home infusion setting. No set number of clock hours are required but significant time must be spent in the setting to meet the outcome expectations. The pharmacist also will spend a day with the nurse or pharmacist in home patient care settings.

Hospital Pharmacy 6673. The Hospital Practice clerkship is designed to teach nontraditional students who haven't had any hospital experience the activities and responsibilities commonly occurring in hospital pharmacy practice. The course is devised to integrate pharmacy-related concepts, patient care normally addressed in a hospital setting, and hospital distribution systems. This is accomplished through the pharmacist's hands-on involvement in a hospital setting, discussions, selected readings, and selected exercises. The preceptor and the pharmacist will accomplish scheduling of individual work times. Actual hours on site shall be decided by the preceptor according to the pharmacists need to meet the goals and competencies of the rotation. Although no set number of clock hours are required, it is expected the pharmacist will have to spend enough time to develop skills in certain areas such as compounding IV's, interpretation of physicians orders, processing of drug orders, and picking and checking of the unit dose carts. The pharmacist usually will spend two to three days with the primary preceptor during the week and be exposed to as many of the required competencies as possible. After this time, the pharmacist will work at the preceptor's hospital with other pharmacy staff (under the primary preceptor's direction) on evenings or weekends until practice competencies are met.