Guidelines for Assessment Plan Report (2013-2014)

Guidelines for Assessment Plan Report (2013-2014) For each annual assessment plan, programs should submit a short narrative report (2-3 pages plus appendices) to the school assessment coordinator on or before January 1. The report should be submitted to the school assessment coordinator as a Microsoft WORD document with a file name that identifies the year and the program, example (PTAYearAssessmentReport.docx). The school assessment coordinator will either sign off on the report or return it to the program assessment coordinator for revision and strengthening. Once approved at the school level, the report will be converted to pdf format and forwarded to the CSN Director of Assessment and Accreditation. The report format is shown below. Date Submitted: February 19, 2015 School: Engelstad School of Health Sciences Program: Pharmacy Technician Program Report Format Person(s) responsible for the design and implementation of assessment plan and writing the report: Cheryll Carlock-Arinwine 1. Project Overview and Assessment Goals A. List the program Learning Outcome(s) that the plan is assessing. Outcome 1: Demonstrate broad competency in pharmacy techniques and procedures, pharmaceutical math, and pharmacology. Outcome 2: Demonstrate the relevant skills and competency necessary for licensure as a Nevada State Pharmacy Technician. Outcome 4: Demonstrate effective and ethical pharmacy practice techniques in accordance with defined state, federal, and professional industry guidelines and legal parameters. B. Provide a brief description of the plan and the assessment question(s) being addressed. Outcome 1: (Question) Did the fall 2013 cohort demonstrate broad competency in pharmacy techniques and procedures, pharmaceutical math, and pharmacology? This competency is assessed via a pre-clinical placement assessment examination. Outcomes 2 & 4: (Question) Did the fall 2013 cohort demonstrate the relevant skills and competency necessary for licensure as a Nevada State Pharmacy Technician? Did the fall 2013 cohort demonstrate effective and ethical pharmacy practice techniques in accordance with defined state, federal, and professional industry guidelines and legal parameters? These two outcomes are assessed via three (3) clinical competency rubric evaluations: Inpatient Pharmacy, I.V. Room, and Retail.

C. If this report does not correspond to the most recent program assessment plan sent to the school assessment coordinator please submit a copy of the revised plan along with this report. This report does not correspond directly with the most recent program assessment plan (see 2014-2015 Assessment Plan, Appendix A). Student learning outcomes were revised to assess higher cognitive domain levels and to create more direct assessment measures of student learning outcomes. D. Indicate when the outcome(s) were assessed and what conclusions were reached from the previous assessment, and what closing the loop changes, if any, were made based on those conclusions. Also indicate whether the assessment method used previously is the same as the one described in this report. If not, what is changed? Outcome 1: Assessment Instrument: PHAR 126B Pre-Placement Assessment Examination; spring 2014 Conclusion: 2 of 2 students took the assessment and passed. Changes: No changes needed at this time. The assessment examination will be reviewed for any needed updates and/or revisions during the 2015-2016 academic year. Outcomes 2 & 4: Assessment Instrument: Inpatient, I.V. Room, and Retail rubric evaluations Conclusion: 2 of 2 students were assessed on all three measures. One student passed with 100% competency overall on all three rubric evaluations. The second student passed with an 85% competency rating overall. This student s greatest area of deficit appeared to be in time management of retail tasks. Changes: Program faculty met to discussion ways to implement timed skills assessment in laboratory course PHAR 101L. Timed skills assessments will be introduced during the 2015-2016 academic year. 2. Project Design and Coherence A. Identify the student product(s) used for direct assessment of the Learning Outcome(s) that you listed in 1.A. Explain the context for this product [course name(s) and number(s), place in curriculum, instructor(s), and so forth). NOTE: If your project depends on anonymity, report only contextual information that doesn t need to be anonymous. If the project focused on a single or common assignment, please attach the assignment handout or explanation in the syllabus as an appendix. Outcome 1: Course: PHAR 126B - Pharmacy Technician Practicum (2 nd semester course), fall 2014 Instructors: Cheryll Carlock-Arinwine and Lorinda Trinidad-Lohner Context: Pre-Placement Assessment Exam conducted by Cheryll Carlock-Arinwine Outcomes 2 & 4: Course: PHAR 126B - Pharmacy Technician Practicum (2 nd semester course), fall 2014 Instructors: Cheryll Carlock-Arinwine and Lorinda Trinidad-Lohner Context: Rubric evaluations conducted clinical site preceptors.

B. Explain how the student product was scored and by whom [for example, objective scoring by machine; course instructor using a rubric; judging panel using a rubric] If the project used a rubric, please explain who created the rubric and attach it as an appendix. Outcome 1: The PHAR 126B Pre-Placement Assessment is a 100-question assessment instrument, comprised of questions related to course content in: PHAR 100B - Introduction to Pharmacy Practice, PHAR 101B - Pharmacy Techniques, PHAR 105B - Pharmaceutical Math for Technicians, and PHAR 110B - Pharmacology I. The examination also consists of various questions designed to assess students mastery of the Top 200 drugs learned. All examination questions, excluding the Top 200 drug assessment questions, were drawn from textbook publisher s test bank items. The Top 200 drug assessment questions are developed by the Program Director from industry drug lists; which are updated every two years in accordance with industry standards. Outcomes 2 &4: The clinical rubric evaluations (inpatient, I.V. Room, and Retail) were developed by the Program Director, and are evaluated for updates/revisions every two years; with input from program faculty and clinical site evaluators. Evaluation scores are recorded for each student by clinical site preceptors who mentor, monitor, and supervise each student throughout the duration of their hands-on clinical skills training. Competencies are evaluated on a 5-point scale (1=lowest, 5= highest). C. Explain the fit or match between the program Learning Outcome(s) being assessed and the student product used as a direct measure. In other words, how fully does the quality of the product reveal achievement of the learning objective? [Sometimes there may be a one-to-one correspondence between the learning objective and the product. At other times, only some features of the product are relevant to the learning objective. In such cases, the learning objective might be assessed only by one or two rows of a rubric or by a few selected questions on an exam.] Outcome 1: Demonstrate broad competency in pharmacy techniques and procedures, pharmaceutical math, and pharmacology. The PHAR 126B Pre-Placement Assessment Exam directly measures students knowledge of broad pharmacy concepts and content. The assessment also directly assesses students technical competence in pharmaceutical math. The assessment exam indirectly assesses students levels of procedural skill. Outcomes 2 & 4: Demonstrate the relevant skills and competency necessary for licensure as a Nevada State Pharmacy Technician; Demonstrate effective and ethical pharmacy practice techniques in accordance with defined state, federal, and professional industry guidelines and legal parameters. The rubric evaluations (Inpatient, I.V. Room, and Retail) directly assess the ability of the students to perform essential clinical functions, to include assisting the Pharmacist in providing appropriate, effective, and safe pharmaceutical care; prescription processing; dosage calculations; evaluating and filling prescriptions/medication orders; inventory management; and medication delivery (see Appendix B). D. Explain how program faculty defined achievement terms (example: minimally competent, proficient, aspiring, satisfactory etc.) for the learning objective and how they distinguished between the levels of achievement (criteria). If the project used a rubric, does the rubric clearly indicate these categories and specify the corresponding criteria? If not, explain how rubric scores correspond to these categories. If program faculty haven t yet defined terms and criteria for achievement of the learning objective(s), how and when do you plan to do so?

Outcome 1: Achievement for this outcome is clearly defined by a passing threshold score of 70% or higher on the PHAR 126B Pre-Placement Assessment Examination. Outcomes 2 & 4: Achievement for these two learning outcomes is defined by ASHP professional guidelines, state and federal legislation, as well as, industry standards. A 5-point rubric scale is clearly defined. E. If your project used a rubric, did program faculty try to establish inter-rater reliability in the use of the rubric? If so, explain how. If not, explain why. Outcome 1: N/A Outcomes 2 & 4: Yes, inter-rater reliability is used in the development, modification, and updating of program rubric evaluations (Inpatient, I.V. Room, and Retail). Program faculty meets bi-annually, at the end of each semester, to evaluate necessary assessment revisions and/or updates. Clinical preceptor feedback and input is also solicited and contributed accordingly. 3. Project Methods Narrate how the project was conducted. Who did what when? Outcome 1: The Pre-Placement assessment is administered by Cheryll Carlock-Arinwine to second semester students in the program, in course PHAR 126B. Outcome 2 & 4: Students are assessed via rubric assessments. The Inpatient and I.V. Room rubric evaluations are completed by clinical site preceptors, working in local area hospitals, who monitor, supervise, and evaluate students progressively over a duration of 200 clinical training hours. Retail rubric evaluations are completed by clinical site preceptors, working in local community-based retail pharmacies, who supervise and evaluate program students over the duration of 120 clinical training hours. 4. Project Results Report your results as a table or chart showing the number of student products evaluated and the distribution of performances across the quality categories shown in your rubric or across the continuum of objective scores. Particularly highlight the percentage of performances meeting your program s aspirational goals and the percentage failing to meet minimal standards. Outcome 1:

Outcomes 2 & 4: 5. Discussion of Results This section of your report is central to the assessment process and therefore essential to the assessment report. Explain what program faculty learned through their analysis of the results. Discuss results from the perspective of both summative and formative assessment. Summative assessment: To what extent are program faculty members satisfied with these results? Why or why not? Formative assessment: what problem areas or patterns of weakness were uncovered? How might these problem areas be addressed through changes in pedagogy, course or assignment design, or sequencing of instruction? If the outcome(s) have been previously assessed, what changes in student performance have been revealed? Outcome 1: The student success rate for this outcome was 100%; 2 of 2 students took this assessment; and passed with a threshold score of 70% or higher. Outcome 2 & 4: The student success rate for these two outcomes was 100%. 2 of 2 students were assessed on Inpatient (100% pass rate), I.V. Room (100% pass rate), and Retail (100% pass rate) competencies. Each student exceeded the minimum competency proficiency threshold of 70%. 6. Closing the loop actions What follow-up actions do program faculty plan to take next as a result of this project? You might decide to institute changes, to decide no changes are needed, or to gather more data. Typically, your action plan will fall into one of the following categories. Choose the most appropriate. A. If your assessment data suggest changes that might improve student learning, what changes will you make? (Changes might include new assignments, shifts in pedagogy, closing of gaps in the curriculum, improved scaffolding, more effective sequencing, and so forth.) How and when will you try to assess whether the changes were helpful? N/A

B. If the assessment data suggest that no changes are needed, what follow-up action is planned for the continued assessment of student performance in relation to this outcome (for example, in other assignments, courses, or areas of the curriculum)? Although the assessment data has not suggested that changes were needed, the program s student learning outcomes have been revised to assess for higher student cognitive domain abilities and to create more direct assessment measures of student learning outcomes, in accordance with the college s newly revised assessment standards (see Appendix A). C. If the assessment data are not conclusive enough to make sound decisions about changes, what action will you take either to refine assessment results or gather the additional data necessary for further deliberation? Describe the plan and time table for this additional information gathering. N/A 7. Project ownership To what extent were all program faculty involved in this project s discussion and analysis? When, how, and by whom were assessment findings discussed and decisions made about appropriate actions to take in relation to these findings? The Program Director reviewed and discussed the findings and outcomes for the AY 2013-2014 assessment with program faculty, in spring 2015. The discussion also included the implementation of timed skills assessment in PHAR 101L; to enhance students time management skills. Program faculty will again meet at the end of spring 2015 to finalize drafting a learning outcome assessment matrix, relative to the newly revised student learning outcomes being implemented AY 2014-2015.

Appendix A AY 2014-2015 Pharmacy Technician Program Assessment Plan

2014-2015 ASSESSMENT PLAN Form 1 School: Engelstad School of Health Sciences Academic Program: Pharmacy Technician Program Program external Accrediting Organization: American Society of Health-System Pharmacists (ASHP) Year of Next Accreditation Review: 2015 Submitted By: Cheryll Carlock-Arinwine Date Submitted to School Assessment Coordinator (Due November 1): December 8, 2014 A. Learning Outcome B. Covered by Accreditation Standard(s) C. Which Standard(s) Cover this Outcome? D. If not covered through accreditation, when and how will students demonstrate achieving this outcome? E. AY in which assessment will occur Acquire and synthesize knowledge of pharmaceutical standards, ethics, laws and regulations Yes VII-A-11 VII-A-17 Semester 1: 14/15 Semester 2: 14/15 Effectively model the duties and responsibilities of the profession in accordance with defined professional standards and guidelines; as well as, local, state, and federal laws. Yes VII-A-1; VII-A-2; VII-A-3; VII-A-4; VII-A-5; VII-A-6; VII-A-7; VII-A-8; VII-A-9; VII-A-10; VII-A-11; VII-A-12; VII-A-13; VII-A-16; VII-A-17; VII-A-18; VII-A-25; VII-A-26; VII-A-27; VII-A-28; VII-A-29; VII-A-31; VII-A-32; VII-A-33; VII-A-34; VII-A-35 Semester 1: 14/15 Semester 2: 14/15 Employ requisite skills and technical proficiencies necessary to acquire licensure in the State of Nevada as a Pharmacy Technician. No N/A Semester 1: 14/15 Semester 2: 14/15 Assess preparedness to successfully complete the national certification examination to become a Certified Pharmacy Technician. No N/A Semester 2: 14/15

2014-2015 ASSESSMENT PLAN Form 2 School: Engelstad School of Health Sciences Academic Program: Pharmacy Technician Program Submitted By: Cheryll Carlock-Arinwine Date Submitted to School Assessment Coordinator (Due November 1): December 8, 2014 A. Learning Outcome B. Course(s) where outcome C. Course(s) where is Introduced or First outcome is reinforced Covered D. Course(s) where Students Achievement of This Outcome is assessed E. Semester in which outcome receives final assessment Acquire and synthesize knowledge of pharmaceutical standards, ethics, laws and regulations PHAR 100B PHAR 100B PHAR 100B PHAR 126B 1 st Semester 2 nd Semester in the program Effectively model the duties and responsibilities of the profession in accordance with defined professional standards and guidelines; as well as, local, state, and federal laws. PHAR 100B, PHAR 101B, PHAR 101L, PHAR 105B, PHAR 110B, PHAR 115B, PHAR 120B, PHAR 126B PHAR 101L PHAR 120B PHAR 126B PHAR 100B PHAR 101L PHAR 126B 1 st Semester 2 nd Semester in the program Employ requisite skills and technical proficiencies necessary to acquire licensure in the State of Nevada as a Pharmacy Technician. PHAR 100B PHAR 105B PHAR 101L PHAR 101L PHAR 126B PHAR 101L PHAR 126B 1 st Semester 2 nd Semester in the program Assess preparedness to successfully complete the national certification examination to become a Certified Pharmacy Technician. PHAR 100B, PHAR 101B, PHAR 101L, PHAR 105B, PHAR 110B, PHAR 115B, PHAR 120B, PHAR 126B PHAR 101L PHAR 126B PHAR 126B 2 nd Semester in the program

Appendix B Pharmacy Technician Program Clinical Competency Rubric Evaluations Inpatient I.V. Room Retail

COLLEGE OF SOUTHERN NEVADA PHARMACY TECHNICIAN COMPETENCY EVALUATION INPATIENT PHARMACY ROTATION STUDENT NAME: TERM: NSHE #: CLINICAL SITE: The supervising pharmacist or designee of a specified training area is requested to observe each trainee and evaluate their ability to handle each of the items listed in this competency evaluation. Each item listed is to be evaluated on a scale of 1 to 5, with 1 being the lowest score and 5 being the highest. At the pharmacist s discretion, the ranking may or may not be discussed with the trainee prior to the score being indicated. A score of less than 3 received in any of the trained upon areas will require the student to spend more time working on those competency areas until the mean score is 3 or better. The pharmacist is requested to sign-off on and date each item of the competency upon successful completion. COMPETENCY RATING PRECEPTOR S INITIALS DATE ATTENDANCE & PUNCTUALITY 1. Consistently reports for shift assignment as scheduled. 2. 3. 4. 5. Provides advanced notification, up to 8 hours, when needing to miss a scheduled shift assignment. Conforms to assigned work schedules, including breaks, meals, and duration of shifts. Consistently arrives promptly for assigned work tasks or duties. Completes assigned work tasks in a timely and efficient manner. PROFESSIONALISM 6. Always adheres to professional dress-code policies. 7. 8. 9. 10. Routinely presents in a fresh, clean, and well-groomed professional image. Arrives for each assigned work task adequately prepared and properly garbed in the appropriate professional attire. Personal grooming, including hygiene, hair, fingernails, fragrance, make-up, and jewelry, are properly maintained or withheld in strict accordance with professional policies. Exhibits professional behavior at all times, in accordance with both written and unwritten guidelines, without specific instruction to do so. 1 Revised 10-5-09

COMPETENCY RATING PRECEPTOR S INITIALS DATE PROFESSIONALISM (cont.) 11. 12. Approaches assigned work tasks with enthusiasm, interest, and a willingness to learn. Demonstrates diligence and commitment to work tasks assigned. CRITICAL THINKING & INITIATIVE 13. 14. 15. 16. 17. Maintains an accurate focus on work task responsibilities and does not become easily distracted. Demonstrates confidence and ability to reason and draw logical inferences or conclusions in decision making. Systematically organizes data, information, and tasks into well-structured, conducive processes to produce efficient work strategies. Demonstrates a willingness and ability to complete tasks beyond the scope of the assigned requirement. Demonstrates an interest in learning or assuming additional work tasks or responsibilities beyond those initially assigned. SUPERVISION & QUALITY OF WORK 18. 19. 20. 21. 22. 23. Accepts feedback or instruction openly and consistently strives to incorporate it into work tasks or processes. Requires minimal supervision in the performance of assigned work tasks. Completes assigned tasks with a high degree of consistency, neatness, and accuracy. Exhibits high standards in work quality and quantity of output. Achieves expected results in an efficient, effective, and timely manner. Produces acceptable product output with dependable results 24. Neatly organizes and structures work tasks. INTERPERSONAL RELATIONS 25. 26. Always interacts appropriately with staff of various levels and backgrounds within the organization. Works effectively with others to achieve desired performance outcomes. 27. Demonstrates positive relationships with others. 2 Revised 10-5-09

COMPETENCY RATING PRECEPTOR S INITIALS DATE LEGAL AND ETHICAL RESPONSIBILITIES 28. 29. 30. 31. 32. 33. 34. Knows, understands, and abides by all applicable laws, regulations, and standards of practice governing the duties and responsibilities of the pharmacy technician. Knows, understands, and follows all appropriate departmental security measures. Knows, understands, and follows all pertinent policies and procedures utilized for the distribution of medications. Deals appropriately with confidential information and maintains discretion in work tasks or procedures in accordance with facility policies and/or standards. Demonstrates integrity, high ethical character, and respect for confidentiality at all times. Routinely adheres to all ethical and professional standards of the profession. Follows appropriate guidelines for addressing ethical or professional concerns. COMMUNICATION SKILLS 35. 36. 37. 38. 39. 40. 41. Demonstrates professionalism in all work or taskrelated communications. Demonstrates an ability to effectively listen and adequately receive instruction. Actively listens to receive information, feedback, or instruction from others and responds appropriately. Demonstrates ability to convey pertinent details or information in a well-articulated, clear, and concise manner. Demonstrates proper communication etiquette and professionalism when receiving, initiating, or forwarding telephone calls or paging. Knows what questions or requests may be handled by a technician and when the query must be referred to the pharmacist. Communicates written information clearly, concisely, without errors, and in a well-structured manner. ORDER PROCESSING 42. 43. Possesses clear knowledge and understanding of responsibilities and tasks to be performed. Performs accurate mathematical calculations using Metric, Household, or Apothecary systems. 3 Revised 10-5-09

COMPETENCY RATING PRECEPTOR S INITIALS DATE ORDER PROCESSING (cont.) 44. 45. 46. 47. 48. 49. Effectively reads and understands commonly used medical terminology and abbreviations. Knows most commonly used generic and brand name medications. Associates drug formulations with the appropriate route of administration. Demonstrates proficiency in utilizing computerized pharmacy database systems. Demonstrates ability to locate specific information from a medical record or profile. Understands proper storage conditions for particular pharmaceutical items. MEDICATION FILLING & DISPENSING 50. Routinely monitors pharmacy printers to ensure new medication orders are processed in a timely manner. 51. Maintains a neat, orderly, well-organized work area. 52. 53. 54. 55. Accurately interpret medication labels and retrieves from stock the appropriate medication strength, dosage form, and quantity. Accurately prepares medications requiring reconstitution. Appropriately packages and labels all medication preparations. Properly initials and places filled preparations into appropriate receptacles for pharmacist verification. 56. Accurately delivers medications to designated areas. 57. 58. 59. Accurately replenishes floor stock and automation systems items. Fills and restocks crash carts and maintains necessary documentation involved in crash cart exchange. Demonstrates knowledge of extemporaneous compounding procedures and record keeping. CART-EXCHANGE 60. 61. Knows how to operate pharmacy software system to generate pharmacy cart fill list reports. Adequately labels individual patient medication drawers with appropriate patient location information. 4 Revised 10-5-09

COMPETENCY RATING PRECEPTOR S INITIALS DATE CART-EXCHANGE (cont.) 62. 63. 64. 65. 66. 67. Properly places the correct medication and quantity into the correct patient's individual medication drawer. Properly delivers and exchanges medication cart cassettes to appropriate floors and nursing unit locations. Assures that all medication cart cassettes have been exchanged. Appropriately processes credits for all required individual patient medication drawers. Appropriately restocks unit dose medications returned to the pharmacy unused from cart-fill on floors. Adequately maintains any necessary documentation involved in cart fill exchange. BULK REPACKING 68. 69. 70. 71. 72. 73. 74. 75. 76. Follows established policies and procedures for repackaging and documenting medications repackaged from bulk containers. Makes all of the calculations necessary in order to repackage medications into different units of measure. Appropriately determines the expiration date for the repackaged formulations. Appropriately enters all pertinent information necessary for the repackaging labels. Follows standardized formulas and procedures in weighing, counting, measuring, pouring, or mixing bulk quantities for repackaging. Properly loads and operates bulk repackaging equipment to ensure safety and product integrity. Properly repackages and labels liquids, capsules, tablets, and other drug formulations from bulk containers into specified quantities and various size containers. Properly records all repackaging operation data, such as drug name, strength, lot #, control #, etc. onto the repackaging control log. Ensures repackaged formulations are verified by a pharmacist and that signatures are properly recorded onto the repackaging control log. INVENTORY MANAGEMENT 77. Demonstrates knowledge of drug inventory management and drug ordering systems. 5 Revised 10-5-09

COMPETENCY RATING PRECEPTOR S INITIALS DATE INVENTORY MANAGEMENT (cont.) 78. 79. 80. 81. 82. Returns medications and/or equipment to their appropriate storage place(s) when not in use. Demonstrate an understanding of how controlled substance products are ordered and handled. Demonstrates ability to perform Quality Assurance functions, such as out-of-date product checking and maintenance of refrigeration temperature control records. Consistently and accurately restocks medication bins as needed. Consistently rotates pharmacy stock to ensure older drug products or equipment are used first. The student appears to show the most strength in the following areas: Student could likely benefit from the following additional suggestions for improvement: Additional Comments: To the best of my knowledge, the above named student has demonstrated measureable competency, knowledge, and experience in all of the above areas of training, so indicated by the rating assigned, as it relates to the practice of pharmacy. Pharmacist s Signature: Print Name: Date: 6 Revised 10-5-09

COLLEGE OF SOUTHERN NEVADA PHARMACY TECHNICIAN COMPETENCY EVALUATION I.V. ROOM ROTATION STUDENT NAME: TERM: NSHE #: CLINICAL SITE: The supervising pharmacist or designee of a specified training area is requested to observe each trainee and evaluate their ability to handle each of the items listed in this competency evaluation. Each item listed is to be evaluated on a scale of 1 to 5, with 1 being the lowest score and 5 being the highest. At the pharmacist s discretion, the ranking may or may not be discussed with the trainee prior to the score being indicated. A score of less than 3 received in any of the trained upon areas will require the student to spend more time working on those competency areas until the mean score is 3 or better. The pharmacist is requested to sign-off on and date each item of the competency upon successful completion. COMPETENCY RATING PRECEPTOR S INITIALS DATE APPEARANCE 1. 2. 3. 4. Arrives for each work task adequately prepared and properly garbed in the appropriate professional attire. Personal grooming, including hygience, hair, fingernails, fragrance, make-up, and jewelry, are properly maintained or withheld in strict accordance with professional policies. Properly dons all appropriate clearroom attire, including cap, mask, shoe covers, gloves, and gown. Properly scrubs nails, hands, and arms to mid-forearm with approved disinfecting agent for at least 30 seconds. ATTITUDE 5. 6. 7. Exhibits professional behavior at all times, in accordance with both written and unwritten guidelines, without specific instruction to do so. Approaches assigned work tasks with enthusiasm, interest, and a willingness to learn. Demonstrates diligence and commitment to work tasks assigned. CRITICAL THINKING & INITIATIVE 8. 9. Maintains an accurate focus on work task responsibilities and does not become easily distracted. Systematically organizes materials, equipment, and tasks into well-structured, conducive, workflow processes to increase productivity and efficiency while ensuring patient safety. 1 Revised 10-15-09

COMPETENCY RATING PRECEPTOR S INITIALS DATE CRITICAL THINKING & INITIATIVE (cont.) 10. Demonstrates an interest in learning or assuming additional work tasks or responsibilities beyond those initially assigned. SUPERVISION & QUALITY OF WORK 11. 12. 13. Accepts feedback or instruction openly and consistently strives to incorporates it into work tasks or processes. Requires minimal hands-on, direct supervision in the completion of assigned work tasks. Completes assigned tasks with a high degree of consistency and accuracy. 14. Exhibits high standards in the quality of work output. 15. 16. Achieves expected results in an efficient, effective, and timely manner. Consistently produces acceptable product output with dependable results ORDER PROCESSING 17. 18. 19. 20. 21. 22. 23. 24. Possesses clear knowledge and understanding of responsibilities and tasks to be performed. Performs accurate mathematical calculations for all ingredient amounts and/or dosages using Metric, Household, or Apothecary systems. Knows most commonly used generic and brand name medications. Demonstrates proper quality assurance techniques, including proper cleaning of horizontal/vertical airflow hoods and proper disposal of wastes. Demonstrates a working knowledge of commonly used, commercially available, solution systems and related products; such as, Mini-Bag Plus, frozen premix solutions, and pre-filled syringes. Appropriately gathers and assembles all materials and equipment necessary before compounding. Properly arranges all items more than 6 inches inside the laminar airflow hood and 3 inches from each side of the hood so as not to disrupt airflow Demonstrates proper aseptic technique in the preparation of all intravenous admixtures, including proper manipulation of syringes so as to not touch the tip or plunger. 2 Revised 10-15-09

25. 26. 27. 28. 29. 30. 31. 32. Routinely follows all mandated safety protocols in the preparation of all medications products. Demonstrates and understand the proper use of a Biological Safety Cabinet for handling chemotherapeutic agents. Understands chemotherapy principles; to include precautions, proper handling, and storage. Routinely maintains a neat and orderly work surface and work environment area, including removal of all non-essential items from the immediate work area. Routinely cleanses and sanitizes the aseptic work surface area between compounded preparations. Visually inspects all intravenous solution containers for signs of cloudiness, particulate matter, punctures or any other indications of defect. Appropriately labels all medications in accordance with departmental policies, including affixing required auxiliary labels. Properly initials all preparation labels and places the items into the appropriate receptacles for pharmacist verification. INVENTORY MANAGEMENT 33. 34. 35. 36. 37. 38. Understands proper storage conditions for particular pharmaceutical items. Returns medications and/or equipment to their appropriate storage place(s) when not in use. Consistently and accurately restocks medication and equipment bins as necessary. Consistently dates and evaluates product expiration dates at the time of use to ensure expired drug products are not introduced into the compounded preparation. Regularly rotates inventory stock to ensure older drug products or equipment are used first. Monitors and records temperatures of refrigerators to ensure conformance with drug storage requirements. The student appears to show the most strength in the following areas: 3 Revised 10-15-09

Student could likely benefit from the following additional suggestions for improvement: Additional Comments: To the best of my knowledge, the above named student has demonstrated measureable competency, knowledge, and experience in all of the above areas of training, so indicated by the rating assigned, as it relates to the practice of pharmacy. Pharmacist s Signature: Print Name: Date 4 Revised 10-15-09

COLLEGE OF SOUTHERN NEVADA PHARMACY TECHNICIAN COMPETENCY EVALUATION (RETAIL/OUT-PATIENT ROTATION) STUDENT NAME: TERM: NSHE #: CLINICAL SITE: The supervising pharmacist or designee of a specified training area is requested to observe each trainee and evaluate their ability to handle each of the items listed in this competency evaluation. Each item listed is to be evaluated on a scale of 1 to 5, with 1 being the lowest score and 5 being the highest. At the pharmacist s discretion, the ranking may or may not be discussed with the trainee prior to the score being indicated. A score of less than 3 received in any of the trained upon areas will require the student to spend more time working on those competency areas until the mean score is 3 or better. The pharmacist is requested to sign-off on and date each item of the competency upon successful completion. COMPETENCY RATING PRECEPTOR S INITIALS DATE ATTENDANCE & PUNCTUALITY 1. Consistently reports for shift assignment as scheduled. 2. 3. 4. Provides advanced notification, up to 8 hours, when needing to miss a scheduled shift assignment. Conforms to assigned work schedules, including breaks, meals, and duration of shifts. Completes assigned work tasks in a timely and efficient manner. PROFESSIONALISM 5. Always adheres to professional dress-code policies. 6. 7. 8. 9. 10. Routinely presents in a fresh, clean, and well-groomed professional image. Presents for each assigned work task adequately prepared. Exhibits professional behavior at all times, in accordance with both written and unwritten guidelines, without specific instruction to do so. Approaches assigned work tasks with enthusiasm, interest, and a willingness to learn. Demonstrates diligence and commitment to work tasks assigned. 1 Revised 10-13-09

COMPETENCY RATING PRECEPTOR S INITIALS DATE CRITICAL THINKING & INITIATIVE 11. 12. 13. 14. 15. Maintains an accurate focus on work task responsibilities and does not become easily distracted. Demonstrates confidence and ability to reason and draw logical inferences or conclusions in decision making. Systematically organizes data, information, and tasks into well-structured, conducive processes to produce efficient work strategies. Demonstrates a willingness and ability to complete tasks beyond the scope of the assigned requirement. Demonstrates an interest in learning or assuming additional work tasks or responsibilities beyond those initially assigned. SUPERVISION & QUALITY OF WORK 16. 17. 18. 19. 20. Accepts feedback or instruction openly and consistently strives to incorporate it into work tasks or processes. Requires minimal supervision in the performance of assigned work tasks. Completes assigned tasks with a high degree of consistency, neatness, and accuracy. Exhibits high standards in work quality and quantity of output. Achieves expected results in an efficient, effective, and timely manner. 21. Neatly organizes and structures work tasks. INTERPERSONAL RELATIONS 22. 23. Always interacts appropriately with staff of various levels and backgrounds within the organization. Works effectively with others to achieve desired performance outcomes. 24. Demonstrates positive relationships with others. LEGAL AND ETHICAL RESPONSIBILITIES 25. 26. Knows, understands, and abides by all applicable laws, regulations, and standards of practice governing the duties and responsibilities of the pharmacy technician. Knows, understands, and follows all appropriate departmental security measures. 2 Revised 10-13-09

COMPETENCY RATING PRECEPTOR S INITIALS DATE LEGAL AND ETHICAL RESPONSIBILITIES (cont.) 27. 28. 29. 30. 31. Knows, understands, and follows all pertinent policies and procedures utilized for medication dispensing. Deals appropriately with confidential information and maintains discretion in work tasks or procedures in accordance with facility policies and/or standards. Demonstrates integrity, high ethical character, and respect for confidentiality at all times. Routinely adheres to all ethical and professional standards of the profession. Follows appropriate guidelines for addressing ethical or professional concerns. COMMUNICATION SKILLS 32. 33. 34. 35. 36. 37. 38. Demonstrates professionalism in all work or taskrelated communications. Demonstrates an ability to effectively listen and adequately receive instruction. Actively listens to receive information, feedback, or instruction from others and responds appropriately. Demonstrates ability to convey pertinent details or information in a well-articulated, clear, and concise manner. Demonstrates proper communication etiquette and professionalism when receiving, initiating, or forwarding telephone calls or paging. Knows what questions or requests may be handled by a technician and when the query must be referred to the pharmacist. Communicates written information clearly, concisely, without errors, and in a well-structured manner. CUSTOMER RELATIONS 39. 40. 41. Greets each customer with a smile and professionalism for every interaction. Attends to customers promptly and in a confident manner. Listens to and responds promptly and willingly to customer inquiries, needs, and concerns. 42. Assists customers in locating over-the-counter items. 3 Revised 10-13-09

COMPETENCY RATING PRECEPTOR S INITIALS DATE CUSTOMER RELATIONS (cont.) 43. 44. 45. Appropriately queries customer for pertinent demographic information, including customer s full name w/correct spelling, date of birth, age, telephone number, address, insurance information, allergies, medical conditions, etc. Routinely makes offers to patients for pharmacist counseling. Verifies prescription medication(s), equipment, or item(s) are in stock prior to customer departure from drop-off window. PRESCRIPTION PROCESSING 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. Possesses clear knowledge and understanding of responsibilities and tasks to be performed. Effectively reads and understands most commonly used medical terminology and abbreviations. Knows most commonly used generic and brand name medications. Associates drug formulations with the appropriate route of administration. Correctly reads, interprets, and transcribes prescription orders, to include both electronic and handwritten forms. Routinely performs accurate mathematical calculations of prescription quantities, amounts, dosages, and days supply. Demonstrates proficiency in utilizing computerized pharmacy database systems. Demonstrates ability to locate specific information from a medical record or profile. Routinely screens prescriptions for accuracy, validity, and completeness of information. Correctly enters complete and accurate customer or prescription information into the pharmacy management system. Demonstrates the ability to accurately process claims for third-party prescriptions via online adjudication. Routinely prioritizes printed prescription labels according to the respective pick-up time indicated. Routinely selects the correct medication, including manufacturer, strength, and dosage form from inventory when filling a prescription. 1 2 3 4 5 N/A 4 Revised 10-13-09

COMPETENCY RATING PRECEPTOR S INITIALS DATE PRESCRIPTION FILLING 59. 60. Selects the appropriate dispensing containers for medication or prescription item(s) being filled. Accurately counts, measures, pours, or mixes the appropriate amount of medication required to fill the prescription or refill order. 61. Correctly prepares medications requiring reconstitution. 62. 63. 64. Correctly affixes prescription labels and auxiliary labels to the prescription container Reviews filled prescriptions accuracy and properly initials before passing to pharmacists for review. Appropriately organizes filled preparations and related documentation into designated area(s) for pharmacist verification. MEDICATION DISPENSING 65. 66. 67. 68. Correctly places completed prescriptions in the designated pickup area. Routinely verifies that each customer receives the correct prescription(s). Routinely has customer sign signature pick-up log for every prescription pick-up transaction. Properly files completed prescription order documents into the respective designated filing area(s). INVENTORY MANAGEMENT 69. 70. 71. 72. 73. Demonstrates knowledge of drug inventory management and drug ordering systems. Understands proper storage conditions for particular pharmaceutical items. Returns medications and/or equipment to their appropriate storage place(s) when not in use. Correctly restocks received medication inventory, equipment, and supplies. Consistently rotates pharmacy stock to ensure older drug products or equipment are used first. 5 Revised 10-13-09

The student appears to show the most strength in the following areas: Student could likely benefit from the following additional suggestions for improvement: Additional Comments: To the best of my knowledge, the above named student has demonstrated measureable competency, knowledge, and experience in all of the above areas of training, so indicated by the rating assigned, as it relates to the practice of pharmacy. Pharmacist s Signature: Print Name: Date: 6 Revised 10-13-09