General Medicine – Objectives

I am excited to be heading back to Surrey Memorial Hospital for my general medicine rotation! 🙂 My rotation-specific objectives are:

  1. Develop and strengthen my systematic approach to assess and work up patients
    – demonstrate the ability to obtain a complete medication history (e.g. with patient interviews, P’net, community pharmacy, GP, charts)
    – identify and prioritize medical problems and drug therapy problems
    – compare pros and cons for at least 3 therapeutic alternatives, if available
    – demonstrate the ability to justify and defend my therapeutic recommendations
    – actively monitor my patients
  2. Develop my ability to clearly and concisely document my soap notes and important patient interactions
  3. Develop my ability to effectively perform therapeutic drug monitoring on medications such as vancomycin, aminoglycosides, digoxin and anticoagulation
  4. Develop my ability to practice antimicrobial stewardship (e.g. assessing when therapy can be narrowed, for IV to PO stepdown)

Another goal is to find a potential case for my BC case-wide presentation.

 

 

Objectives: Ambulatory AF/HF Clinic

My first clinical rotation will be at an ambulatory atrial fibrillation and heart function clinic in VGH. This will be my first time working in ambulatory care, but I am excited to develop my cardiology knowledge and clinical skills in an out-patient setting.

My rotation-specific objectives are:

  1. Use a systematic approach to assess and work up patients (i.e. gather information, interview patients, identify DTPs, therapeutic alternatives, recommendations, plan and monitoring) in a time frame that is reasonable for an ambulatory setting.
  2. List the study populations, medication regimens and outcomes achieved in the landmark trials for heart failure and atrial fibrillation, as well as, use them in my practice.
  3. Effectively teach about atrial fibrillation and heart failure, and tailor the information presented according to the needs of the audience.
  4. Perform basic physical assessment assessments that will help with pharmacotherapeutic decision making and monitoring
  5. Be able to describe how pharmacists can ensure seamless continuity of care and prevent gaps in care after patients are discharged from the hospital

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Objectives: Clinical Orientation

I can’t believe that I will be starting my clinical orientation at Surrey Memorial Hospital this coming Monday! Although I am incredibly nervous, I am also excited to be moving from unconscious incompetence to conscious incompetence.

  1. Use the head-to-toe approach to assess my patients and if time provided, present at least 5 full patient work-ups to my preceptor (i.e. not just reading out the information I have gathered)
  2. Conduct at least 1-2 patient interviews in an organized and comprehensive manner
    – Have a list of interview questions ready prior to visiting the patient
    – Prioritize my interview questions in case time with the patient is limited
    – Make sure to also inquire about adherence, community pharmacy, family support, OTCs/herbals/supplements
  3. Discuss with my  preceptor and write at least 1 clinical pharmacy note. Observe how my preceptor writes his clinical pharmacy notes and collaborates with other health care professionals and implement them into my practice.
  4. Give 1 presentation. Practice my presentation at least 3 times while paying attention to my body language, tone and flow of presentation.
  5. Take opportunities to ensure continuity of care (e.g. with discharge counselling, communicating with the community pharmacy)

How to achieve:

  • Take the initiative to ask my preceptor for any feedback at the end of each day
  • Reflect on my progress and check in with my preceptor on what he feels I should work on and whether or not  at the end of each week
    – Reflect on my patient work up and if I am missing things, reflect on why and how I can ensure I don’t miss them during my next work-up
  • Use GoogleKeep to record a list of things I should work on. Prioritize the items and complete them either end of day, end of week or end of rotation based on urgency and importance to my ability to provide patient care
  • Ask my preceptor if a mock oral assessment would be possible at the end of my orientation
  • Make one(or two..or three)-pagers of medical conditions