Madison Clinic
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Student Rotation Goals and Objectives

HMC New Student Orientation

For new Students entering a rotation. Please click link below and follow instructions.

http://depts.washington.edu/odtreg/wordpress/welcome/training

Preceptor Pager Email
Bradley Kosel, PharmD 982-5195 bkosel@u.washington.edu
Bob Loeffelbein, PharmD 994-6863 bloeffel@u.washington.edu
Ji Lee, PharmD 540-4268 jilee2@u.washington.edu

Introduction

The Madison Clinic at Harborview is an HIV/AIDS multidisciplinary clinic. There are approximately 1100 active patients who seek services at the clinic. There are 45 providers affiliated with the Madison Clinic who see 50 to 80 patients a day. The primary goal of the clinic is to provide a full range of care to its clients.

The face of AIDS has changed with the advent of Highly Active Antiretroviral Therapy or HAART. The goal at the Madison Clinic is to ensure that every person starting on HAART has a better than average chance of succeeding on therapy. The pharmacy, along with nutrition, social work and the medical provider, are all involved in this protocol. You, as a student or resident on this rotation, will be involved in the many aspects of the HAART protocol.

Learning Goal

By the end of the first week, you should present the preceptor with your goal statement. This should summarize in one or two sentences what you wish to learn during the rotation. We can then sit down and develop a list of learning activities that will help you to accomplish your goal. Furthermore, there are certain goals and objectives specifically related to the care of HIV/AIDS patients, which we will expect you to fulfill during the rotation

Goals and Objectives

  1. Demonstrate your knowledge of antiretroviral therapy by describing: usual doses; dose modifications, side effects; drug monitoring parameters; drug interactions and mechanisms of action of nucleoside reverse transcriptase inhibitors (NRTI’s); non-nucleoside reverse transcriptase inhibitors (NNRTI’s) and protease inhibitors (PI’s). This information will be assessed by a written post-test or through verbal communication.
  2. Demonstrate your knowledge of the prophylaxis, treatment and maintenance therapies available for opportunistic infections. This information will be assessed by a written post-test or through verbal communication.
  3. Perform patient teaching and patient counseling in the distributive setting as well as in the more formal HAART protocol format.
  4. Become familiar with the current strategies that are being utilized to develop HIV vaccines. Also, know the current recommendations for immunizations of the HIV infected individual.
  5. Understand and describe the importance of adherence to HAART, barriers to adherence, tools used to improve adherence and the association of non-adherence to drug-resistant HIV. This information will be assessed by active participation in the HAART protocol
  6. Identify and utilize the various information databases used in responding to drug information questions in the HIV/AIDS practice setting.

Specific Learning Activities

  1. Understand and participate in the HAART protocol by interacting and educating patients in all phases of the protocol, including pre-HAART, new HAART starts, and On-HAART interventions. By the end of the rotation, you should have completed at least one pre-HAART, one new HAART start, and one on-HAART patient visit.
  2. Follow inpatients from the Madison Clinic and perform patient work-ups to assess and discuss drug-related problems, selection of therapeutic regimens, and initiation of monitoring plans. You should follow inpatients on a daily basis as determined by the preceptor.
  3. Understand and participate in distribution activities to appreciate the importance of problem solving and patient counseling in this environment. Your preceptor will determine the time that you spend in the distribution role.
  4. Initiate a compliance or adherence education appointment with a patient who may benefit from this intervention to improve adherence. Identify at least one patient by the end of the rotation.
  5. Prepare a 15 to 20 minute case presentation to be delivered to your peers and preceptors once a week. This presentation will be in a verbal format with a written outline of pertinent patient information.
  6. Prepare at least one patient information sheet for a commonly prescribed medication. The information must be written in simple language that patients can understand.
  7. Participate in ongoing clinical projects that expand your knowledge base of HIV management. Please discuss any special interests during your first week of the rotation with your preceptor. We will attempt to tailor such projects to satisfy your interests.
  8. Prepare to discuss weekly topics with your preceptor as outlined on your rotation calendar. The articles will either be given to you, or your preceptor may instruct you to conduct a literature search to identify 1 or 2 current articles on the weekly topic.

Optional Activities

  1. Present an article to the pharmacists in journal club format.
  2. Observe a patient examination given by one of the medical providers.
  3. Design and implement a Drug Use Evaluation form.
  4. Deliver an in-service talk to nurses, pharmacists, social work or medical providers

Student / Resident Responsibilities / Requirements

  • Familiarize yourself with and adhere to the University of Washington student guidelines for professional conduct. Patient confidentiality is of paramount importance in this practice setting.
  • Arrive at the Madison Clinic pharmacy by 8:30 AM each morning, unless otherwise arranged with the preceptor well in advance.
  • It is important to attend all educational sessions at the Madison Clinic; this includes monthly clinical conferences, bi-monthly journal club meetings, afternoon educational sessions and any other opportunities that may be available. Date and times of confirmed educational sessions, which you are required to attend, are marked on your rotation calendar.
  • Read and evaluate all required readings and be prepared to discuss the weekly topic(s) with your preceptor.

Preceptor Schedule

  1. The Madison Clinic pharmacists rotate through different job responsibilities on a weekly basis.
  2. The preceptor of the week will be the pharmacist in the clinical role. The name of the person will be listed on your rotation schedule.
  3. You will be assigned to a Primary preceptor on your first week. This person will be responsible for completing your rotation evaluation (online when possible). You are responsible for providing the appropriate evaluation forms in a timely manner to the Primary preceptor. Any problems or issues should be discussed with the Primary preceptor. The Primary preceptor will help coordinate your rotation here at the Madison Clinic.

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