Professional Documents
Culture Documents
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At the lowest level of interaction, the students take time to access and sense the available
information. Once students access the online materials, there must be learner- content interaction
to process the information. Learners navigate through the content to access the components of
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Key Element 4.1: Self-awareness the graduate is able to examine and reflect on personal
knowledge, skills, abilities, beliefs, biases, motivation, and emotions that could enhance or
To provide evidence of achievement of the standards and key elements, colleges and schools
must provide outcomes data and documentation. Development and implementation of these
online learning modules for use during an ambulatory care APPE, would allow the college to
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Significant
Contributors
VN, CW, GF, ED,
ambulatory care
faculty
VN
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Significant
Contributors
VN, GF, and APPE
ambulatory care
faculty
VN = Veronica Nieto, Pharm.D.1; CW = Courtney West, Ph.D.2; RB = Regina Bentley, RN, EdD, CNE3; CD =
Charles Douglas, PhD.4, GF= Gary Frech, MBA, MS, RPh5; ED = Elaine Demps, Ph.D6; Ambulatory Care Faculty7
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6.
7.
DepartmentofVeteransAffairs,SamRayburnMedicalCenter,Bonham,TX
DepartmentofInternalMedicine,TexasA&MUniversityCollegeofMedicine,Bryan,TX
DepartmentofAcademicAffairs,TexasA&MUniversityCollegeofMedicine,Bryan,TX
DepartmentofPharmaceuticalSciences,TexasA&MRangelCollegeofPharmacy,Kingsville,TX
OfficeofExperientialEducation,TexasA&MRangelCollegeofPharmacy,Kingsville,TX
OfficeofInstructionalDesignandSupportServices,TexasA&MRangelCollegeofPharmacy,Kingsville,TX
DepartmentofPharmacyPractice,TexasA&MRangelCollegeofPharmacy;AmbulatoryCareFacultyare
presentlylocatedinCollegeStation,CorpusChristi,Houston,RoundRock,andTemple,Texas
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Apply therapeutic management strategies, national clinical guidelines and clinical trial data to
make clinical decisions in simple and complex patients
Develop treatment plans for core primary care disease states given case-based scenarios
1) Identify risk factors and signs and symptoms of deep vein thrombosis (DVT) and
pulmonary embolism (PE)
2) Calculate the CHA2DS2-VASc score to determine the risk of a thromboembolic event in
a non-anticoagulated patient with non-valvular atrial fibrillation
3) Review the clotting cascade and identify targets of anticoagulation therapies along the
intrinsic and extrinsic pathways
4) Identify risk factors for bleeding complications and strategies for minimizing the risk of
bleeding with oral anticoagulant agents
a. HEMORR2HAGES, ATRIA, HAS-BLED scoring systems
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Calculate the bleeding risk using the HAS-BLED scoring system for a patient with atrial
fibrillation on warfarin
Calculate a CHA2DS2-VASc score to determine if a patient with atrial fibrillation
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management
a. Metered dose inhalers (MDI) with or without a valved-holding chamber (VHC)
b. Dry-power inhalers (DPI)
c. Soft mist inhalers
d. Nebulized solutions
List a stepwise approach for managing asthma in an adult patient
Counsel a patient on the appropriate management of exercise induced asthma
Review recommended vaccination requirements for adult patients with asthma/COPD
Design a therapeutic plan for the management of a patient with COPD in the ambulatory
care setting
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therapy
Develop an asthma action plan providing spirometric parameters and medication
prescribed
Provide recommendation for vaccinations for an adult patient with asthma
Provide recommendation for initiation of corticosteroids and/or antibiotics for a
patient with a COPD exacerbation
Module 3: Diabetes
Objectives:
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5)
Outline the pathogenesis of Type 2 Diabetes and targets for drug therapy
Compare and contrast current diabetes treatment guidelines
List screening and diagnostic criteria for diabetes
Differentiate between signs and symptoms of hypo- and hyper-glycemia
Identify appropriate screening criteria (including timelines) for microvascular and
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complications
Classify oral hypoglycemic medications according to their adverse effects
Classify insulin products according to their onset, peak, and duration of action
Upon review of a patient case
Identify appropriate goals of therapy for a 50-y/o T2DM patient without
complications
Identify appropriate goals of therapy for a 75-y/o T2DM with multiple major
hypoglycemia
Develop a plan for initiating insulin therapy for a patient with symptomatic
Module 4: Hypertension
Objectives:
Outline a diagram of the RAAS system and identify sites of pharmacologic action of
available therapies
Match goals of therapy for patients with hypertension based on underlying comorbidities
and age
Blood pressure assessment simulation: obtain blood pressure reading using
or hypertensive emergency
Establish a step wise plan for a patient to self-monitor blood pressure
Upon review of a patient case:
Counsel a patient on lifestyle modifications to assist with blood pressure control
Recommend an appropriate antihypertensive regimen based on patient specific
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1) List the major lipoproteins and described their role in lipoprotein metabolism and the
development of atherosclerosis
2) Identify the statin-benefit groups and intensity of statin therapy according to the
American College of Cardiology (ACC)/American Heart Association (AHA)
3) Review current guidelines for the management of hyperlipidemia
4) Identify the key components of the atherosclerotic cardiovascular disease (ASCVD) risk
calculation and potential limitations to this risk assessment tool
5) Determine a patients atherosclerotic cardiovascular disease risk and corresponding
treatment goals according to the National Lipid Association (NLA)
6) Recommend appropriate therapeutic lifestyle changes (TLC) and pharmacotherapy
interventions for patients with hyperlipidemia
7) Design a monitoring plan to assess effectiveness and adverse effects of pharmacotherapy
for hyperlipidemia
Content outline:
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triglycerides
Develop a therapeutic plan for the management of hyperlipidemia in a patient
lowering therapies
Provide education on therapeutic lifestyle changes
The next steps involve selection of content material from current pharmacy resources,
disease state review articles, organizational guidelines, and standards of care. Patient cases, selfassessments, and pre- and post-module assessments also need to be developed to address
modular learning objectives. The selected learning materials can then be placed into a blueprint
for use as a reference to develop the course. Five interactive self-paced learning modules will be
created for the five aforementioned disease states. Ambulatory care faculty and invited
ambulatory care preceptors will review the blueprints. Their primary role will be to determine if
both modular and disease state objectives are met and to provide feedback with regard to
corrections, revisions, or clarifications necessary.
Once created, the online modules will be piloted to students nearing completion of the
PharmD program to review and assess the learning tool. Initial assessment will look at the
feasibility, accessibility, ease of use, and students perception of improved understanding of
pharmaceutical care in the ambulatory care setting. The resultant pilot data will provide
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