Learning Outcomes and Entrustable Professional Activities
Learning Outcomes
Learning happens both through the curriculum and through engagement in required co-curricular activities. The faculty of the College has established a set of learning outcomes that are desired for all students by the time they complete the PharmD program. These are divided into three “domains”:
Foundational Knowledge
Professional Skills
Personal and Professional Attitudes
Each of these three domains contains subdomains, along with specific learning objectives associated with each subdomain. They are:
Domain 1: Foundational Knowledge
1.1. Scientific Thinking (Learner): Seek, analyze, integrate, and apply foundational knowledge of medications and pharmacy practice (biomedical, pharmaceutical, social, behavioral, administrative, clinical sciences, drug classes, and digital health).
Learning Objectives
Develop and demonstrate depth and breadth of knowledge in biomedical, pharmaceutical, social/behavioral/administrative, clinical sciences, and healthcare technology (e.g., informatics, digital health).
Articulate how knowledge in foundational sciences is integral to clinical reasoning; evaluation of future advances in medicine; supporting health and wellness initiatives; and delivery of contemporary pharmacy services.
Integrate knowledge from multiple foundational sciences to explain how specific drugs or drug classes work, compare differences among therapeutic regimens, and evaluate their potential value in individuals and populations.
Apply knowledge in foundational sciences to solve therapeutic problems, to advance patient-centered care and population- based care.
Apply critical thinking skills to evaluate information (e.g., scientific literature, emerging theories, technologies) and determine if factual, reliable, accurate, fair, objective, and/or appropriate by systematically examining the problem, evidence and solution.
Critically analyze scientific literature related to drugs and diseases to enhance clinical decision making.
Domain 2: Professional Skills
2.1. Problem-solving process (Problem Solver): Use problem solving and critical thinking skills, along with an innovative mindset, to address challenges and to promote positive change.
Learning Objectives
Identify and define the primary problem.
Define and prioritize goals along with contextual constraints.
Use an innovative mindset to consider and develop alternative ideas and approaches to address challenges and/or advance the profession.
Explore multiple solutions by organizing, prioritizing, and defending each possible solution with evidence and/or rationale.
Assess the anticipated and actualized resources implications of decisions (e.g., human, financial, and physical resources).
Anticipate positive and negative outcomes by considering assumptions, biases, barriers, inconsistencies, and unintended consequences.
Develop a strategy to implement the most viable solution, including outcome measures.
Reflect on the solution implemented and its effects to improve future outcomes.
2.2. Communication (Communicator): Actively engage, listen, and communicate verbally, nonverbally, and in writing when interacting with or educating an individual, group, or organization.
Learning Objectives
Assess baseline knowledge or skills of individuals or groups to identify needs.
Identify and address barriers, including beliefs and biases that could impact communication and outcomes (e.g., stereotypes, assumptions, time constraints, privacy considerations, space availability, internet disruptions, etc.).
Ensure information is current, relevant, and tailored for the individual or group with whom you are communicating.
Use an organized structure when educating an individual or group.
Use specific communication strategies (e.g., motivational interviewing, conflict resolution, writing progress notes, assessing understanding) to achieve goals.
Actively listen and ask appropriate open- and closed-ended questions to gather information.
Evaluate verbal feedback and nonverbal cues to assess how well communication was received and verify if it was interpreted the way intended.
Communicate assertively, confidently, clearly and with empathy to establish rapport, build trusting relationships, and navigate difficult conversations.
Employ clear, concise, and accurate written communication strategies to achieve intended outcomes.
Provide goal-directed feedback to others (e.g., direct reports, trainees, colleagues).
Use technology (e.g., telehealth, digital health applications), media and other resources (e.g., interpreter services) to facilitate and support communication as appropriate.
2.3. Cultural and structural humility (Ally) – Mitigate health disparities by considering, recognizing, and navigating cultural and structural factors (e.g., social determinants of health, diversity, equity, inclusion, and accessibility) to improve access and health outcomes.
Learning Objectives
Engage in self-reflection with the intention to understand how one’s personal identities, biases, and experiences may influence one’s perspectives, interactions, and decision making.
Demonstrate knowledge about assumptions such as explicit and implicit bias when interacting with others.
Identify the practices and values of cultural humility that foster belongingness with a diverse group of individuals.
Recognize ways to reduce biases and stereotypes and stereotyping.
Discuss strategies for navigating situations where injustices related to diversity, equity, inclusion, and accessibility, stigma, bias, and racism are present.
2.4. Person-centered care (Provider): Provide whole person care to individuals as the medication specialist using the Pharmacists’ Patient Care Process.
Learning Objectives
Collect subjective and objective Information related to the patient in order to identify a patient’s medication-related problems.
Assess, interpret, and prioritize information and patient data to determine the effects of therapy.
Formulate evidence-based and cost-effective care goals, plans, assessments, and recommendations.
Implement individualized, person-centered care plans.
Follow-up and monitor the patient and adjust the care plan as needed.
Document person-centered care related activities.
2.5. Advocacy (Advocate): Promote the best interests of patients and/or the pharmacy within healthcare settings and at the community, state, or national level.
Learning Objectives
Assure that patients’ best interests are represented.
Empower patients to take responsibility for, and control of their health.
Review resources to assist patients in navigating the complex healthcare system.
Ensure patients obtain the resources and care required in the most efficient and cost-effective manner possible.
Discuss how to advocate in the workplace for yourself and other pharmacy colleagues around important issues (e.g., working conditions, expected performance, patient safety, practice advancement, interprofessional equity).
Demonstrate a commitment to the advancement of the pharmacy profession through advocacy at the local, state, or national level.
2.6. Medication-use process stewardship (Steward): Optimize patient healthcare outcomes using human, financial, technological, and physical resources to improve the safety, efficacy, and environmental impact of medication-use systems.
Learning Objectives
Outline the components of typical medication-use processes in different pharmacy practice settings.
Describe the role of the pharmacist in impacting the safety and efficacy of each component of a typical medication-use process (i.e., procurement, storage, prescribing, transcription, dispensing, administration, disposal, regulatory requirements, monitoring, documentation, and supervising others).
Identify and utilize human, financial, and physical resources to optimize the medication-use process.
Apply standards, guidelines, best practices, and established processes related to safe and effective medication use.
Utilize continuous quality improvement techniques in the medication-use process.
Develop professional documents pertinent to organizational needs (e.g., monographs, policy documents).
2.7. Interprofessional collaboration (Collaborator): Actively engage and contribute as a healthcare team member by demonstrating core interprofessional competencies.
Learning Objectives
Work with individuals of other professions to establish and maintain a climate of mutual respect and shared values.
Use the knowledge of one’s own role and those of other professions to appropriately assess and address the health care needs of patients and to promote and advance the health of populations.
Communicate with patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to the promotion and maintenance of health and the prevention and treatment of disease.
Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan, deliver, and evaluate patient/population-centered care and population health programs and policies that are safe, timely, efficient, effective, and equitable.
2.8. Population Health and Wellness (Promoter): Assess factors that influence the health and wellness of a population and develop strategies to address those factors.
Learning Objectives
Identify personal, social, economic, and environmental factors that influence individual and population health and wellness.
Describe advocacy approaches and efforts that impact individual and population health and wellness.
Outline the steps for conducting a community health needs assessment.
Collect and interpret population-based health and wellness qualitative and quantitative data to assess the needs of a patient population and satisfaction of care.
Evaluate the existing approaches and suggest tailored interventions to maximize health and wellness.
Participate in the development and/or implementation of preventive care strategies for a population (e.g., risk/needs assessment, risk reduction, screening, and education).
2.9. Leadership (Leader): Demonstrate the ability to influence and support the achievement of shared goals on a team, regardless of one’s role.
Learning Objectives
Determine when it is appropriate to use leadership skills, management skills, or both.
Demonstrate understanding of one’s role in a team-based situation, including taking responsibility for a leadership or supporting role, when appropriate.
Explore the history (e.g., successes and challenges) of a team before implementing changes.
Develop trusting relationships, actively listen, and value diverse perspectives to promote collaboration and teamwork.
Use persuasive communication when necessary.
Engage team members by building shared goals, gathering input or feedback, utilizing individual strengths, and managing conflict to promote team functionality.
Identify and address factors that affect team morale and performance.
Domain 3: Personal and Professional Attitudes
3.1. Self-awareness (Self-Aware): Examine, reflect on, and address personal and professional attributes (e.g., knowledge, metacognition, skills, abilities, beliefs, biases, motivation, help-seeking strategies, and emotional intelligence that could enhance or limit growth, development, & professional identity formation).
Learning Objectives
Use metacognition to understand and regulate one’s own thinking and learning.
Demonstrate motivation (e.g., desire to learn, attention, interest, habits of mind, persistence, flexibility) during didactic and experiential activities.
Identify, create, implement, evaluate, and modify plans, using available resources (e.g., career counselors, mentors) as needed, for personal and professional development for the purpose of individual growth.
Recognize, correct, and learn from errors.
Select and use constructive coping strategies or help-seeking behaviors (personal, professional, or academic support) to manage stress and improve well-being.
Utilize elements of emotional intelligence when working with others.
Reflect on the evolution of one’s own professional identity formation during the Doctor of Pharmacy program and how it will continue to evolve across one’s career.
3.2. Professionalism (Professional): Exhibit attitudes and behaviors that embody a commitment to building and maintaining trust with patients, colleagues, other health care professionals, and society.
Learning Objectives
Demonstrate altruism, integrity, trustworthiness, flexibility, compassion, inclusiveness, and curiosity.
Display preparation, initiative and accountability consistent with a commitment to adding value and/or a commitment to excellence.
Conduct activities and fulfill responsibilities in a legal, moral, and ethical manner.
Describe the impact of one’s actions (positive or negative) on how the profession is perceived by patients, other health care providers, and society.
Navigate how to balance between responsibility to self and others, seeking mentoring if needed.
Describe the pharmacy profession’s core values and beliefs outlined in the Oath of a Pharmacist and how they contribute to professional identity formation.
Entrustable Professional Activities
Entrustable Professional Activities (EPAs) are designed to translate the above Learning Outcomes into pharmacy practice activities. The EPAs describe pharmacy workplace activities that all students are entrusted to do in experiential settings with either direct or distant supervision by pharmacist preceptors. Preceptors are expected to assess student using an entrustment decision scale.
The entrustment decision scale utilized by the College consists of four levels of entrustment of the student by the preceptor. They are:
Level 1: Low Trust/Observe Only: requires complete hands-on guidance.
Level 2: Moderate Trust/Direct Supervision: requires constant supervision.
Level 3: High Trust/Reactive Supervision: requires occasional supervision.
Level 4: Complete Trust/On Demand Supervision: doesn’t require supervision—practices independently, and the student knows that a preceptor is available in case of need.
Students are expected to achieve at least Level 3 on the entrustment scale for all EPAs. Listed below are the thirteen EPAs the College has adopted along with example tasks associated with each EPA.
1. Collect information to identify a patient’s medication-related problems and health-related needs
Example tasks:
Collect a history from a patient or caregiver.
Collect a medication history from a patient or caregiver.
Collect a patient’s experience with medication.
Collection information related to barriers for patients to take their medication(s).
Collect objective information from the patient (e.g., physical exam, point of care testing)
Collect data from a patient’s electronic health, digital health or medication record.
2. Assess collected information to determine a patient’s medication-related problems, health-related needs.
Example tasks:
Assess the indication of the medication treatment plan.
Assess the safety of the medication treatment plan including drug interactions.
Assess the effectiveness of medication treatment plans, including existing, previous, and new medications.
Assess the alignment of the medication plan with the patient’s goals, needs, abilities, values, and beliefs.
Assess the relative priority of each health-related need of the patient to create a prioritized problem list.
Assess if a patient requires a referral for their health-related needs.
Assess whether a patient is eligible for CDC-recommended immunizations.
3. Create a care plan in collaboration with the patient, others trusted by the patient, and other health professionals to optimize pharmacologic and nonpharmacologic treatment.
Example tasks:
Create person-centered treatment goals.
Create a prioritized list of evidence-based and patient-centered treatment options to discuss with members of the healthcare teams/patient/caregiver(s)
Create a person-centered treatment plan.
Create a plan to mitigate the risk of drug interactions and polypharmacy.
Create a treatment plan that incorporates potential strategies to minimize cost for the patient such as formulary review, patient assistance programs, and medication discount programs.
Create a plan to monitor the safety and efficacy of the treatment plan.
Create an individualized education plan for the patient and/or caregiver.
4. Contribute patient specific medication-related expertise as part of an interprofessional care team.
Example tasks:
Explain a pharmacist’s role and responsibilities to a healthcare team.
Apply the PPCP as a member of an interprofessional team.
Communicate a patient’s medication-related problem(s) to the healthcare team.
Provide recommendations to the health care team to resolve and/or monitor medication-related problems.
Provide evidence-based drug information to the health care team.
5. Answer medication related questions using scientific literature.
Example tasks:
Ask clarifying questions to identify and address the true question.
Perform a systematic search of tertiary, secondary, and primary resources.
Identify and retrieve high-quality scientific literature.
Analyze scientific literature.
Provide a written or verbal response to the true question, including findings and recommendations.
6. Implement a care plan in collaboration with the patient, others trusted by the patient, and other health professionals.
Example tasks:
Initiate, modify, or discontinue medication therapy.
Present necessary information to a colleague during a handoff or transitions of care.
Schedule follow-up care as needed (e.g., labs or tests, follow-up appointments)
Document the findings, recommendations, plan, and pharmacy services provided.
Discuss the care plan with a patient and/or others trusted by the patient.
Fulfill a medication order.
Example tasks:
Enter an order or prescription into an electronic health or pharmacy record system.
Perform calculations required to compound, dispense, and administer medications.
Perform a prospective drug utilization review.
Adjudicate a third-party claim.
Identify and manage drug therapy problems.
Consider formulary preferred medications when making recommendations.
Complete an authorization process for a non-preferred medication.
Assist a patient to acquire medication(s) through support programs.
Prepare non-sterile and/or sterile medications.
Perform a quality assurance check on prepared medications prior to dispensing.
Dispense and administer a product including injectable medications and immunizations.
Adhere to state and federal laws/regulations and site quality and safety procedures.
Educate the patient and others trusted by the patient regarding the appropriate use of a medication, device to administer a medication, or self-monitoring test.
Example tasks:
Provide education and self-management training to the patient or caregiver.
Assess the learning needs of a patient and others trusted by the patient.
Select a method for providing education in the given environment.
Actively engage the patient in the education session.
Identify, select, or develop supportive education materials (e.g., written, models, demonstration, devices, videos).
Adapt the terminology and verbal delivery of information.
Determine the effectiveness of education provided by assessing a patient’s understanding and/or their ability to demonstrate the technique.
Reinforce key points, correct misunderstandings, or address gaps with the patient as needed.
9. Monitor and evaluate the safety and effectiveness of a care plan.
Example tasks:
Collect monitoring data at the appropriate time interval(s).
Evaluate the selected monitoring parameters to determine the therapeutic and adverse effects related to the treatment plan.
Recommend modifications or adjustments to an existing medication therapy regimen based on patient response.
10. Report adverse drug events and/or medication errors in accordance with site specific procedures.
Example tasks:
Identify factors of system(s) (e.g., personnel, infrastructure, interfaces) associated with errors or risk of errors.
Determine points of intervention within system(s) to prevent or minimize medication-related errors.
Report and document adverse drug events and medication errors to stakeholders.
11, Deliver medication or health-related education to health professionals or the public.
Example tasks:
Lead a discussion regarding published primary literature and its application to patient care (e.g., journal club)
Develop and deliver a verbal, digital, or written medication or health-related educational program to health professionals, a community, or other groups.
Identify populations at risk for prevalent diseases and preventable adverse medication outcomes.
Example tasks:
Perform a screening assessment to identify patients at risk for prevalent diseases in a population and triage, when needed.
Evaluate individual and/or aggregated patient data to determine patients or populations at risk for a disease.
13. Perform the technical, administrative, and supporting operations of a pharmacy practice site.
Example tasks:
Execute pharmacy policies and procedures.
Delegate work activities to pharmacy team members.
Provide formative feedback on pharmacy team dynamics, workflow, processes, and operations.
Manage pharmacy workflow to ensure efficiency and safety.
Use technology to support the pharmacy workflow.
Execute pharmacy quality improvement activities.
Procure inventory to ensure continued pharmacy operations.
Prepare for regulatory visits and inspections.