Spreadsheet: 0552bc00-7acd-4cb7-bcc5-00ebbed480fc
Sheet: Sheet1

PROFESSIONALISM
Attendance | Student is always on time, communicated delay/ absences. | Students is not  on time twice or less, but notified site of delays/ absences. | Students is not  on time more than twice or failed to notify site of delays or absences. | Student failed to meet attendance requirements for rotation.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Dress Code | The student follows the University and site dress code all of the time. | The student follows the University and site dress code most of the time. | The student required coaching with regard to the dress code requirements. | Student did not follow the University or site dress code in spite of coaching.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant Improvement needed | Much Improvement Needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant Improvement needed | Much Improvement Needed
Personal Hygiene | The student is always neatly groomed and maintains good personal hygiene. | The student is neatly groomed and maintains good personal hygiene most of the time. | The student required coaching regarding grooming and personal hygiene. | The student did not meet expectations for grooming and hygiene after coaching.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant Improvement needed | Much Improvement Needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant Improvement needed | Much Improvement Needed
Self Direction | The student is self-directed in undertaking tasks and completing assignments independently. | The student requires some guidance in undertaking tasks and completing assignments independently. | The student required significant guidance in undertaking tasks and completing assignments. | The student was unable to complete tasks and assignments even with significant guidance and mentoring.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant Improvement needed | Much Improvement Needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant Improvement needed | Much Improvement Needed
Cultural Competency | The student  always  recognizes and respects cultural differences of healthcare professionals and patients. | The student  sometimes recognizes and respects cultural differences of healthcare professionals and patients. | The student  required coaching regarding recognition and respect cultural differences of healthcare professionals and patients. | The student consistently failed to recognize and respect cultural differences of healthcare professionals and patients.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant Improvement needed | Much Improvement Needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant Improvement needed | Much Improvement Needed
Professionalism  Subtotal | Total Professionalism Points ______ | 20 Points Possible
COMMUNICATION SKILLS
Patient Interaction | The student always speaks to the patients in a professional manner while treating them with courtesy and empathy. | The student almost always speaks to the patients in a professional manner while treating them with courtesy and empathy. | The student requires redirection in order to speak to the patients in a professional manner while treating them with courtesy and empathy. | The student did not speak to the patients in a professional manner in spite of repeated redirection.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Patient Confidentiality | The student protects patient privacy by always following procedures set forth to assure confidentiality of patient information. | The student protects patient privacy by following procedures set forth to assure confidentiality of patient information with redirection. | The student protects patient privacy by following procedures set forth to assure confidentiality of patient information with repeated redirection. | The student failed to protect patient privacy by following procedures set forth to assure confidentiality of patient information in spite of redirection.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Professional Interaction | The student is able to  communicate effectively with the pharmacy staff and interact appropriately with colleagues at this site. | The student is sometimes able to communicate effectively with the pharmacy staff and interact appropriately with colleagues at this site. | The student is only able to communicate effectively with the pharmacy staff and interact appropriately with colleagues at this site after coaching. | The student is unable to communicate effectively with the pharmacy staff and interact appropriately with colleagues at this site even after coaching and mentoring.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Language Skills | The student always uses appropriate oral, written, and nonverbal language. | The student almost always uses appropriate oral, written, and nonverbal language. | The student uses appropriate oral, written, and nonverbal language with the help of the preceptor. | The student is unable to use appropriate oral, written, and nonverbal language.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Electronic Devices (Smart/Cell phones, PDA,  internet, email  etc.) | The student always uses electronic devices and resources professionally and according to the sites policies. | The student almost always uses electronic devices and resources professionally and according to the sites policies. | The student uses electronic devices and resources professionally and according to the sites policies only after redirection. | The student consistently fails to use electronic devices and resources professionally and according to the sites policies in spite of redirection.
Midpoint Evaluation | Meets expectation for this stage of development | Focused Attention Required | Less than Expected for Stage of Development | Much Improvement Needed
Final Evaluation | Meets expectation for this stage of development | Focused Attention Required | Less than Expected for Stage of Development | Much Improvement Needed
Telephone Etiquette | The student always exhibits professional telephone skills and electronic communications etiquette. | The student sometimes exhibits professional telephone skills and electronic communications etiquette. | The student exhibits professional telephone skills and electronic communications etiquette only after coaching. | The student fails to exhibit professional telephone skills and electronic communications etiquette even after coaching.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Communication Skills  Subtotal | Total Points ______ | 24 Points Possible
PRESCRIPTION PROCESSING
Prescription Intake | The student can verbalize, without prompting, the minimum patient information required for processing a prescription. | The student can verbalize, with prompting, the minimum patient information required for processing a prescription. | The student can verbalize, with extensive prompting, the minimum patient information required for processing a prescription. | The student can not verbalize, with prompting, the minimum patient information required for processing a prescription.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Prescription Processing | The student can diagram the steps required to process a prescription, without prompting. | The student can diagram the steps required to process a prescription, with some prompting. | The student can diagram the steps required to process a prescription with an extensive amount of prompting. | The student could not diagram the steps required to process a prescription.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Formulary Management | The student can verbalize, without prompting, the institution's formulary process outlining the difference between formulary and non-formulary medications. | The student can verbalize, with some prompting,  the institution's formulary process outlining the difference between formulary and non-formulary medications | The student can verbalize, with an extensive amount of prompting,  the institution's formulary process outlining the difference between formulary and non-formulary medications. | The student can not verbalize the  institution's formulary process.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Focused Attention Required | Less than Expected for Stage of Development | Much Improvement Needed
Prescription Types | The student can verbalize,  without prompting, the different medication dispensing types such as controlled substance, intravenous, oral, chemotherapy. | The student can verbalize, with some prompting,  the different medication dispensing types such as controlled substance, intravenous, oral, chemotherapy. | The student can verbalize,  with an extensive amount of prompting, the different medication dispensing types such as controlled substance, intravenous, oral, chemotherapy | The student can not verbalize the different medication dispensing types such as controlled substance, intravenous, oral, chemotherapy.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Legal Requirements of Prescription | The student can identify, without prompting,  all the legal requirements of a medication prescription and prescription label. | The student can identify, with some prompting,  the legal requirements of a medication prescription and prescription label. | The student can identify, with an extensive amount of prompting,  the legal requirements of a medication prescription and prescription label. | The student can not identify the legal requirements of a medication prescription and prescription label.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Calculations | The student is able to calculate dose, days supply and total quantity, without assistance. | The student is able to calculate dose, days supply and total quantity with minimal help from the pharmacy staff. | The student requires extensive assistance in order to calculate dose, days supply and total quantity. | The student is unable to perform calculations to determine dose, days supply and total quantity.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Drug Dispensing Safety | The student can discuss, without prompting, key components of the institution's drug safety program such as double checks, automation, database alerts, formulary restrictions, medication error tracking and policies. | The student can discuss, with some prompting,  key components of the institution's drug safety program such as double checks, automation, database alerts, formulary restrictions, medication error tracking and policies. | The student can discuss, with extensive prompting, key components of the institution's drug safety program such as double checks, automation, database alerts, formulary restrictions, medication error tracking and policies. | The student is unable to discuss key components of the institution's drug safety program such as double checks, automation, database alerts, formulary restrictions, medication error tracking and policies.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Interprofessional Experience | The student spent at least 2 hours with a medication nurse and can discuss, without prompting, key aspects of obtaining and administering medications. | The student spent at least 2 hours with a medication nurse and can discuss, with some prompting, key aspects of obtaining and administering medications. | The student spent at least 2 hours with a medication nurse and can discuss, with extensive prompting, key aspects of obtaining and administering medications. | The student spent at least 2 hours with a medication nurse and is unable to describe, with extensive prompting, key aspects of obtaining and administering medications.
Midpoint Evaluation | Meets expectation for this stage of development | Some improvement needed | Significant improvement needed | Much improvement needed
Final Evaluation | Meets expectation for this stage of development | Some Improvement needed | Significant improvement needed | Much improvement Needed
Prescription Processing Subtotal (32 points possible) | Points ______
Professionalism (30 points possible) | Points ______     = | Section Points x 1.5
Communication (24 Points possible) | Points ______
Workbork (10 points possible) | Points _____ = | (points = 10 x % grade )
Refelection Paper (4 points possible) | Points ______ | Paper Completed: 4 Points Not Completed:     0 Points
Final Number of Points | Total Points ______ | Out of 100 Points
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