Learning Experiences
Core learning experiences are offered in several specialty areas. The descriptions below are specific to PGY1 residents. Many experiences are also applicable to PGY2 Emergency Medicine residents but with a higher level of responsibility and expectations and with a greater emphasis on disease states specific to the ED population.
Clinical Precepting: This learning experience is designed to provide the resident with experiences in experiential teaching. The resident will be responsible for patient care, educating students through precepting and didactic sessions, as well as dedicating time to both service and scholarship activities. The primary patient care responsibilities will occur at MercyOne West Des Moines. Time will be dedicated to developing the resident’s precepting and mentoring styles as well as providing feedback to learners. (Required for PGY1)
Cardiology: The primary goal of the cardiology experience is to facilitate the resident's familiarity and confidence in managing complex cardiac disease states. The resident will be responsible for reviewing patients’ drug regimens, developing pharmacotherapeutic plans, and actively seeking out and preventing problems associated with medication use. The pathophysiology and drug therapies for acute coronary syndromes, congestive heart failure, arrhythmias and other cardiac disease states will be reviewed. The primary focus of the experience takes place with the cardiology fellowship and internal medicine teaching service, but may also include opportunities to round with other cardiovascular specialty services, observe in the cath lab, and teach in cardiac or advanced heart failure classes. (Elective for PGY1 and EM PGY2)
Critical Care: The Medical Critical Care experience will expose the resident to critically ill patients. Emphasis will be placed on assessing and understanding commonly used medications for the management of highly acute, complicated disease states and effectively communicating with other members of the healthcare team. The focus of the practice is in the neurosurgical/ medical ICU and trauma patient populations. Some areas covered include anticoagulation, pain management, sedation, nutrition, antibiotics and hemodynamics as it applies to the critical care patient. (Medical Critical Care - Required for PGY1, Surgical Critical Care – Elective for PGY1; Required EM PGY2)
Emergency Medicine: The EM learning experience offers an extremely hands-on approach to patient care where pharmacists work at the bedside alongside physicians, medical residents, and nurses among other members of the interdisciplinary healthcare team. Residents will respond to medical and traumatic resuscitations and other alerts, provide drug therapy consultations, perform culture follow-up activities, assist with medication administration, answer drug information questions, and other tasks as necessary. (Required for PGY1; each EM experience for PGY2 EM has a different area of focus, see PGY2 section)
Independent Practice: This learning experience provides an opportunity for work in the integrated practice model. Residents are expected to provide direct patient-care services in the area of their choice (e.g. critical care, medicine/surgery, etc). They will be exposed to and expected to perform a variety of roles and responsibilities of a pharmacist practicing in a specific area. This may include, but is not limited to: attending and actively participating in multidisciplinary patient care rounds, performing order review and verification for assigned patients, participating in program-oriented services (anticoagulation, therapeutic drug monitoring, TPNs, discharges), providing drug information and education to healthcare professionals, precepting students, and/or performing any other functions expected of a pharmacist in specified area. (Elective for PGY1)
Infectious Diseases: The goal of the infectious disease experience is to provide the resident with an intensive and broad exposure to infectious diseases while developing competency in the clinical application of antimicrobial drug knowledge. During this rotation, the resident will be involved in the care of patients with a wide variety of infectious diseases. Activities during this rotation include rounding with the infectious disease team, completing antimicrobial stewardship activities, pharmacokinetic dosing of antimicrobials, and monitoring anti-infective therapies of patients. Other activities include education of pharmacy students, physicians, nurses, other pharmacy staff and residents. The residents will also be involved in current research activities within the Pharmacy and Infection Control Departments. (Required for PGY1 and longitudinal for EM PGY2)
Internal Medicine: This rotation is designed to provide residents with a broad training experience in managing acutely ill internal medicine patients admitted for diverse and complex medical management with the goal of effectively participating in therapeutic decision making, drug therapy selection and optimization, monitoring of acutely ill patients, and multidisciplinary and patient education. Pharmacy residents will work as a member of the multidisciplinary team which may include physicians, nurses, dieticians, social workers, and consult teams to optimize pharmacotherapy during admission and plan for discharge. As a member of the team, pharmacy residents provide daily pharmacotherapy assessment that includes: screening medication profiles for potential drug-therapy problems, monitoring antibiotic therapy and any medication that requires additional laboratory monitoring, adjusting medications based on the evolving clinical status, completing kinetic consults, and designing safe, effective, and affordable discharge medication regimens. (Required for PGY1)
Leadership: The goal of the leadership learning experience is to give residents a deeper understanding of pharmacy leadership roles and responsibilities. This includes: 1) organizational structure and practice leadership, 2) operations and personnel development, 3) medication-use process and formulary management, 4) medication safety, and 5) department finances and inventory management. Longitudinally residents will be assigned to pharmacy or hospital committees and are responsible for meeting minutes and agendas. (Required 4-week rotation for PGY1 and EM PGY2)
Oncology: Oncology provides opportunities for the resident to develop clinical knowledge and skills that will assist in identifying and resolving drug therapy problems in adult oncology patients. Emphasis is placed on assessing and understanding treatment regimens for lymphomas, acute leukemias, and common solid tumors. Activities during this rotation include daily patient monitoring with an emphasis on patients receiving chemotherapy, completing TPN and pharmacokinetic consults, interaction with the medical oncology rounding team, patient-based case presentations and/or topic discussions, and regular attendance at multidisciplinary cancer conferences. Additional activities may include observation in the outpatient medical oncology clinic and/or chemotherapy suite and precepting pharmacy students if schedules coincide. Some topics covered during the rotation include lymphomas, leukemias, myeloma, common solid tumors, prevention/management of chemotherapy- and targeted therapy-related toxicities, and management of chronic cancer pain. (Elective for PGY1)
Pediatrics: The focus of this experience is to expand the resident’s knowledge of various diagnoses and treatments commonly seen in neonate and pediatric patients. During this experience, the resident will spend time within the general pediatric unit and pediatric intensive care unit (PICU), and optionally in the neonatal intensive care unit (NICU). Within the PICU residents will gain experience with complex medical and cardiac conditions including congenital heart defects, neurologic conditions, trauma, surgery, and ECMO. All of our pediatric units emphasizes a multidisciplinary approach where pharmacists work alongside physicians, medical residents, nurses, and other healthcare professionals. The resident will be responsible for reviewing medication orders, attending interdisciplinary rounds, performing pharmacokinetic consults, attending pediatric medical emergencies, being available for drug therapy consultations, and other tasks as necessary. (Elective for PGY1; Required for EM PGY2 with cross over into the Pediatric Emergency Department)
Rural Health: The rural/critical access hospital learning experience will provide a view of pharmacy practice at a different perspective. You learn alongside the rural pharmacist as the “jack-of-all trades” including the medication use process, interdisciplinary care, and management of a rural hospital on a daily basis. The resident will be expected to participate in the care of patients in all areas of the hospital that have medication needs including consults, compounding, and provide ins-service education. (Elective for PGY1)
Trauma: The focus of this learning experience is to develop an understanding of the various disciplines involved in the treatment of traumatically injured patients, establish a relationship with multiple providers, and continue to refine drug therapy management skills needed to care for traumatically injured patients. The resident will be expected to attend and actively participate in daily bedside rounds with the trauma team (attending physician, surgical residents, mid-level providers, medical students, etc) in the critical care, medical floor, and/or pediatric units, weekly multidisciplinary rounds and all trauma alerts in the Emergency Department. The resident will design, monitor, and evaluate evidence-based patient specific therapies for patients with traumatic injuries as well as address other medication concerns as they arise. (Elective for PGY1; Required for EM PGY2)
