College of Pharmacy
Experiential Education Manual
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Modified on: January 31, 2012
Created by: Dr. Christy Cox, Dr. Jacqueline Gregory, Dr. Nina Morris, and Dr. DianaSteinl
View/Print the complete version of the Experiential Education Manual.
Appendix Table of Contents
General EE Documents
- Affiliation Agreement
- Agreement to Maintain Confidentiality of Patient Protected Health Information
- Anticipated Place of Employment during Rotations
- Community Service Agreement
- Informed Consent Regarding Hazards on Clinical Rotations
- Permission to Release Agreement
- Pharmacy Practice Agreement
- Professionalism Policy
- Professionalism Policy Attestation Statement
- Student Evaluation of Site
- Student Nomination for Preceptor Recognition
IPPE:
- Community so now I have a student handout
- Discussion Board Rubric
- Institutional so now I have a student handout
- Integrated Documentation
- IPPE Immunization Policy and Agreement
- IPPE Pharmacist Letter Agreement
- Pharmacy Information Sheet
- Preceptor Evaluation of Student
- Site Evaluation/Site Visit Form
- Student Evaluation of Preceptor
- Students - Important tasks to complete
- Weekly Assignment List
APPE:
- Anticipated Place of Employment during Rotations Form
- APPE Immunization Policy and Agreement
- Concurrent Hours Form
- Instructions for Change in Assignment Form
- APPE Pharmacist Letter Agreement
- Medicine APPE Appendix
- Medicine Rotation Evaluation
- Non-Medicine Evaluation
- Non-Medicine Evaluation Conversion to Points/Grading Scale
- Region Request Form
- Student Evaluation of Preceptor
- Vitae Form
