IPTeC INDIANA PHARMACY TEACHING CERTIFICATE PROGRAM

Teaching Experience Log

Participants are required to perform:

1. At least two hours of lectures either as a didactic lecture or part of a CE program
2. Additional experience of at least 15 hours of other teaching activities such as (all 15
hours cannot be from a single area
▪ 6 hrs precepting or co-precepting students
▪ 6 hrs leading topic discussions/journal clubs
▪ 3 hrs recitation/lab facilitation

TOTAL TEACHING HOURS: 187.5

Date Description of experience, Location (eg, site or Setting (eg, course, Time
topic pharmacy program) program, audience) (hours)
Lecture and/or CE
Total hours: 4

Living in a DOAC World: Outpatient Pharmacy

02/04/2022 The Future of Ascension St. Vincent –
Team + 2 APPE 1
Anticoagulation Clinics Outpatient Grand Rounds
Students

H. Pylori Treatment Ascension St. Vincent – Outpatient Pharmacy 1

04/29/2022
Updates Outpatient Grand Rounds Team

Bone, Joint, and Muscle

05/13/2022 Manchester University College PHRM 465 – 16 P2 2
Diseases: Osteoporosis and
of Pharmacy and P3 students
Osteomalacia
Precepting/Co-precepting experiences
Total hours: 127.5

Interdisciplinary Free Clinic North West Free Clinic –

09/22/2021 1 P2/P3 Student 4
– Pharmacist Indianapolis, IN

Interdisciplinary Free Clinic North West Free Clinic –

10/09/2021 1 P2/P3 Student 4
– Pharmacist Indianapolis, IN

Interdisciplinary Free Clinic North West Free Clinic –

12/04/2021 1 P2/P3 Student 4
– Pharmacist Indianapolis, IN

Interdisciplinary Free Clinic North West Free Clinic –

12/11/2021 1 P2/P3 Student 4
– Pharmacist Indianapolis, IN

Week of Community Pharmacy Ascension St. Vincent Primary

1 APPE Student 7
01/03/2022 Precepting Care Center Pharmacy

INDIANA PHARMACY TEACHING CERTIFICATE PROGRAM

Updated 5/2019
 IPTeC INDIANA PHARMACY TEACHING CERTIFICATE PROGRAM

Week of Community Pharmacy Ascension St. Vincent

1 APPE Student 8
01/10/2022 Precepting Outpatient Retail Pharmacy

Week of Community Pharmacy Ascension St. Vincent Primary

1 APPE Student 7
01/17/2022 Precepting Care Center Pharmacy

Week of Community Pharmacy Ascension St. Vincent

1 APPE Student 8
01/24/2022 Precepting Outpatient Retail Pharmacy

Interdisciplinary Free Clinic North West Free Clinic –

02/12/2022 1 P2/P3 Student 4
– Pharmacist Indianapolis, IN

Week of Community Pharmacy Ascension St. Vincent Primary

1 APPE Student 7
02/28/2022 Precepting Care Center Pharmacy

03/07/2022 Ambulatory Care Pharmacy Ascension St. Vincent Center

1 APPE Student 3
Precepting for Healthy Aging

Week of Community Pharmacy Ascension St. Vincent

1 APPE Student 8
03/07/202 Precepting Outpatient Retail Pharmacy

Interdisciplinary Free Clinic North West Free Clinic –

03/12/2022 1 P2/P3 Student 4
– Pharmacist Indianapolis, IN

03/14/2022 Ambulatory Care Pharmacy Ascension St. Vincent Center

1 APPE Student 3
Precepting for Healthy Aging

Week of Community Pharmacy Ascension St. Vincent Primary

1 APPE Student 3.5
03/14/2022 Precepting Care Center Pharmacy

03/21/2022 Ambulatory Care Pharmacy Ascension St. Vincent Center

1 APPE Student 3
Precepting for Healthy Aging

Week of Community Pharmacy Ascension St. Vincent

1 APPE Student 8
03/21/202 Precepting Outpatient Retail Pharmacy

03/28/2022 Ambulatory Care Pharmacy Ascension St. Vincent Center

1 APPE Student 3
Precepting for Healthy Aging

Week of Community Pharmacy Ascension St. Vincent Primary

1 APPE Student 7
03/28/2022 Precepting Care Center Pharmacy

04/04/2022 Ambulatory Care Pharmacy Ascension St. Vincent Center

1 APPE Student 3
Precepting for Healthy Aging

INDIANA PHARMACY TEACHING CERTIFICATE PROGRAM

Updated 5/2019
 IPTeC INDIANA PHARMACY TEACHING CERTIFICATE PROGRAM

Week of Community Pharmacy Ascension St. Vincent

1 APPE Student 8
04/04/202 Precepting Outpatient Retail Pharmacy

Interdisciplinary Free Clinic North West Free Clinic –

04/09/2022 1 P2/P3 Student 4
– Pharmacist Indianapolis, IN

04/11/2022 Ambulatory Care Pharmacy Ascension St. Vincent Center

1 APPE Student 3
Precepting for Healthy Aging

Week of Community Pharmacy Ascension St. Vincent Primary

1 APPE Student 7
04/11/2022 Precepting Care Center Pharmacy

04/18/2022 Ambulatory Care Pharmacy Ascension St. Vincent Center

1 APPE Student 3
Precepting for Healthy Aging

INDIANA PHARMACY TEACHING CERTIFICATE PROGRAM

Updated 5/2019
 IPTeC INDIANA PHARMACY TEACHING CERTIFICATE PROGRAM

Topic discussions/Journal clubs

Total Hours: 9 hours
08/02/2021 TD: Devices Ascension St. Vincent APPE students 0.75
08/06/2021 TD: Anticoagulation Ascension St. Vincent APPE students 0.75
08/30/2021 TD: Devices Ascension St. Vincent APPE students 0.75
09/28/2021 TD: Devices Ascension St. Vincent APPE students 0.75
10/25/2021 TD: Devices Ascension St. Vincent APPE students 0.75
01/06/2022 TD: Anticoagulation Ascension St. Vincent APPE students 0.75
02/03/2022 TD: Anticoagulation Ascension St. Vincent APPE students 0.75
02/18/2022 TD: Gout Ascension St. Vincent APPE students 0.75
03/03/2022 TD: Anticoagulation Ascension St. Vincent APPE students 0.75
03/18/2022 TD: Gout Ascension St. Vincent APPE students 0.75
03/31/2022 TD: Anticoagulation Ascension St. Vincent APPE students 0.75
04/15/2022 TD: Gout Ascension St. Vincent APPE students 0.75
Laboratory/Recitation/Case facilitation
Total Hours: 46 hours
09/10/2021 Case facilitation: Alcohol Butler University COP 16 P2 Students 2.5
Withdrawal
09/24/2021 Case facilitation: Butler University COP 16 P2 Students 2.5
Contraception
10/01/2021 Case facilitation: Butler University COP 16 P2 Students 2.5
Osteoporosis
10/08/2021 Case facilitation: Fluids & Butler University COP 16 P2 Students 2.5
Electrolytes
10/29/2021 Case facilitation: Diabetes Butler University COP 16 P2 Students 2.5
11/05/2021 Case facilitation: Rounds Butler University COP 16 P2 Students 2.5
Simulation
11/12/2021 Case facilitation: Individual Butler University COP 16 P2 Students 2.5
Oral Presentations
11/19/2021 Case facilitation: IBD/Anemia Butler University COP 16 P2 Students 2.5

12/03/2021 Case facilitation: Purdue University COP 20 P2/P3 Students 2

Asthma/Contraception
01/11/2022 Lab facilitation: Butler University COP 28 P2 Students 2
Self-Care Boot Camp

INDIANA PHARMACY TEACHING CERTIFICATE PROGRAM

Updated 5/2019
 IPTeC INDIANA PHARMACY TEACHING CERTIFICATE PROGRAM

01/25/2022 Lab facilitation: Butler University COP 28 P2 Students 2

Blood Pressure Assessment
Review, Constipation Cases

02/01/2022 Lab facilitation: Butler University COP 28 P2 Students 2

Musculoskeletal Injuries, Pain
& Headache
02/08/2022 Lab facilitation: Butler University COP 28 P2 Students 2
Pediatric Case Fever, Self-
care of CVD, Home BP
Monitoring
02/15/2022 Lab facilitation: Butler University COP 28 P2 Students 2
Blood Pressure Practice
Session/BP counseling
02/22/2022 Lab facilitation: Butler University COP 28 P2 Students 2
Blood Glucose Monitoring/
Introduce “Life as a Patient
with Diabetes” Project
03/01/2022 Lab facilitation: Butler University COP 28 P2 Students 2
Practice Readiness
Assessment: Blood Pressure
and Patient Counseling
03/15/2022 Lab facilitation: Butler University COP 28 P2 Students 2
Diabetes Self-Care
Management
03/22/2022 Lab facilitation: Butler University COP 28 P2 Students 2
Tobacco Cessation/Individual
PIP Presentation
03/29/2022 Lab facilitation: Butler University COP 28 P2 Students 2
Pediculosis/SubQ Injections
Practice/Review for Lab Final
04/12/2022 Lab facilitation: Butler University COP 28 P2 Students 2
Practice Readiness
Assessment: Lab Final
04/19/2022 Lab facilitation: Butler University COP 28 P2 Students 2
Geriatrics/DME

Additional teaching experiences

Total Hour: 1
PHRM 464 – Residency
04/13/2022 Virtual 3 P3 Students 1
Preparation Elective (Mock
Interviews)

INDIANA PHARMACY TEACHING CERTIFICATE PROGRAM

Updated 5/2019