Teaching Experience Log

Name Institution Program type Funding by academic institution (any %)

Jaclyn Collier Deaconess Hospital
Didactic Teaching

If "College of Pharmacy,"
Type of Teaching (Select the BEST Location (Institution/Setting) Delivery (Select the BEST Would you have completed If any “other” responses
Date please list. If "Other," Target audience Time (hours)
fit) Select the BEST fit fit) this if not part of IPTeC? selected, please explain here.
describe location.

10/17/2023 2 = Instruction for health professionals3 = Practice setting (community, clinic, hospital, industry, regulatory,
1 =etc.)
In-person 2 = Healthcare professionals 1 = Yes 0.5
11/14/2023 2 = Instruction for health professionals3 = Practice setting (community, clinic, hospital, industry, regulatory,
1 =etc.)
In-person 2 = Healthcare professionals 1 = Yes 1
12/19/2023 2 = Instruction for health professionals3 = Practice setting (community, clinic, hospital, industry, regulatory,
1 =etc.)
In-person 2 = Healthcare professionals 1 = Yes 0.5
3/19/2024 2 = Instruction for health professionals3 = Practice setting (community, clinic, hospital, industry, regulatory,
1 =etc.)
In-person 2 = Healthcare professionals 1 = Yes 0.5
Total 2.5

Small Group Teaching

If "College of Pharmacy,"
Type of Teaching (Select the BEST Location (Institution/Setting) Delivery (Select the BEST Would you have completed If any “other” responses
Date please list. If "Other," Target audience Time (hours)
fit) Select the BEST fit fit) this if not part of IPTeC? selected, please explain here.
describe location.

2/22/2024 2 = Discussion-based course (i.e., case2studies

= Othercourse,
health etc.)
professions school (outside
Butler University
of pharmacy) 2 = Online synchronous 1 = Students 2 = No 2
2/23/2024 2 = Discussion-based course (i.e., case2studies
= Othercourse,
health etc.)
professions school (outside
Butler University
of pharmacy) 2 = Online synchronous 1 = Students 2 = No 1

Total 3
Precepting/Co-precepting

Location of precepting
Type of Teaching (Select the BEST Delivery (Select the BEST Would you have completed If any “other” responses
Date (Institution/Setting). Select the Learners precepted Time (hours)
fit) fit) this if not part of IPTeC? selected, please explain here.
BEST fit

1/25/2024 2 = Co-precepting (contributes to parts

1 =ofCommunity
design, delivery, or assessment of rotation) 1 = In-person 1 = IPPE student 2 = No 2
2/7/2023 2 = Co-precepting (contributes to parts
1 =ofCommunity
design, delivery, or assessment of rotation) 1 = In-person 2 = APPE student 2 = No 2
3/13/2024 2 = Co-precepting (contributes to parts
1 =ofCommunity
design, delivery, or assessment of rotation) 1 = In-person 1 = IPPE student 2 = No 2

Total 6

Experiential Didactics

If "College of Pharmacy,"
Type of Teaching (Select the BEST Location (Institution/Setting) Delivery (Select the BEST Would you have completed If any “other” responses
Date please list. If "Other," Target audience Time (hours)
fit) Select the BEST fit fit) this if not part of IPTeC? selected, please explain here.
describe location.

8/22/2023 2 = Topic discussion evaluation 3 = Practice setting (community, clinic, hospital, industry, regulatory,
1 =etc.)
In-person 4 = More than one of the above
2 = No 1
11/2/2023 2 = Topic discussion evaluation 3 = Practice setting (community, clinic, hospital, industry, regulatory,
1 =etc.)
In-person 4 = More than one of the above
2 = No 1
1/12/2024 2 = Topic discussion evaluation 3 = Practice setting (community, clinic, hospital, industry, regulatory,
3 =etc.)
Online asynchronous 4 = More than one of the above
2 = No 1
1/13/2024 1 = Topic discussion facilitation 3 = Practice setting (community, clinic, hospital, industry, regulatory,
1 =etc.)
In-person 4 = More than one of the above
2 = No 1
2/15/2024 4 = Journal club evaluation 3 = Practice setting (community, clinic, hospital, industry, regulatory,
3 =etc.)
Online asynchronous 4 = More than one of the above
2 = No 1
2/16/2024 3 = Journal club facilitation 3 = Practice setting (community, clinic, hospital, industry, regulatory,
1 =etc.)
In-person 4 = More than one of the above
2 = No 1

Total 6

Other teaching experiences

If "College of Pharmacy,"
Location (Institution/Setting) Delivery (Select the BEST Would you have completed If any “other” responses
Date Type of Teaching please list. If "Other," Target audience Time (hours)
Select the BEST fit fit) this if not part of IPTeC? selected, please explain here.
describe location.

Total 0

Total teaching time 17.5

1 = Classroom-based 1 =instruction
Topic discussion
for learners
facilitation 1 = College of Pharmacy 1 = In-person 1 = Yes
2 = Instruction for health
2 = Topic
professionals
discussion evaluation 2 = Other health professions school (outside of pharmacy) 2 = Online synchronous 2 = No
3 = Other 3 = Journal club facilitation 3 = Practice setting (community, clinic, hospital, industry,3 regulatory,
= Online asynchronous
etc.)
4 = Journal club evaluation 4 = Professional conference (Great Lakes, IPA, ASHP, national event, etc)
5 = Patient case presentation lead 5 = Other
6 = Patient case presentation evaluation 1 = Students
7 = Other 1 = Community 2 = Healthcare professionals
2 = Institutional 3 = Both of the above
1 = Primary preceptor
1 =(lead
Skills-based
in design,
course
delivery,
(i.e., AND
laboratory,
assessment
simulation,
of a rotation)
etc) 3 = Industry 4 = Other
2 = Co-precepting (contributes
2 = Discussion-based
to parts ofcourse
design, (i.e.,
delivery,
case studies
or assessment
course, etc.)
of rotation) 4 = Other
3 = Other
1 = PGY1 1 = IPPE student
2 = PGY2 2 = APPE student
3 = Other 3 = PGY1
4 = More than one of the above
2 hours required

3 hours required

6 hours required

6 hours required