IPTeC INDIANA PHARMACY RESIDENT 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

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

03/07/2019 Medical Counseling Skills and University of Notre SCPP 30401: Medical 1
Patient-Centered Medicine: Dame Counseling Skills and Patient-
Motivational Interviewing South Bend, IN Centered Medicine
~30 Students

04/03/19 Drug Induced Diseases Lecture at Manchester PHRM 465 – Drug Induced 2
Manchester University University College of Diseases
Pharmacy ~33 Students
Fort Wayne, IN

09/19/18 Ambulatory Care Lecture at Purdue University PHPR 101: Introduction to 1

Purdue University West Lafayette, IN Pharmaceutical Care in Today’s
Practice
>140 students

05/01/19 Graduate Medical Education Saint Joseph Health Graduate Medical Education 1.33
(GME) Family Medicine Residency System (GME) Family Medicine
Didactics Mishawaka, IN Residency Didactics
~30 Students

Precepting/Co-precepting experiences
09/27/18 Orientation of APPE Student Saint Joseph Health Ambulatory Care APPE Student 3
System and Pharmacy Residents
Mishawaka, IN
09/28/18 APPE Student in Anticoagulation Saint Joseph Health Ambulatory Care APPE Student 4
clinic System
Mishawaka, IN
09/28/18 Oral Case Presentation Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System and Pharmacy Residents
Mishawaka, IN

INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

Updated 10/2018
 IPTeC INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

09/30/18 APPE Student Present Patient Saint Joseph Health Ambulatory Care APPE Student 1
Cases System
Mishawaka, IN
10/4/18 APPE Student in Anticoagulation Saint Joseph Health Ambulatory Care APPE Student 4
clinic System
Mishawaka, IN
10/5/18 APPE Student Present Patient Saint Joseph Health Ambulatory Care APPE Student 1
Cases System
Mishawaka, IN
10/7/18 Midpoint Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System
Mishawaka, IN
10/13/18 APPE Student Present Patient Saint Joseph Health Ambulatory Care APPE Student 1
Cases System
Mishawaka, IN
10/18/18 APPE Student in Anticoagulation Saint Joseph Health Ambulatory Care APPE Student 4
clinic System
Mishawaka, IN
10/18/18 Oral Case Presentation Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System and Pharmacy Residents
Mishawaka, IN
10/20/18 APPE Student Present Patient Saint Joseph Health Ambulatory Care APPE Student 1
Cases System
Mishawaka, IN
10/21/18 APPE Student Present Patient Saint Joseph Health Ambulatory Care APPE Student 4
Cases System
Mishawaka, IN
10/21/18 Final Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System
Mishawaka, IN
10/22/18 APPE Student in Diabetes Clinic Saint Joseph Health Ambulatory Care APPE Student 3
System
Mishawaka, IN
10/22/18 Orientation of APPE Student Saint Joseph Health Ambulatory Care APPE Student 3
System and Pharmacy Residents
Mishawaka, IN
10/24/18 Physical Skills Assessment Saint Joseph Health Ambulatory Care APPE Student 0.5
System and Pharmacy Residents
Mishawaka, IN
10/29/18 Oral Case Presentation Evaluation Saint Joseph Health Ambulatory Care APPE Student 1.5
System and Pharmacy Residents
Mishawaka, IN
11/1/18 APPE Student Present Patient Saint Joseph Health Ambulatory Care APPE Student 1
Cases System
Mishawaka, IN

INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

Updated 10/2018
 IPTeC INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

11/2/18 Midpoint Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System
Mishawaka, IN
11/8/18 APPE Student Present Patient Saint Joseph Health Ambulatory Care APPE Student 1
Cases System
Mishawaka, IN
11/9/18 APPE Student in Diabetes Clinic Saint Joseph Health Ambulatory Care APPE Student 4
System
Mishawaka, IN
11/12/18 Oral Case Presentation Evaluation Saint Joseph Health Ambulatory Care APPE Student 1.5
System and Pharmacy Residents
Mishawaka, IN
11/15/18 APPE Student Present Patient Saint Joseph Health Ambulatory Care APPE Student 1
Cases System
Mishawaka, IN
11/16/18 APPE Student in Diabetes Clinic Saint Joseph Health Ambulatory Care APPE Student 4
System
Mishawaka, IN
11/16/18 Final Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System
Mishawaka, IN
1/2/19 APPE Student Orientation Saint Joseph Health Ambulatory Care APPE Student 5
System and Pharmacy Residents
Mishawaka, IN
1/3/19 APPE Student Present Patient Saint Joseph Health Ambulatory Care APPE Student 0.5
Cases System
Mishawaka, IN
1/4/19 Oral Case Presentation Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System and Pharmacy Residents
Mishawaka, IN
1/11/19 Midpoint Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System
Mishawaka, IN
1/21/19 Oral Case Presentation Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System and Pharmacy Residents
Mishawaka, IN
1/25/19 Final Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System
Mishawaka, IN
2/25/19 APPE Student Orientation Saint Joseph Health Ambulatory Care APPE Student 5
System and Pharmacy Residents
Mishawaka, IN
2/26/19 Oral Case Presentation Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System and Pharmacy Residents
Mishawaka, IN

INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

Updated 10/2018
 IPTeC INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

02/27/19 APPE Student Present Patient Saint Joseph Health Ambulatory Care APPE Student 1
Cases System
Mishawaka, IN
03/08/19 Midpoint Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System
Mishawaka, IN
03/22/19 Final Evaluation Saint Joseph Health Ambulatory Care APPE Student 1
System
Mishawaka, IN

INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

Updated 10/2018
 IPTeC INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

Topic discussions/Journal clubs

09/31/18 Diabetes Topic Discussion Saint Joseph Health Ambulatory Care APPE Students 1.5
(Presenter) System
Mishawaka, IN
10/5/18 Journal Club Presentation Saint Joseph Health Ambulatory Care APPE Students, 1
(Facilitated) System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
10/14/18 Topic Discussion (Facilitated) Saint Joseph Health Ambulatory Care APPE Students, 1
System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
10/21/18 Final Presentation (Facilitated) Saint Joseph Health Ambulatory Care APPE Students, 1
System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
10/31/18 Journal Club Presentation Saint Joseph Health Ambulatory Care APPE Students, 1.5
(Facilitated) System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
11/2/18 Diabetes Topic Discussion Saint Joseph Health Ambulatory Care APPE Students 1
(Presenter) System
Mishawaka, IN
11/9/18 Topic Discussion (Facilitated) Saint Joseph Health Ambulatory Care APPE Students, 1.5
System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
11/15/18 Final Presentation (Facilitated) Saint Joseph Health Ambulatory Care APPE Students, 1.5
System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
11/28/18 Medication use within the Geriatric Saint Joseph Health Family Practice Medical Resident 1
Population & Medicare (Presenter) System
Mishawaka, IN
1/3/18 Diabetes Simulation (Presenter) Saint Joseph Health Ambulatory Care APPE Students 1
System
Mishawaka, IN
1/7/19 Diabetes Topic Discussion Saint Joseph Health Ambulatory Care APPE Students 1
(Presenter) System
Mishawaka, IN
1/10/19 STEPS Group Presentation Saint Joseph Health Ambulatory Care APPE Students, 2
(Facilitated) System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
1/16/19 Clinical Trial Presentation Saint Joseph Health Ambulatory Care APPE Students, 1
(Facilitated) System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
1/16/19 Medication use within the Geriatric Saint Joseph Health Family Practice Medical Resident 1
Population & Medicare (Presenter) System
Mishawaka, IN

INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

Updated 10/2018
 IPTeC INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

1/18/19 Clinic Shark Tank (Facilitated) Saint Joseph Health Ambulatory Care APPE Students, 1
System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
1/23/19 Final Presentation (Facilitated) Saint Joseph Health Ambulatory Care APPE Students, 1
System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
02/28/19 Topic Discussion Saint Joseph Health Ambulatory Care APPE Students 1
System
Mishawaka, IN
03/03/19 Diabetes Topic Discussion & Saint Joseph Health Ambulatory Care APPE Students 1
Diabetes Simulation (Presenter) System
Mishawaka, IN
03/06/19 Clinical Trial Presentation Saint Joseph Health Ambulatory Care APPE Students, 1
(Facilitated) System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
03/20/19 Final Presentation (Facilitated) Saint Joseph Health Ambulatory Care APPE Students, 1
System Pharmacy Residents, and
Mishawaka, IN Ambulatory Care Pharmacists
03/21/19 Medication use within the Geriatric Saint Joseph Health Family Practice Medical Resident 1
Population & Medicare (Presenter) System
Mishawaka, IN
Laboratory/Recitation/Case facilitation
09/06/18 Prescription Verification and Manchester First-Year Pharmacy Student Lab 5
Counseling Lab University College of Manchester University
Pharmacy ~35 Students
Fort Wayne, IN
10/17/18 SBAR Lab with Manchester Manchester Second-Year Pharmacy Student 5
University University College of Lab
Pharmacy Manchester University
Fort Wayne, IN ~35 Students
(Coordinated
Remotely)
10/24/18 Medical Counseling Skills and Notre Dame SCPP 30401: Medical Counseling 1.25
Patient-Centered Medicine: University Skills and Patient-Centered
Motivational Interviewing Case South Bend, IN Medicine
Facilitation ~30 Students

03/21/19 Medical Counseling Skills and Notre Dame SCPP 30401: Medical Counseling 1.25
Patient-Centered Medicine: University Skills and Patient-Centered
Motivational Interviewing Case South Bend, IN Medicine
Facilitation ~30 Students

Additional teaching experiences

09/04/18 Diabetes Group Class #1 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants

INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

Updated 10/2018
 IPTeC INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

09/11/18 Diabetes Group Class #2 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants
09/18/18 Diabetes Group Class #3 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants
09/25/18 Diabetes Group Class #4 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants
10/2/18 Diabetes Group Class #1 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants
10/9/18 Diabetes Group Class #2 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants
10/16/18 Diabetes Group Class #3 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants
10/23/18 Diabetes Group Class #4 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants
11/6/18 Diabetes Group Class #1 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants
11/13/18 Diabetes Group Class #2 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants
11/20/18 Diabetes Group Class #3 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants
11/27/18 Diabetes Group Class #4 Saint Joseph Health Saint Joseph Health System 2
System Family Medicine Center Diabetes
Mishawaka, IN Group Classes ~8-10 participants

09/26/18 Osteoporosis Saint Joseph Health Pharmacy Team Didactics: 1

System Ambulatory Care Pharmacists and
Mishawaka, IN Pharmacy Residents
11/28/18 Diabetes Group Classes Update Saint Joseph Health Pharmacy Team Didactics: 1
System Ambulatory Care Pharmacists and
Mishawaka, IN Pharmacy Residents

INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

Updated 10/2018
 IPTeC INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

01/16/2019 Smoking Cessation Group Class Saint Joseph Health Saint Joseph Health System 1
System Smoking Cessation Community
Mishawaka, IN Classes

01/16/19 Hardwiring Excellence Part 1 Saint Joseph Health Pharmacy Team Didactics: 1
System Ambulatory Care Pharmacists and
Mishawaka, IN Pharmacy Residents
01/16/19 GERD Box Saint Joseph Health Pharmacy Team Didactics: 1
System Ambulatory Care Pharmacists and
Mishawaka, IN Pharmacy Residents
2/2019 Manchester University Capstone: Manchester Manchester University Capstone: 8
Care Plan Grading University College of Care Plan Grading
Pharmacy
Fort Wayne, IN
04/03/19 If Disney Ran Your Hospital:9 ½ (Coordinated
Saint Joseph Health Pharmacy Team Didactics: 1
Things You Would Do Differently Remotely)
System Ambulatory Care Pharmacists and
Mishawaka, IN Pharmacy Residents
05/01/19 GI Bleeds Saint Joseph Health Pharmacy Team Didactics: 1
System Ambulatory Care Pharmacists and
Mishawaka, IN Pharmacy Residents

INDIANA PHARMACY RESIDENT TEACHING CERTIFICATE PROGRAM

Updated 10/2018