Module 8

[Audio] Welcome to the Career Readiness & Externships: Soft Skills for Pharmacy Technician's Externship Preparation & Practice presentation. This module walks you through several stages of the externship process. Some of the topics include general and program-specific externship requirements, registration paperwork, prerequisite health screening and background checks, preceptor assignment and initial meeting, facility orientation, and expected technical and professional competencies of an extern..

[Audio] In this module, you will: Define the terms experiential learning and preceptor. Recognize the benefits that an externship provides to students and to practice sites. Understand the general externship requirements, including the submission of personal identification and educational documentation. Know the experiential hour requirements and program levels for schools accredited by ASHP/ACPE. Learn the program-specific externship requirements, including knowledge of learning objectives, responsibilities of externs, related externship assignments, required hours, state pharmacy laws and regulations, and provisions for transportation and childcare..

[Audio] Understand pre-externship health screening requirements, including a physical exam, an immunization update, and a urine drug test. Recognize the components of a criminal background check, a mandatory procedure for externship participation. Understand the general externship requirements, including the submission of personal identification and educational documentation. Prepare for an initial meeting with your preceptor and a facility orientation. Know the professional and technical competencies expected of an extern..

[Audio] As a pharmacy technician student, you must fulfill the education and training requirements established by your state's board of pharmacy. If your academic program adheres to the standards of the American Society of Health-System Pharmacists (ASHP) and the Accreditation Council for Pharmacy Education (ACPE), you must also complete an experiential learning experience in an actual pharmacy setting. In experiential learning you will further develop the knowledge and skills of a pharmacy technician while engaged in a professional work environment. Consequently, experiential learning is considered "learning by doing" and is referred to by many names: externship, internship, apprenticeship, practice experience, or practicum. For pharmacy technician programs, the most commonly used term is externship. A pharmacy externship site has a seasoned pharmacy professional, such as a pharmacist or another pharmacy technician, who serves as a preceptor. This individual is responsible for your training while participating in an externship and serves as the primary contact between the school and the practice site. As part of those responsibilities, a preceptor coordinates your schedule, signs your time sheets, conducts your midterm and final evaluations, and oversees your training..

[Audio] The Module 8 Section 8.1: Benefits of an Externship presentation for the Career Readiness & Externships: Soft Skills for Pharmacy Technicians program covers the basic concepts of externship preparedness, such as the benefits to the student and to the practice site. An externship provides you with the opportunity to step into the role of a pharmacy technician in a variety of settings. Under the guidance of a preceptor, you will apply the knowledge, skills, and abilities you learned in your academic program to your technician responsibilities in a pharmacy setting. This authentic experience is beneficial to your professional development. However, you may be surprised to learn that your externship may also be beneficial to the practice site itself..

[Audio] The student benefits of an externship are considerable. The experience allows you to assess your current knowledge and skills, gain real-world pharmacy experience, undergo pharmacy software training, learn from the guidance of a professional mentor, and profit from networking opportunities. Assesses Your Current Knowledge and Skills. An externship is a means to gauge your ability to apply your academic knowledge. It also allows you to practice your soft skills and professionalism while performing daily tasks and interacting with patients. Consequently, your externship helps you to assess the proficiencies and deficiencies of your knowledge, skills, and abilities. This assessment helps you to improve those areas of deficiency as you prepare for the national certification exam and your entrance into the job market. Provides Real-World Pharmacy Practice. An externship offers you an authentic pharmacy practice experience. This experience is different from the simulated practice environment that was part of your academic instruction. One difference is that you will gain experience with site-specific technologies and processes that may not be covered in your academic coursework. Another distinction is that real-world practice has real-life consequences for patients. For that reason, you must seek frequent guidance and feedback from your preceptor and pharmacy colleagues as you perform your daily responsibilities. Another benefit of an authentic pharmacy practice experience is that the training provides you with a level of comfort prior to securing an entry-level position. You gain experience in several areas: daily operations of a pharmacy, roles of pharmacy staff members, interprofessional skills, customer service relations, time management, efficiency, problem-solving scenarios, conflict management, and proficiency in dispensing medications..

[Audio] Supplies Pharmacy Software Training. An externship provides you with training in the use of pharmacy software programs. These programs support different pharmacy operations, depending on the setting. Such operations include entering prescription data, printing prescription medication labels, using a retail point-of-sale system, conducting inventory, and tracking medications. These programs also serve as databases of patients, prescribers, medications, and insurance companies. The pharmacy software program that you learn during your externship may or may not be the program used at the pharmacy where you secure your entry-level position. The good news is that all pharmacy software programs are designed to essentially perform the same functions. If you learn one system, it becomes much easier to learn another one. Provides a Professional Mentor. Your externship program is under the tutelage of a preceptor. This experienced individual serves as a professional mentor and externship supervisor who provides guidance, advice, and support during your externship. Once your externship is completed, your preceptor will be an invaluable resource for career opportunities and provide a reference for your career portfolio. For that reason, make every effort to establish a strong, positive, professional relationship with your mentor. Other pharmacy employees you work with during your externship will also provide you with guidance during your training. Make every effort to establish good relationships with your colleagues and seek their guidance as needed. Offers Networking Opportunities. An externship is an opportunity for you to demonstrate your knowledge, skills, and professional demeanor to a potential employer. For that reason, consider your externship as a "working interview" for a potential position after you graduate. Your demonstrated job competencies and interactions with your colleagues and patients provide a pharmacy manager with insight into how well suited you are for employment at that facility. Even if that pharmacy does not have an opening when you begin your job search, the relationships that you establish with the healthcare staff (such as the preceptor, pharmacy colleagues, providers, nurses) form a professional network that may assist you in launching your career. Be sure to ask individuals with whom you have closely worked during your externship for contact information and references before completing your externship..

[Audio] Think It Through: Building Your Pharmacy Relationships. Consider how you interact with individuals in positions of authority: supervisors, instructors, coaches, and so on. What aspects of these interactions can you bring to your relationship with a preceptor? How can you demonstrate initiative to a preceptor and other pharmacy employees during an externship?.

[Audio] The practice site itself benefits from participating in pharmacy technician externships in conjunction with academic programs. These benefits include an increase in staffing, an investment in the pharmacy profession, and an enhanced public image. Provides Additional Staff. While participating in your externship, you are considered a contributing staff member. You provide an extra pair of hands to assist pharmacy personnel in meeting the healthcare needs of customers and patients. Although initially your training may have a minimal positive impact on pharmacy procedures, you will, with time, learn the facility's operations and become comfortable and competent in your responsibilities. Invests in the Future of the Pharmacy Profession. A pharmacy's externship program keeps the pharmacy profession moving forward. Pharmacy technician students who have a positive externship experience are inclined to continue in the profession and secure its future success. Employers that train students, even if they are unable to employ them at their facility, help improve the quality of every pharmacy technician who comes through their facility. This training helps to raise the level of competency for technicians throughout the industry. Enhances Public Image. An externship practice site is an investment in the local community. The relationship between the school and the pharmacy promotes the pharmacy's views on the importance of education..

[Audio] Workplace Wisdom: Leveling Up. Be aware that the initial phase of your training may slow down pharmacy operations. Your training may also test the patience of some colleagues, who may be used to working with personnel who know the ins and outs of that facility's processes. However, with time, that phase will transition to a more collaborative practice environment. As you become versed in the processes and procedures, your presence will speed up operations. Remember to always give your maximum effort while working to compensate for any decrease in efficiency in the early stages of your training..

[Audio] The Module 8 Section 8.2: General Externship Requirements presentation for the Career Readiness & Externships: Soft Skills for Pharmacy Technicians program covers the basic concepts of externship preparedness, such as completing basic requirements and professional standards. General externship requirements vary among states, schools, employers, and practice sites. For that reason, check with your externship coordinator for the externship requirements associated with your program. Often, these requirements are addressed in an orientation just before your externship begins. Basic requirements include the submission of proper identification (ID) and academic documentation. In addition, if your school is accredited by ASHP/ACPE, you must fulfill the externship requirements set by those organizations..

[Audio] Submitting the required documentation within the allotted time frame designated by your school is critical. This documentation typically includes a proper means of personal ID, your educational documents, and—in some states—evidence of your state registration or licensure. This evidence may be a technician-in-training license or registration. Verify the necessary paperwork with your externship coordinator. Present Personal ID. You are required to submit proof of personal ID, such as a driver's license or photo ID card, before beginning a pharmacy technician externship. Submit Educational Documents. To participate in a pharmacy technician externship, you must meet your state requirements for eligibility. These requirements may vary, but typically you must be enrolled in a high school program, have attained a high school diploma, or have passed a general educational development (GED) test. You must also be actively enrolled in a pharmacy technician program, have taken your program's required prerequisite courses, and have earned the stated grade minimums in these courses. Submit State Registration and Certification Documents. Before participating in an externship, some states require that you are registered as a pharmacy technician trainee and licensed with the state, with no suspension, limitation, revocation, or denial of your registration or licensure. In some states, this license may be called a technician-in-training license, which is similar to a learner's permit for driving. It allows you to perform technician duties while learning under the supervision of others. Once you have fulfilled your course of study, this technician-in-training license converts to a full pharmacy technician license. The acquisition of this registration or license is typically handled by the externship coordinator in your program of study..

[Audio] All pharmacy technician programs that have earned accreditation by the American Society of Health-System Pharmacists (ASHP) and the Accreditation Council for Pharmacy Education (ACPE) must adhere to the organizations' standards for the fulfillment of a pharmacy technician externship. The ASHP/ACPE Accreditation Standards are developed to do the following: • protect the public by ensuring the availability of a competent workforce. • describe pharmacy technician education and training program development at the entry level and the advanced level. • provide criteria for the evaluation of new and established education and training programs. • promote continuous improvement of established educational and training programs. These standards state that an externship must be an authentic, hands-on experience under the supervision of a preceptor. An externship cannot be a job-shadowing or simulated experience. As such, you are given the opportunity to practice most of the activities that pharmacy technicians perform daily in a given setting. One of the few areas you may not be allowed to practice would be the handling of money during dispensing transactions. Because you are considered a pharmacy team member during your externship, you must abide by the policies and procedures of the practice site..

[Audio] The current ASHP/ACPE Accreditation Standards include two levels of pharmacy education and training: entry level and advanced level. These levels can be offered sequentially or concurrently. The term sequentially means that you must complete the entry-level coursework before you are eligible to pursue the advanced-level coursework. The other option that schools have is to offer both levels simultaneously as part of an all-inclusive program. These levels reflect the expected competencies needed in entry-level and advanced-level roles in a variety of pharmacy settings. The entry-level and advanced-level programs share a similar framework. Both programs have three educational components: didactic, simulated, and experiential. The didactic educational component is the instruction that provides a foundation for the simulated and experiential components. It is the knowledge learned in an academic setting. The simulated educational component refers to hands-on practice in a simulated pharmacy environment, such as a school lab, that has no real-world consequences. The experiential educational component is an externship experience in a real-world pharmacy setting..

[Audio] If you are enrolled in an entry-level program, you need to obtain 400 health-related curriculum hours over a period of eight weeks, of which 300 hours are specified by educational modality: • 120 hours of didactic component. • 50 hours of simulated component. • 130 hours of experiential component. The remaining 100 hours may be allocated to any of these three modalities, as specified by your academic program. When you have finished your entry-level program, you are issued a certificate of completion or a diploma. If you are enrolled in an advanced-level program, you must obtain an additional 200 health-related curriculum hours over a period of at least seven weeks, of which 160 hours are specified by educational modality: • 40 hours of didactic component. • 50 hours of simulated component. • 70 hours of experiential component. The remaining 40 hours may be allocated to any of these three modalities, as specified by your academic program. When you have finished your advanced-level program, you are issued a certificate of completion or a diploma..

[Audio] The Module 8 Section 8.3: Program-Specific Externship Requirements presentation for the Career Readiness & Externships: Soft Skills for Pharmacy Technicians program covers the basic concepts of externship preparedness, such as understanding the learning objectives and responsibilities of an externship and extern, respectively. Your program director, adviser, or externship coordinator typically meets with you to discuss program-specific externship requirements. This discussion may address the learning objectives of an externship and the student responsibilities while working at the pharmacy site..

[Audio] Before beginning an externship, you should be familiar with the learning objectives that your school has established for this experience. Learning objectives are statements that define what is meant to be learned in a given course of study. These learning objectives are based on the skill sets that pharmacy technicians must demonstrate in a workplace. These objectives will appear in your course syllabus as well as in your midterm and final evaluations completed by your preceptor. Review these learning objectives before starting your externship to ensure that you understand the expectations of this experiential learning experience. Also, periodically review the skill sets during your externship to gauge your level of competency and to target areas for growth or improvement before starting your career search..

[Audio] Learn the Related Externship Assignments. Your coordinator will discuss with you the related items that must be completed during your externship. These items may include progress reports, interviews, time sheets, evaluations, and competencies. You are responsible for the completion and timely submission of these items. In addition, you are accountable for fulfilling the required number of externship hours for the program, knowing your state's pharmacy laws and regulations, observing patient privacy standards, and arranging transportation and childcare (if applicable) during this practice experience. Your program may require you to complete related assignments while participating in your externship. Make sure that you are aware of any assigned activities, including their guidelines, due dates, and percentage of your final grade. Complete the Required Hours. The number of externship hours that must be completed are determined by your school and, possibly, your state board of pharmacy. Institutions accredited by ASHP/ACPE must adhere to the minimum number of experiential hours required by these organizations. However, many of these accredited schools require additional experiential hours than the ASHP/ACPE standards state. Your school also determines the number of weeks per term and the minimum number of hours per week for pharmacy technician externships. To document your experiential hours, you will complete daily or weekly time sheets that will be signed by your preceptor and reviewed by your externship coordinator..

[Audio] Know Your State's Pharmacy Laws and Regulations. As a pharmacy extern, you are required to follow your state board of pharmacy's laws and regulations during your externship. For example, in some states, you must maintain an active registration as a pharmacy technician or technician-in-training during your experiential rotation(s). Other states have different requirements for pharmacy externs. For that reason, be sure to investigate what is needed for registration or licensure before your practice experience. No matter where you reside, you must adhere to the scope of practice set forth by your state's board of pharmacy. Scope of practice determines what responsibilities pharmacy technicians may assume. These responsibilities vary among states; for example, pharmacy technicians in Idaho are allowed to administer immunizations. For that reason, familiarize yourself with state laws that dictate what you can and cannot do in a pharmacy setting. Your preceptor will also provide guidance regarding scope of practice during your externship. Observe Patient and Pharmacy Confidentiality Standards. As a pharmacy extern, you are required to uphold the patient confidentiality standards dictated by the Health Insurance Portability and Accountability Act (HIPAA) of 1996. These standards prohibit the acquisition, access, use, or disclosure of patient health information and patient records by any means: electronic, written, or verbal communication. This legislation also does not allow you, as an extern, to access your own medical records under any circumstance. You must also adhere to these pharmacy confidentiality standards during your externship. While all pharmacies in the country must follow the law regarding HIPAA, the procedures in which they do so may vary. In some facilities, pharmacy personnel discard documents containing patient information in dedicated, color-coded shred bins. Personnel in other pharmacies may use a separate garbage bin devoted to the disposal of patient documents. Patient acknowledgment of privacy laws may differ among pharmacies as well. In some facilities, pharmacy personnel ask patients to provide an electronic signature as verification of their understanding of HIPAA standards. Personnel in other pharmacies may ask patients to sign a paper logbook. Be sure that you know the policies of your practice site regarding the disposal of patient information and the patient acknowledgment of HIPAA standards..

[Audio] Find Transportation. You are responsible for your transportation to and from the externship practice site(s). If you do not have access to a vehicle, you may want to research public transportation options once you receive your externship assignment. Other options include using a ride-hail service, such as Uber or Lyft, or posting your interest in ride-sharing at your school or on a social media site. Be sure to factor transportation costs into your budget for the academic term. Secure Childcare. If you need childcare, explore your options well before the start of your pharmacy externship. Having a schedule for your childcare coverage is important information to relay to your externship coordinator and to your preceptor at your initial meeting. Like your transportation costs, be sure to factor in your childcare expenditures when creating your budget for the academic term..

[Audio] Think It Through: Assessing Your Backup Plans. Proper planning before the start of your externship allows you to have a successful practice experience and to make a favorable impression on a potential future employer. Consider your current schedule, responsibilities, and potential challenges that may interfere with your externship. Have you made backup plans to manage any situations or difficulties that may arise? What specific backup plans would help you navigate these possible challenges?.

[Audio] The Module 8 Section 8.4: Pre-externship Screening presentation for the Career Readiness & Externships: Soft Skills for Pharmacy Technicians program covers the basic concepts of externship preparedness, such as submitting to a health screening and criminal background check. As an extern, you are not an employee of a pharmacy, but you are expected to behave as if you were. You must adhere to the facility's policies and procedures during your practice experience. For that reason, you must typically undergo a pre-externship health screening and a criminal background check before the start of your externship..

[Audio] A health screening is required for healthcare personnel due to their preparation of medications and their contact with customers or patients. The typical components of this health screening are a physical exam, an immunization update, and a drug-screening test. Documented evidence of the results of this health screening, known as a health screening attestation form, must be submitted to your practice site before the start of your externship. Your externship coordinator typically handles the submission of these forms to your practice site, but you may be responsible for their submission. If you are responsible, be sure to adhere to the established deadline of the practice site for this information..

[Audio] Undergo a Physical Exam. To ensure that you have the physical stamina to meet the demands of a fast-paced pharmacy environment, including long periods of standing on your feet, you will undergo a physical exam. This basic exam typically entails assessing your blood pressure, heart rate, height and weight, balance while standing, mobility, and ability to lift a minimum weight, such as 15 lbs. Receive Required Immunizations. Before the start of your externship, you must submit an up-to-date immunization record as proof that you have received the vaccines and tests required by your school or practice site. Because you will be in close contact with many customers and patients during your practice experience, it is important that you do not contribute to the spread of a viral or bacterial infection. The required vaccines and tests may vary among practice sites. For example, a two-step skin test or QuantiFERON-TB Gold blood screening for tuberculosis is mandatory for personnel working in a hospital setting. A current flu shot may also be required by certain pharmacy settings during flu season. You can receive these immunizations and tests at a physician's office, clinic, pharmacy, health center, or travel clinic. Remember that some immunizations, such as hepatitis B or the MMR booster, require a series of injections to provide immunity. For that reason, be sure to check your immunization record well ahead of the start of your externship. If you do not have access to your immunization record, there are several ways to obtain it, depending on the state where the immunizations were administered. You can search online databases or communicate with the health department of the state where you received the immunizations to request these documents. Take a Drug-Screening Test. As part of your health screening, you are required to undergo a drug-screening test. This test identifies if there are illicit drugs or substances in your system. As such, this test is critical for pharmacy personnel due to their access to controlled substances. The fee for this test may be covered as part of your tuition, so check with your externship coordinator. If the fee is not part of your tuition, you are responsible for paying it. Typically, the drug-screening test that is required for a pharmacy technician externship is a urine drug test. This test analyzes a urine specimen for specific drugs and chemicals, such as marihuana and opioids. The presence of any of these substances in your urine specimen, except a medication that has a valid prescription, may prevent you from participating in an externship. Consequently, the time and money that you have invested in your academic program would be wasted and have no tangible outcome..

[Audio] You will follow a specific protocol to take a urine drug test. This protocol ensures that you are not submitting a fraudulent urine specimen for analysis. After receiving a urine specimen cup and moist cloth from the supervising technician administering the test, you will empty your pockets and place your belongings in a locker. Then you will enter the bathroom, cleanse your genitals with the moist cloth, and void a minimum of 45 mL of urine into the specimen cup. When you have finished voiding, you will place a lid on the cup. Then, without flushing the toilet, you will exit the bathroom and hand your cup to the technician. The technician will then measure the temperature of your urine to ensure that it is within the expected range for a recently voided specimen. Finally, the technician will seal and package the urine specimen in your presence and send the specimen to the laboratory. You will also be required to take some type of drug-screening test before you begin an entry-level pharmacy position. Depending on the hiring facility, you may need to submit a urine specimen or a hair sample. Once you begin your employment, you will undergo regular or random drug-screening tests, depending on the facility's policies..

[Audio] Your school or program of study will have a policy regarding the drug-screening process and what constitutes a failed test. Synthetic urine, controlled substances without a valid prescription, or illegal substances are all things that could constitute a failed test and prevent you from starting your externship. Marijuana has now been legalized in many states for both recreational and medicinal use. However, marijuana is still categorized by the federal government as a Schedule One controlled substance. This dilemma is a gray area in the drug-screening process for states where marijuana use is legal. In most states where marijuana has been legalized, a positive test for marijuana can be ignored. However, this decision rests with the institution. It is entirely the school's right to expect students to not use marijuana while enrolled in their program of study. Furthermore, it is the legal right of employers to choose whether they want to employ someone who uses marijuana, despite its legality. Check your institution's policy regarding a drug-screening test. In addition, talk with your instructor, program chair, or externship coordinator about how a drug-screening test is handled if you live in a state where marijuana is legal..

[Audio] As part of your prescreening employment, you are required to undergo a criminal background check. This procedure applies to all pharmacy employees because of their access to medications—in particular, controlled substances. A criminal background check is often performed as part of the enrollment process with a program of study or before the start of an externship. Check with your program adviser or externship coordinator to determine what actions you must take to fulfill this background check. Disqualifying factors for a pharmacy technician externship include a felony conviction; a suspension, denial, revocation, or limitation on your registration or licensure; or a history of drug-related offenses, including misdemeanors. In some states, such as Nevada, noncompliance with court-ordered child support can prevent a technician-in-training registration and, therefore, can prohibit an individual from completing an externship..

[Audio] Read each statement. Do you feel confident that you can say "yes" to that statement? If not, consider what steps you can take to gain self-awareness in that area. I know the name of the externship coordinator of my pharmacy technician program. I know the pharmacy settings that are available for my externship. I have researched potential externship sites to learn more about them. I am familiar with the roles of pharmacy technicians in various settings. I understand the program-specific externship requirements of my state and school. I understand the need for a health screening and criminal background check before my externship. I feel that my knowledge and skills have prepared me for my externship responsibilities. I have secured reliable transportation to get to and from my practice site. I have arranged my schedule to ensure my availability for my externship. I have made backup plans for any potential challenges to the completion of my externship. I understand the importance of my professional conduct while participating in an externship. I understand the state laws and regulations that dictate the scope of practice for pharmacy technicians..

[Audio] The Module 8 Section 8.5: Externship Assignment presentation for the Career Readiness & Externships: Soft Skills for Pharmacy Technicians program covers the basic concepts of externship preparedness, such as your assignment, rotation requirements, and preceptor..

[Audio] Often, a school's pharmacy technician program has several long-standing partnerships with local pharmacies that host externs for their rotations. Your externship coordinator typically arranges your externship with one of these pharmacies and then meets with you to relay the assigned practice site. When determining your placement, the coordinator considers several factors: • your academic performance • your punctuality and attendance • your behavioral, social, communication, and observational skills • your lab skills (for example, prescription entry, pill counting, sterile compounding) Remember that you are representing the school as well as yourself when you participate in an externship. Therefore, you must exhibit professional behaviors while working at the practice site. If your preceptor reports that you have work-related issues despite corrective feedback, you risk a possible termination from your externship. Termination from an externship site is equivalent to failing a course in your program of study. Your poor performance or unprofessional behavior also jeopardizes the school's partnership with the practice site, which may affect the externship options for future students..

[Audio] The externship coordinator of your pharmacy technician program may post a few practice sites on the school's website and allow you to rank available sites in terms of preference. A program that offers this privilege is not required to grant your request, just as it is not required to grant your request for a specific instructor in your academic program. Other pharmacy technician programs may have you secure your own externship practice site. Most often, your externship coordinator or program director will discuss viable options with you based on your location, availability, and preferences and work with you to try to place you at the most optimal setting..

[Audio] Depending on your school's program, you may be required to rotate through two different pharmacy settings, which may include a community pharmacy, institutional pharmacy, long-term care pharmacy, or mail-order pharmacy. These rotations provide you with an opportunity to use skill sets that may be specific to a certain setting. For example, participating in a community pharmacy externship hones your customer service skills. However, an institutional pharmacy externship gives you more experience with automation and sterile compounding. Your externship coordinator will let you know of the site rotation requirements for your institution..

[Audio] Whether you have the option of choosing your practice site or being assigned one, you should research the site before beginning your externship. Check out basic information about the facility on its website: its location, hours of operation, number of employees, and services. You may also want to review the facility's profile on various social networking sites. Becoming familiar with the pharmacy before beginning your externship provides you with a basic level of comfort regarding the pharmacy's staff and customer or patient services..

[Audio] Your externship coordinator will relay the name of your preceptor at your assigned practice site. You or your coordinator will contact your preceptor to set up either the first day to start your externship or an initial meeting with your preceptor. At that meeting, your preceptor will discuss the preceptor/extern professional relationship, create a mutually agreed-upon work schedule, review evaluation and grading parameters, and conduct a facility orientation. Discuss the Preceptor/Extern Professional Relationship. Your preceptor serves as a supervisor and mentor during your externship, and will offer guidance to help you learn pharmacy operations and navigate professional relationships. Therefore, it is important to establish a good working relationship from the start. At your initial meeting with your preceptor, be sure to create a good first impression by arriving on time for the meeting, exhibiting professionalism in your communications and behaviors, and demonstrating your willingness to learn more about the technician position in a pharmacy. Your preceptor, in turn, will discuss the role of a preceptor in your professional development and the expectations of the position. These expectations include your demonstration of professional and technical competencies..

[Audio] You can foster a good professional relationship with your preceptor by exhibiting the following behaviors: • demonstrating your understanding of all federal and state laws and regulations in your daily responsibilities. • following the policies and procedures of your practice site. • being an active participant and a good listener during your experiential learning experience. • demonstrating respect for your preceptor and other healthcare colleagues while performing your daily tasks. • checking with your preceptor when making professional decisions. • asking questions of your preceptor when you need clarification on a specific task. • seeking guidance from your preceptor, as necessary, to navigate a conflict or disagreement. • using common sense when performing your work responsibilities. • learning from your preceptor's constructive criticism. • demonstrating accountability for your actions..

[Audio] Create a Work Schedule. You and your preceptor will create a work schedule that accommodates your other commitments (for example, a full-time job, classes, or family obligations) as well as the needs of the pharmacy. Be sure to discuss the number of hours that you can work per day and per week so that you can fulfill the required number of experiential hours needed for your program. Once your preceptor has created the schedule, make a copy for yourself as well as one for your academic adviser. Any subsequent changes to your schedule must be approved by your preceptor and your externship coordinator. Your coordinator will provide you with guidance on the completion of daily or weekly time sheets and their form of submission (either a paper or an electronic form). Your coordinator will also relay the options for making up missed time due to illness, vacation, or an emergency. Be aware that your time sheets must accurately reflect the time you have worked at the pharmacy and must be signed by your preceptor and submitted to your externship coordinator either weekly or at the completion of your externship. Finally, your preceptor will discuss the ramifications of habitual tardiness and distracted behaviors at work. Engaging in these behaviors reflects a poor work ethic and has a negative impact on your performance evaluations. Be aware that continuing these behaviors after warnings from your preceptor may result in a failing final grade or termination of your externship..

[Audio] Workplace Wisdom: Doctoring Time Sheets. Your time sheets must reflect an accurate, truthful account of your work hours at the pharmacy. If you were to claim hours you did not work during your employment, you likely would be terminated. If you were to forge hours you did not work during your externship, you likely would be terminated as well. These actions reflect dishonest, unethical behavior, which cannot be traits of a pharmacy technician..

[Audio] Review Evaluation and Grading Parameters. Typically, you will receive two performance evaluations: one midterm appraisal and one final appraisal. These evaluations are completed by your preceptor and reflect observations of your demonstrated competency in each learning objective. Both evaluations are conducted in a private setting. During the midterm and final evaluations, your preceptor will provide you with feedback on practice areas in which you excel as well as areas that need continued development. These evaluations are similar to annual employee evaluations and should be used as a tool for continual improvement. You or your preceptor will send a copy of your midterm and final evaluations to your externship coordinator. These evaluations, as well as related activities assigned by your coordinator, will factor in to your final grade for the term..

[Audio] Participate in a Facility Orientation. Before the start of your externship, your preceptor will conduct a facility orientation to explain the pharmacy's hours of operation, layout, and security. Your preceptor will also discuss areas for vehicle parking and storage of your personal belongings. One important topic that your preceptor may cover during your orientation is the facility's Policy and Procedures (P&P) manual. The P&P manual discusses the policies and procedures that reflect federal and state laws governing pharmacy practice. The manual also outlines specific pharmacy procedures that allow the facility to run safely and efficiently. Additional topics in the P&P manual relate to pharmacy personnel, such as their roles; scope of practice; expected professional behaviors and disciplinary actions for failing to meet those expectations; dress code, including personal ID badges; and ethical responsibilities. Be sure that you study the facility's P&P manual so that your actions are aligned with the pharmacy's policies. Your facility orientation also provides an opportunity for you to meet some of your pharmacy colleagues. Use this opportunity to create a good first impression with individuals by offering a friendly greeting and acknowledging that you are looking forward to working with them and learning from their expertise. These individuals will be invaluable resources to help you navigate your work responsibilities. They may also be assigned to train you in various areas of the pharmacy..

[Audio] Read each statement. Do you feel confident that you can say "yes" to that statement? If not, consider what steps you can take to improve in that area. I know the role of my externship preceptor. I understand the importance of building a strong working relationship with my preceptor. I have considered what questions I would like to ask my preceptor before beginning my externship. I have prepared answers to questions I may be asked by my preceptor at our initial meeting. I am comfortable asking my preceptor questions about what I am expected to learn while participating in my externship. I understand that I am accountable for my attitude and behaviors during my externship. I understand the importance of constructive criticism by my preceptor and am open to it. I understand the practice areas that my preceptor will assess for my midterm and final evaluations..

[Audio] The Module 8 Section 8.6: Externship Practice presentation for the Career Readiness & Externships: Soft Skills for Pharmacy Technicians program covers the basic concepts of externship preparedness. You may be assigned to one experiential rotation in a community pharmacy or institutional pharmacy, or you may need to fulfill two rotations. Regardless, your work performance will be measured by how well you achieve professional and technical competencies, or demonstrated proficiencies or skills in a specific area..

[Audio] Professional competencies are universal to all practice sites and include good communication skills, ethical behavior, time management, multicultural awareness and cultural competence, professional appearance, and critical thinking and problem solving. These professional skills are assessed by your preceptor during your externship and are reflected on your midterm and final evaluations. Professional competencies are covered in the other eight modules of Career Readiness & Externships: Soft Skills for Pharmacy Technicians and, consequently, won't be specifically addressed here. Technical competencies may be universal or specific to a community or an institutional pharmacy practice site. Your awareness and understanding of universal and specific technical competencies are critical to your daily responsibilities and your performance evaluations during your externship..

[Audio] At the foundational level, pharmacies in all settings strive for the same goal: to safely and accurately dispense medications for patients. In many instances, the underlying processes are the same: keep medications in stock; enter prescriptions or medication orders; prepare the medications; and interact with customers, patients, and healthcare professionals. In addition to these foundational tasks, other competencies are universal to all pharmacy settings: adhere to federal and state laws and regulations, including scope of practice; know basic pharmacology; perform accurate pharmacy calculations; and implement proper medication safety practices. As a result, these competencies are worded in general terms on midterm and final externship evaluation forms. Adhere to Federal and State Laws and Regulations. To pass these competencies, an extern must follow all federal and state laws and regulations pertaining to pharmacy practice. Examples of these regulations include the completion of HIPAA training to ensure patient confidentiality; an adherence to the storage, handling, and dispensing of controlled substances; an understanding of the labeling of prescription medications; and an understanding of the scope of practice of pharmacy technicians. Be sure that you follow the policies and procedures of your school and your practice site. These policies and procedures are based on federal and state laws and regulations; therefore, your adherence to these protocols allows you to pass legal competencies with ease. Know Pharmacology. An extern must demonstrate technical competencies in several areas of pharmacology. These competency areas include knowing the generic names and brand names of medications, drug classes, routes of administration, dosage formulations, indications for use, side effects and adverse effects, contraindications, and drug interactions. While memorization is the first level of knowing these pharmacology areas, knowledge of how medications cause their intended effects allows you to be a more effective pharmacy technician and be more confident in your externship responsibilities. Perform Pharmacy Calculations. Pharmacy calculations are a vitally important pharmacy technician responsibility. You are expected to have an understanding of basic mathematical operations (e.g., adding, subtracting, multiplying, and dividing of fractions as well as the proper use of decimals), a knowledge of Arabic number and Roman numeral systems, an ability to convert ratios and percentages, a knowledge of metric and household systems and the conversions within and between these systems, and an understanding of day's supply and quantity calculations. A consistent demonstration of accurate pharmacy calculations allows you to pass these technical competencies. Implement Medication Safety Practices. To ensure medication safety, you must demonstrate deliberate, detail-oriented actions in your daily practices as an extern. Technical competencies in this area include verifying and accurately filling prescriptions or medication orders, double-checking pharmacy calculations, checking labeling and packaging of medications, handling computer warning screens properly, and assisting in medication reconciliation and medication therapy management. Many of the processes and safeguards dictated by the policies and procedures of your pharmacy practice site ensure the highest level of safety in medication dispensing. In addition, you should be familiar with several medication safety initiatives that alert you to the potential dangers of handling certain medications. These initiatives include the following resources from the Institute for Safe Medication Practices (ISMP): • List of Confused Drug Names • List of Error-Prone Abbreviations, Symbols, and Dose Designations • List of High-Alert Medications in Acute Care Settings • List of High-Alert Medications in Community/Ambulatory Settings.

[Audio] In a community pharmacy setting, you will prepare prescriptions for dispensing directly to customers and initiate payment requests. You will also help to ensure that the pharmacy is stocked with sufficient quantities of required medications. Some of the technical competencies necessary to accomplish these goals include processing and dispensing prescriptions; using technology/informatics; implementing quality assurance practices; managing procurement, billing, reimbursement, and inventory of pharmacy supplies; and understanding insurance/billing practices. Process and Dispense Prescriptions. Competencies in this area involve assisting the pharmacist in collecting patient demographic information, including new patient intake and data entry; receiving and screening prescriptions for completion, accuracy, and authenticity; and preparing medications for dispensing, including selecting the correct medication, counting tablets and capsules, and labeling prescription vials. A large part of screening prescriptions is understanding the signa, or instructions for use. This understanding ensures proper calculation of both quantity and day's supply for a prescription, as well as additional instructions for use of the medication. A strong knowledge of medical abbreviations and terminology is necessary for this process. Use Technology/Informatics. Expected technical competencies in a community pharmacy include learning and navigating the pharmacy's software program. As mentioned earlier, this software provides a patient database and allows you to enter prescription information, print labels, and track medication inventory. To pass this competency, you must demonstrate consistent accuracy in entering patient and drug information. Other technology competencies you may encounter include the use of a pill-counting machine, bar-code scanning devices, and reconstitution devices. Ensure Quality Assurance of Environment. Quality assurance competencies you must demonstrate in a community pharmacy environment include monitoring the cleanliness of work areas; equipment, such as pill-counting machines; and nonsterile compounding work environments. In addition, you may be asked to calibrate digital scales to ensure accuracy and to monitor refrigerator and freezer temperatures at required intervals to ensure the quality, safety, and effectiveness of stored medications. These monitoring activities are documented via log sheets. If these activities are assigned to you, make sure you fill out the appropriate log sheet consistently and accurately to pass this competency. Manage Procurement and Inventory of Pharmacy Supplies. In a community pharmacy, technical competencies include the initiation, verification, and billing for pharmacy goods and services. These competencies may require you to perform business-related calculations, such as overhead, gross and net profit, and markup. Other technical competencies you may need to demonstrate relate to inventory management, such as receiving daily orders for restocking medications, verifying expiration dates of medications, returning medications to stock, handling product recalls, and reviewing medications in inventory quarterly..

[Audio] Understand Insurance/Billing Procedures. Insurance and billing competencies address your knowledge of medical insurance providers, patient insurance coverage for prescription drugs, prior authorization, and billing of medications. Prior authorization is a process that requires communication with a prescriber and an insurance provider to confirm medical necessity and ensure reimbursement for a medication or medical device before dispensing or sale. This insurance knowledge is a technical competency but is closely tied to a professional competency: your ability to provide clear communication and active listening in your interactions with customers and prescribers regarding prescription drug insurance. Billing prescriptions involves adjudication. Adjudication is the process of determining how much of the cost of the prescription will be covered by the insurance company when processing an order. It may require communication with insurance companies to determine coverage on specific medications or for particular patients..

[Audio] In an institutional pharmacy setting, you will prepare medications for delivery to different units in the facility while ensuring that the equipment used is properly maintained and kept within appropriate operating ranges. Some of the technical competencies learned in this setting include processing medication orders; performing nonsterile and sterile compounding; using technology/ informatics; implementing quality assurance practices; and managing procurement, billing, reimbursement, and inventory of pharmacy supplies. Process Medication Orders. Technical competencies in an institutional pharmacy involve processing medication orders rather than prescriptions. These orders are often submitted electronically by nursing units. Medication orders are typically written by physicians or other licensed prescribers in patients' charts, scanned by charge nurses on the hospital units, and sent to the pharmacy. These orders contain patient care directives and medications for patients during their hospital stay. If your institution allows pharmacy technicians to perform order-entry operations, you will identify what drugs and dosages have been ordered, enter them into the pharmacy software, create labels for each medication, and then fill the orders for delivery to nursing units. To fill these orders, you may need to consult online drug databases that are available in an institutional setting, such as Micromedex or Lexicomp. You may also need to refer to printed drug reference materials, such as texts on injectable medications and pediatric dosing. Perform Nonsterile and Sterile Compounding. The processing of medication orders may require you to perform nonsterile or sterile compounding of medications. Nonsterile compounding is the preparation of a patient-specific medication or dosage form that is not commercially available. For example, you may need to reconstitute a powdered medication, create a suspension from a crushed tablet or capsule, or prepare a topical cream or ointment. Regardless of the task, you will follow a specific recipe, perform necessary calculations, and prepare the medication in a sanitized compounding space in the pharmacy. For these operations, specialized equipment— such as digital scales, ointment mills, and compounding slabs—may be used. Standards for nonsterile compounding are in the United States Pharmacopeia General Chapter <795>, more commonly referred to as USP <795>. Knowledge of USP <795> allows for efficient training of this technical competency during your externship program. Sterile compounding is the dilution, mixing, reconstitution, or otherwise altering of various drugs or drug substances to create a sterile medication using aseptic technique. Sterile compounding procedures are performed by individuals who received special training, passed competency assessments, and—where applicable—achieved certification to compound sterile products for patient administration. Standards for sterile compounding are in USP General Chapter <797>, more commonly referred to as USP <797>. Knowledge of USP <797> allows for efficient training of this technical competency during your externship program..

[Audio] Use Technology/Informatics. Similar to a community pharmacy setting, expected technical competencies in an institutional pharmacy include learning and navigating the pharmacy's software program. Because many practitioners use an electronic health record, you have access to intake records and patient medical and medication histories, medication orders, and electronic medication administration records. Once you access the medication order, you can proceed with medication filling and distribution. You may occasionally receive a handwritten medication order via personal delivery, fax, phone call, or pneumatic tube. Using the pharmacy's software program, you must input the medication order and have the information verified by a pharmacist. In other instances, you would be required to credit a patient's profile for unused orders to be returned to pharmacy stock. To pass the technical competency of navigating a pharmacy's software program, you must demonstrate an understanding of the different functions of the program. In addition to learning a hospital pharmacy's software program, you are expected to learn and demonstrate your understanding of any specialized technology used in a given institutional setting. Ensure Quality Assurance of Environment. In an institutional pharmacy, infection-control measures are critical to the health and safety of patients. The quality assurance policies in a facility are designed to monitor the mechanisms and processes that are used to prevent contamination of medications before they are dispensed, which includes storage requirements and preparation protocols. You may be asked to monitor refrigerator and freezer temperatures at required intervals to ensure the quality, safety, and effectiveness of stored medications. You may also be tasked with completing log sheets for cleaning primary engineering controls, more commonly referred to as hoods; calibrating the compounder; and checking the expiration dates of medications. These technical competencies are components of your externship evaluations. Manage Procurement, Billing, Reimbursement, and Inventory of Pharmacy Supplies. Unlike a community pharmacy, an institutional pharmacy uses a single drug formulary, or a list of approved drugs for use in the facility. This list is based on the recommendations of the hospital's Pharmacy and Therapeutics (P&T) Committee. The P&T Committee considers several factors when creating a drug formulary: generic drug preferences, effectiveness of drugs, hospital budgets, and insurance reimbursements. To order medications for the pharmacy, you may work with pharmaceutical sales representatives to receive bids and purchase contracts. Once the medications are received at the pharmacy, you may check the order against the wholesaler's or manufacturer's receipt and store the medications in inventory. Placing the daily order of medications in inventory as well as working with and shadowing the buyer (a specialized role held commonly by a pharmacy technician) satisfy these technical competencies in an institutional pharmacy setting. Inventory management competencies involve filling unit-dose and emergency crash carts for patient care units; processing the returned unit-dose carts; stocking the automated central pharmacy and floor stock dispensing units; monitoring inventory and narcotic control in both the pharmacy and nursing units; verifying the expiration dates of medications, including the expiration dates of drugs on emergency crash carts; returning medications to stock; and handling product recalls..

[Audio] The Module 8, Section 8.7: Module Summary presentation of the Career Readiness & Externships: Soft Skills for Pharmacy Technicians program provides a brief summary of this module..

[Audio] Completing a pharmacy technician externship provides you with many benefits: an assessment of your knowledge and skills, an opportunity for real-world pharmacy practice, a training experience in pharmacy software programs, and an opportunity for mentorship and networking. Your participation in an externship also provides the practice site with many benefits, such as an additional staff member to help with operations. You must complete several basic and program-specific externship requirements. Basic externship requirements include submitting personal ID, educational documents, and registration/certification documents as appropriate. In addition, if your academic program is ASHP/ACPE-accredited, you must fulfill the pharmacy education and training standards of these organizations. These standards dictate the number of health-related curriculum hours and the specific educational modality of these hours—didactic, simulated, and experiential. Program-specific externship requirements include knowledge of the learning objectives, extern responsibilities, related externship assignments, required hours, and federal and state pharmacy laws and regulations. To participate in an externship, you must undergo a pre-externship health screening. This screening includes a physical exam, an immunization update, a drug-screening test, and a criminal background check. These health-screening components have specific, individual requirements that must be met. Failure to meet these requirements prohibits you from participating in a pharmacy technician externship. You are assigned a specific practice site and a preceptor who guides you through the externship experience. At the initial meeting, your preceptor discusses the role of a preceptor and the professional relationship that exists between a preceptor and an extern. In addition, your preceptor addresses your rotation requirements, work schedule, midterm and final evaluations, grading parameters, and expected professional and technical competencies of your externship. Technical competencies may be universal or specific to a community or an institutional pharmacy practice site..