Pharmacy Practice IV - Prescriber communication (15%) 시험 후기

pharm prac assessment

     
이번 학기 Pharmacy Practice IV 시험 중 가장 낯설었던 부분은 Oral Communication Assessment (25%) 중 Prescriber Communication (15%)였다. 지난 포스팅에 간략히 설명해놓긴 했지만, 이번 평가에서 지난 OSCE와 가장 큰 차이점은 

2024.09.25-호주 유학일기 30 - 4학년 마지막 학기 이게 맞나?

호주 유학일기 30 - 4학년 마지막 학기 이게 맞나?

 
환자에게서 히스토리 테이킹만 하고 끝나는 게 아니라, 히스토리 테이킹을 통해 문제점을 발견하고 그 내용을 prescriber와 직접 통화해 prescription을 수정하는 과정까지 해야 한다.

큰 틀은 지난 OSCE와 비슷하지만, 이번 Pharmacy Practice IV 은 Women's reproductive health가 주요 Topic이라서 그와 관련된 질문을 추가적으로 더 해야한다.
  
    

Part1.  Patient History taking and Identify MRP

 

1) Introduction

• Hello, I’m Joy, your pharmacist today. How Can I help you? 

 

2) Patient identification and purpose

• May I confirm your full name and date of birth please?
• Thank you, [Patient's name]. I see you’ve brought in a prescription for [Medication name]. Is it okay if I ask you a few questions regarding your medicine to better understand your situation.
• Thank you. Is it for yourself? 
• Have you had this before?
• This medication can be used for different conditions, may I ask what are you using it for?

 

3) Confirm Symptoms

• What symptoms are you experiencing? Could you tell me a bit more about them?
• How long have you had these symptoms? 
• Have you experienced these symptoms before?
• Are there any other symptms?

 

4) Reproductive health and Pregnancy 

• (Consent) Is it okay if I ask a few personal questions?
• When was your last menstrual period?
• Is your period regular?
• Do you currently need contraception?
• Are you planning for pregnancy?

 
5) Establishes Medical conditions 

• Do you have any other health conditions? 
• Do you have any allergies?
• Have you had any surgery before? (intact uterus 확인 목적)
• By any chaance you are pregnant or breastfeeding? 
• (If pregnant) How far along are you? Is everything going well with both you and your baby?
• Have you recently given birth or are you in the postpartum period?

 

6) Confirms current Rx medications

• Are you on any other medications? 
• Have you recently started or stopped any medications?

 

7) Confirms OTC medication 

• Do you take any over the counter medications? 

 

8) Confirms CAM medication 

• Do you take any supplements? 

 

9) Establishes Lifestyles and contextual information

• Do you smoke? Do you drink alcohol? (if so, ask how often and how much)
• How about your diet? Do you have a balanced diet?
• Do you drink coffee? (if so, how many cups do you usually have?)
• Do you exercise regularly?
• Could I confirm your age, weight and height?
• Have you booked any follow up appointment with your doctor?

 

10) Diagnosis

• Thank you for answering these questions. Would you mind if I have a look at my resources, and come back to you? 

 

11) Before contacting the prescriber, must obtain consent from the patient.

• Thank you for waiting, ______. I just need to double-check something with your doctor about the prescription to make sure everything is perfect for you. 
• If you don’t mind, could I contact your doctor to confirm this?

  

Part2. Prescriber contact and resolve MRP

  

1) Introduce themselves in a professional way to prescriber 

• Hello Dr. [Prescriber’s Name], this is Joy, a pharmacist from Griffith pharmacy. I’m calling regarding a prescription for one of your patients. Is this a good time to discuss?

 

2) Identify the Patient

• Thank you. I have a patient, [Patient’s Full Name], date of birth (if I have it), who came in today with a prescription for [Medication name]. 

 

3) Identify the MRP 

• I noticed some potential issues regarding [the medication] and would like to discuss them with you.
• According to AMH and considering the patient's [specific circumstances], [explain the reason for inappropriateness].

 

4) Offer Recommendation 

• Given the patient’s [concerns], I would recommend [option]. Would you consider switching to [Recommendation]?

 

5) Confirm Agreed Course of Action 

• Great, just to confirm, we’ll update the dose to 9ml once daily for 3 days. Could you please send me a new prescription with the correct dosing?
• If you’re happy with this change, I’ll dispense it as we discussed.
• Thank you for your time and help. If there’s anything else you need from me, please let me know. Have a good day!

  
+ 시험 후기
방에 들어가면 Patient와 Prescriber 역할을 겸하는 평가자 1 (나는 브리오니 교수님이었음) 가 앉아있고, 시험이 시작되면 Part1 히스토리 테이킹부터 진행하면 된다. MRP는 수업 때 중요하다 언급된 포인트들이 나와서 찾는 데 어렵진 않다. 이 시험은 Oral communication assessment 이기 때문에 MRP를 찾는 것도 중요하지만 실제 환자나 의사와 커뮤니케이션하듯 쌍방소통을 얼마나 적절하게 잘 하냐가 평가 기준인 듯했다 (영어 실력 자체보다는 대화의 흐름과 질문 능력이 중요한 듯. 영어는 나도 못함ㅠ). 시험 직전, MRP를 못찾으면 fail하는 건가 걱정을 많이 햇는데 (왜냐면 교수님은 데니스 Hopeless이기 때문이지) Part1만 완벽하게 다 해도 절반 이상의 점수를 받는 것 같았다. 친한 동기가 긴장해서 시간 내에 MRP를 못찾고, Prescriber와 통화하는 Part2로 못 넘어갔지만, Part1에서 약사로서 물어볼 수 있는 질문들을 모두 침착하게 했더니 절반 이상의 점수를 맞았다고 하니 너무 걱정하지 않아도 될듯하다. 그리고 시험 분위기도 딱딱하지 않아서 좋았다! 나는 Part2까지 다 끝냈는데(이미 앞에 있는 브리오니 교수님이 Prescriber 역할까지 했고 Thank you for your time. Bye 하고 전화까지 끊었음), 갑자기 Part1에서 깜박하고 물어보지 못한 질문이 생각난 거다ㅠㅠ그래서 앞에 브리오니 있는데 놀라서 육성으로 '헐!!!!!ㅇㅅㅇ' 이러고 다시 환자 역할 좀 해달랬음ㅠㅋㅋㅋㅋㅋㅋㅋㅋㅋㅋㅋㅋ그랬더니 브리오니가 웃으면서 다시 해 줌. Pass 길만 걷자🌸