This document discusses engaging pharmacy students in wellness and disease prevention services through community pharmacy advanced practice experiences (APPEs). It provides guidance for preceptors to incorporate these activities, which include establishing foundations, student activities around health observances, risk assessments, health screenings, immunizations, and specific disease prevention topics. Student activities range from developing educational materials to directly interacting with patients through counseling, assessments, and screenings. The goal is to prepare pharmacists for their role in promoting healthy behaviors and lifestyles.
1. COMMUNITY PHARMACY
Engaging Students in Wellness and Disease Prevention Services
Audra S. Anderson, PharmD* and Jean-Venable R. Goode,
PharmD
School of Pharmacy, Virginia Commonwealth University
Pharmacy education has traditionally focused on medications
and treatment of disease. However, as an
accessible health care professional, pharmacists can influence
healthy behaviors in their patients. En-
couraging/promoting healthier lifestyles in the United States is
essential because the leading causes of
mortality are tobacco use, poor nutrition, and inactivity. In
order to prepare pharmacists for this role,
student pharmacists must be taught how to implement and
deliver wellness and prevention services.
Community advanced pharmacy practice experiences (APPEs)
occur at an ideal point in the curriculum
to engage students in these activities. This article provides
preceptors with guidance and tools for
restructuring the community APPE at their sites to incorporate
wellness and disease prevention activities.
Keywords: wellness, disease prevention, health promotion,
advanced pharmacy practice experiences, community
pharmacy
INTRODUCTION
Much of the morbidity and mortality associated with
2. chronic disease in the United States could be prevented
though lifestyle and behavioral changes. Although the
leading causes of death in the United States are heart
disease and cancer, the actual leading causes of mortality
are tobacco use, poor nutrition, and inactivity.1 Tradition-
ally, pharmacy education has focused on medications and
the treatment of disease. However, as accessible health-
care professionals, pharmacists are in an ideal position to
make an impact on patients’ behaviors. Furthermore,
pharmacists have been identified as key healthcare pro-
fessionals to help the nation meet the goals of Healthy
People 2010.
2-4 Healthy People 2010 is a document re-
flecting the nation’s health goals for reducing significant
preventable threats to public health. There are 2 overarch-
ing goals, which are to increase the quality and years of
life of Americans and to eliminate health disparities.2 In
order to accomplish these goals, as a profession, pharma-
cists will need to be prepared to deliver wellness and
disease prevention services.
The Center for Advancement of Pharmaceutical Ed-
ucation (CAPE) recently revised the educational out-
comes for colleges and schools of pharmacy.
5 The
advisory panel identified public health as a major area
for improvement and expansion in pharmacy education,
including teaching students strategies for promoting
health improvement, wellness, and disease prevention
to patients, communities, and at-risk populations, in col-
laboration with other health care providers. Community
advanced pharmacy practice experiences (APPE’s) are
3. ideal areas of the curriculum for offering these learning
experiences for students. Therefore, preceptors may need
to restructure APPE learning activities to provide oppor -
tunities for students to gain knowledge about wellness and
disease prevention. This article will provide preceptors
with ideas for incorporating wellness and disease preven-
tion into student learning experiences.
ESTABLISHING A WELLNESS AND
DISEASE PREVENTION FOUNDATION
Community practitioners should prepare for teaching
wellness and disease prevention by building a basic foun-
dation. The basic foundation for preceptors recommended
by these authors includes the following:
(1) Creating a model of wellness and disease pre-
vention in the advanced practice setting. This
means being a role model for students by hav-
ing at least one active service relating to well-
ness or disease prevention in the practice.
(2) Providing students with pertinent literature
about wellness, disease prevention, and health
promotion and addressing these issues either
during daily activities or during discussion
sessions.2-4,6-9
From the foundation, preceptors can build on stu-
dent’s knowledge using several different approaches in
their practice. These include students actively participat-
ing in the practice’s wellness and disease prevention
Corresponding Author: Jean-Venable R. Goode, PharmD.
Address: VCU School of Pharmacy, PO Box 980533,
Richmond, VA 23298-0533. Tel: 804-828-3865.
4. Fax: 804-828-8359. E-mail: [email protected]
*Dr. Anderson’s current affiliation is Ukrop’s Pharmacy,
Richmond, Va.
American Journal of Pharmaceutical Education 2006; 70 (2)
Article 40.
1
activities, creating new wellness and disease prevention
activities for the practice, creating tools and educational
materials, discussing pertinent wellness and disease pre-
vention literature, writing newsletters or articles about
wellness and disease prevention, marketing wellness
and disease prevention services, and assessing outcomes
of the programs and services (Figure 1). Ideally, students
should be involved in a range of activities and discussions
about wellness and disease prevention throughout an ad-
vanced practice experience. Activities do not have to be
complicated; however, depending on the activity, it may
take more preceptor time, either through direct supervi-
sion or reviewing and revising the materials students cre-
ate. Preceptors will need to consider their ability to
supervise and provide guidance and teaching as they de-
sign activities and learning experiences around wellness
and disease prevention. The following sections will focus
on how to incorporate these approaches using several
wellness and disease prevention strategies.
STUDENT ACTIVITIES
Health Observances
The Office of Disease Prevention and Health Promo-
tion publishes a comprehensive calendar of national
5. health observances, eg, October is National Breast Cancer
Awareness Month.6 Most of the health observances have
websites with additional information and materials.
These materials are excellent resources for pharmacists
and students developing wellness and disease prevention
activities7 and can be used as a framework for many of
the student activities during an APPE. Students should
choose a health observance that interests them and that
will occur during their experience. The student should
develop an activity that can be accomplished during the
rotation and be incorporated into the practice site. For
example, during National Osteoporosis Awareness and
Prevention Month, when dispensing a prescription, the
student could counsel every female patient about the ap-
propriate amount of dietary calcium and/or supplemental
calcium. This would engage the student in health promo-
tion activities directly with the patient.
Another activity based on the national health observ-
ances includes the development of handouts and patient
education materials to be made available at the pharmacy.
For example, during National Stroke Awareness Month in
May, students could develop handouts and patient educa-
tion materials on the risk factors and signs and symptoms
of stroke, and measures patients can take to prevent strokes.
Students could also evaluate patient education materials
that could be used by the practice site. Evaluation should
Figure 1. Algorthim for engaging students in wellness and
prevention.
American Journal of Pharmaceutical Education 2006; 70 (2)
Article 40.
2
6. include assessing the handout’s literacy level. If the prac-
tice site has a population of patients whose primary lan-
guage is not English, students should research the available
educational materials in other languages.
If the pharmacy has space, students could develop
a bulletin board or display with educational messages
and handouts for a national health observance. The phar-
macy could use these materials each year. If the pharmacy
does not have space for a bulletin board or display, stu-
dents could be involved in developing shelf-talkers or
posters to convey a message about a national health ob-
servance. For example, students could develop a message
around National SAFE KIDS Week that could be put on
the shelves displaying children’s products, toys, etc.
Students could also be involved in developing a pre-
sentation about a national health observance. The presen-
tation could be given in a meeting room or similar space at
the pharmacy or at a community center, church, civic
building, or library for various groups or associations. If
the pharmacy has a newsletter or if other community pub-
lications exist, a student activity could include developing
an article about the national health observance.
National health observances can also be used as a plat-
form for more advanced pharmacy activities such as risk
assessments, screenings, lifestyle counseling, immuniza-
tions, and targeted interventions. These activities will be
discussed later in the article.
Students do not have to focus on a national health
observance. Any of these activities could also center on
7. other health-related issues including seasonal concerns
(eg, sunscreen protection, allergies, bug bites, influenza)
or disease prevention topics (eg, diabetes mellitus,
obesity, depression).
Risk Assessment
If the practice site or state laws do not allow pharma-
cists to conduct health screenings, risk assessments are
another way to increase patient interaction and provide
patients with valuable information.
10,11 Risk assessments
may also be used in combination with screenings, such as
the Framingham Risk Assessment for which obtaining
cholesterol and blood pressure values are necessary. As
mentioned previously, risk assessments may be an activ-
ity related to a national health observance or a standalone
activity that is offered in the pharmacy.
Student activities can be related to designing and
implementing a new risk assessment program. Part of this
activity should include researching different risk assess-
ment tools for a specific disease state and choosing a risk
assessment tool that will be appropriate for the practice
site. Table 1 contains some resources for locating risk
assessments on the Internet. Some risk assessment tools
are available in paper format and others are available for
completion via the Internet. Once a risk assessment tool is
chosen, students should design an educational handout
with the risk assessment score and how to interpret the
patient’s risk. Preceptors should have the students de-
velop policies and procedures for the new risk assessment
program.
8. After designing and implementing the program or if
a risk assessment service is already in place at the practice
site, student activities should center around identifying
patients who should complete the risk assessment, per-
forming and documenting the actual risk assessment, pro-
viding patient counseling and education, recommending
lifestyle changes or preventative measures, referring to
other healthcare providers, and providing follow -up. To
enhance this activity, preceptors should have the student
present 1-2 patient cases from the risk assessments. The
case presentations can be brief but should address patient
demographics, pertinent information about the risk assess-
ment, plan, education and/or counseling, and follow -up.
Health Screenings
If the practice site and state laws permit pharmacists
to conduct health screenings, this is another way for stu-
dents to become involved in wellness and direct patient
care. Providing various screenings within the pharmacy
allows students to have extensive patient contact and will
assist in the development of their communication skills as
well.
Students can assist with implementing a specific type
of screening into the practice or they can improve and en-
hance an existing screening program. Screenings that can
be conducted within the community pharmacy include,
but are not limited to, blood pressure, blood glucose,
Table 1. Selected Patient Risk-Assessment Resources for Use in
a Community Advanced Pharmacy Practice Experience
Risk Assessment Web Site
Health Check Tools
9. www.nlm.nih.gov/medlineplus/interactivetools/
Interactive Health Tools
www.brighamandwomens.org/healthinfor/healthTools.asp
Framingham CHD Risk Calculator
hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype5pub
Men’s Health www.ncpanet.org/knowyourscore/assessment.pdf
Breast Cancer bcra.nci.nih.gov/brc/q1.htm
American Journal of Pharmaceutical Education 2006; 70 (2)
Article 40.
3
cholesterol, osteoporosis, Alzheimer’s disease, depres-
sion, metabolic syndrome, and body fat analysis.12-22
For a practice site that does not already have established
screenings in place, several steps may need to be taken.
Conducting non-invasive tests that do not require
a human specimen, such as blood pressure or osteoporosis
screening, have few or no regulations. Student activities
for implementing these types of screenings include the
development of screening forms, patient education materi-
als, and a general policy and procedures guide for the site.
Tests that require human specimens, such as blood
samples, are considered invasive and there are more strin-
gent regulations and requirements for conducting those
tests.
10. 23 The Clinical Laboratory Improvement Act
(CLIA) of 1988 was enacted to assist in the standar-
dization of laboratory screening, personnel, and quality
control. There are varying levels of laboratory testing
based on the complexity of the test being performed. Most
pharmacy-based screenings, such as blood glucose or
cholesterol testing, are waived tests and are less regulated.
These tests require the site to have a certificate of waiver
from a local or regional Centers for Medicare and Med-
icaid Services (CMS) office and to agree to follow good
laboratory practices. To enroll in the CLIA program
a pharmacy must complete and submit CMS Form 116
for a Certificate of Waiver. A CLIA waiver is required to
allow pharmacy-based laboratory screenings. If there are
multiple screening sites, each site must have its own
CLIA waiver. Complete information regarding CLIA and
the waiver process is available at www.cms.hhs.gov/clia. A
full list of waived tests can be found at www.cms.hhs.gov/
clia/waivetbl.pdf. Students can learn about maintaining
a pharmacy-based laboratory including good laboratory
procedures, standard operating procedures, and quality
control. Along with obtaining the CLIA waiver for per-
forming screenings, pharmacies must also comply with
the universal precautions for blood-borne pathogens
regulations from the Occupational Safety and Health
Administration (OSHA). OSHA regulates worksite
safety and provides guidelines for protection, exposure
actions, and proper policies and procedures. Complete
information is available on the OSHA website at www.
osha.gov.
Another activity for students is researching the vari-
ous instruments and devices to perform screenings. For
example, there are numerous lipid analyzers available for
cholesterol screening. The most commonl y used device is
11. the Cholestech LDX. Obtaining information such as cost,
supplies needed, and reliability of the instrument is im-
portant in selecting the appropriate device.
For practice sites that already have patient screenings
in place, students could assist with enhancing the current
program. Finding ways to increase the number of patients
that take advantage of the screening services is an impor-
tant task with which students could assist.
In addition to assisting with establishing and promot-
ing the screening program, students can participate in
administering the program, performing and documenting
screening tests, providing counseling and education, rec-
ommending lifestyle changes or preventative measures,
referring patients to other healthcare providers, and fol-
lowing up with patients to determine effectiveness/out-
comes of the program. Preceptors should have students
present 1-2 patient cases per week from the screening
program. Students should be able to justify the recom-
mendations made to their patients.
Involving students in planning and implementing
a screening service in a pharmacy practice provides them
with a unique and valuable experience, increased confi -
dence, and the skills and tools for developing their own
services and programs.
Specific Screenings
Students can be asked to lead a presentation and
discussion of particular diseases, prior to conducting
screenings. Providing appropriate and accurate patient
counseling requires knowledge of the current guidelines
and recommendations for the disease. For example,
12. reviewing the JNC 7 Guidelines and all available anti -
hypertensive medications with the student is a good
way to increase his/her knowledge and confidence rela-
ted to the screening and management of high blood
pressure. Also, instruction in the proper operation of
the equipment that will be used in the screening is impor-
tant prior to the students’ interaction with patients. For
example, prior to providing cholesterol screening, the
student should observe how to obtain the blood sample,
operate the lipid analyzer, and counsel the patient based
on the results. Patient education after a screening should
include discussing diet, exercise, and potential drug
therapy alternatives. Observing the preceptor screening
a patient and discussing the patient’s disease state will
help the student become confident in providing patient
care.
Immunizations
Immunizations are another area of wellness and dis-
ease prevention that pharmacists can implement at their
practice site. Pharmacists have the authority to administer
immunizations in 44 states.24 Additionally, many col-
leges and schools of pharmacy have incorporated vaccine
science and vaccines into the curriculum; therefore, APPE
students will usually have some knowledge of immuni za-
tions. In 1997, the American Pharmacists Association’s
Board of Trustees adopted guidelines for pharmacy-based
American Journal of Pharmaceutical Education 2006; 70 (2)
Article 40.
4
13. immunization advocacy.25 The guidelines include 3 lev-
els: advocacy, facilitation, and administration. Activities
for students should be designed around these levels.
In states that do not allow pharmacist or student phar-
macist administration of immunizations, students should
be involved in recommending immunizatio ns to at-risk
populations, educating patients about the vaccines, and
referring patients to an appropriate health care provider.
Additionally, students could research vaccine controver-
sies and create handouts for patients with the facts about
the vaccine controversy. Students could also research
anti-vaccine web sites so they have an understanding of
the information patients may be exposed to on the Inter-
net.
26 Students could be responsible for updating the phar-
macy’s staff on the frequently changing recommendations
regarding vaccines and for developing a vaccine record
card for patients.
If the pharmacy practice is active in the second level,
facilitation of immunizations (having another healthcare
professional administer vaccines at the site), students
could assist with screening patients for immunizations
and processing paperwork. Students could also be in-
volved with identifying at-risk patients, marketing the
service, and answering questions.
In states that allow pharmacists to administer immu-
nizations, students could assist with designing and imple-
menting a new program or enhancing an existing one.
For example, if the practice site offers only influenza
vaccinations during October and November, students
could design and implement a year-round immunization
program, identifying patients at risk for other diseases
14. for which immunizations are available such as tetanus-
diphtheria or pneumococcal vaccine. Students could
assist with the administration of vaccines if allowed by
state law.
Preventative Services
Another way to approach wellness and disease pre-
vention is to target patients based on their age. The US
Preventative Health Services Task Force has a guide to
preventative health services which is based on age and
gender.
27 In addition, several other organizations publish
preventative health checklists based on age and gender
including the American Academy of Family Physicians
(www.aafp.org), the American College of Physicians
(www.acponline.org), and the American College of
Obstetricians and Gynecologists (www.acog.com). Stu-
dents could use these checklists to design a preventative
services counseling program for the practice site. Ano-
ther exercise is to have the student assess the usability
of preventative health guidelines (ie, how difficult is it
to identify the services recommended and determine
how frequently they should be performed), and sug-
gest changes that would make the checklists easier to
use.
Lifestyle Counseling
Knowledge and training about educating patients on
proper lifestyle choices is one of the keys to actually
helping them make positive changes. Realizing each
patient’s specific situation and goals is essential in help-
ing them attain those goals. Additionally, it is important to
15. understand how patients make lifestyle changes. APPE
activities could include researching and learning about
the different theories addressing changing patient behav-
iors. Several models have been used by pharmacists in-
cluding the Health Belief Model, Fishbein-Ajzen Theory
of Reasoned Action, and the Transtheoretical Model.
28-30
Students should observe preceptors using these models
in patient counseling, and then employ them when
working with patients trying to make lifestyle changes.
Other techniques used for disease and wellness programs
that students should learn include conducting motiva-
tional interviewing and providing self-management
education.31
Smoking Cessation
Tobacco use is one of the leading causes of mortality
in the United States. Providing directed interventions to-
ward patients who use tobacco is another way pharmacists
and student pharmacists can become involved in wellness
and disease prevention in their practice.
Students could provide brief interventions with
patients, such as counseling them on the benefits of quit-
ting, or more detailed interventions as part of a com-
prehensive smoking cessation program that includes
conducting one-on-one counseling, making drug ther-
apy recommendations, and providing follow-up care/
counseling.32-34 Students could assist in the development
of forms describing the various nonprescription and pre-
scription smoking cessation products available and the
advantages and disadvantages, side effects, and cost of
each.35 Providing patients with detailed information re-
16. garding available pharmacotherapy can help them make
informed decisions. To assist in the implementation and
delivery of a smoking cessation program within the prac-
tice site, students could develop patient handouts, and
patient interview and documentation forms.32,33
Students could also participate in one-on-one patient
counseling sessions provided for patients. Additionally,
some smoking cessation programs may include group ed-
ucational sessions, students may be involved in creating
and/or teaching these sessions. Offering smoking cessation
therapy management and obtaining payment for the
services will give the student a valuable experience in the
American Journal of Pharmaceutical Education 2006; 70 (2)
Article 40.
5
delivery of wellness and disease prevention services within
a pharmacy practice.
Basic Nutrition and Exercise Counseling
A fundamental component of wellness and disease
prevention is good nutrition and adequate exercise. Stu-
dents should learn the basic nutrition and exercise infor-
mation needed for pharmacists to appropriately and
effectively counsel their patients regarding either pre-
vention or management of disease.
8-9 This topic is usually
not stressed in pharmacy curriculums and APPE’s pro-
vide an excellent forum for students to learn about nutri-
17. tion and exercise and practice their patient counseling
skills.
Preceptors can assign readings and have a topic
discussion about nutrition and exercise.
8-9 Students can
research and learn about the differences between fad
diets and create a chart for the pharmacy staff. Stu-
dents could also do this for vitamins and dietary sup-
plements.
Nutrition and exercise counseling can be incorporated
into patient counseling during risk assessment, disease
screening, and targeted intervention programs. Students
could be involved in developing, implementing, and mar-
keting a new patient care service for weight management or
starting a body composition screening service. Possible
activities would be similar to activities discussed in pre-
vious sections.
Targeted Interventions
Targeted intervention programs are programs designed
to focus on promoting wellness, disease prevention, and
healthy living for patients who already have a chronic
disease. As with the other areas of wellness, student
activities could include developing and implementing
the target intervention program, including writing poli-
cies and procedures, creating monitoring forms, and de-
veloping or evaluating existing patient educational
materials. For example, a targeted intervention program
for patients with diabetes might center on ensuring that
patients who have diabetes are receiving appropriate
medications such as ACE inhibitors or aspirin therapy.
18. 36
Even though this is not really wellness, it is prevention of
future problems related to diabetes mellitus. A targeted
intervention program for patients with diabetes mellitus
could also include ensuring that these patients have access
to appropriate preventative services, such as annual
check-ups with a podiatrist and ophthalmologist and
bi-annual check-ups with a dentist.
Conducting targeted intervention provides students
with lessons in communicating with patients and pro-
viders, and in managing chronic diseases. Other activities
could include the preceptor conducting topic discussions
with the student that reinforce the student’s knowledge of
the pathophysiology and the pharmacologic and non-
pharmacologic (lifestyle modifications and preventative
measures) treatment of the disease. Students could be re-
quired to create a patient case and present all of this in-
formation to the preceptor, or ideally, the preceptor and
the student could discuss specific patients in the targeted
intervention program.
Targeted intervention programs can be used to assess
the outcomes of the practices’ patient care activities.
These outcomes can be used by the pharmacists to market
patient care services to self-insured employers or other
payors. This gives the preceptor another opportunity for
teaching APPE students. Students can be involved in the
process of organizing the outcomes for presentation and
developing materials for the meeting. Additionally, the
preceptor can engage the student in discussions about
compensation for patient care services.
Marketing
19. Acquiring a basic knowledge of marketing is impor-
tant for APPE students since effectively marketing a phar-
macy’s services to the appropriate patient population not
only increases the site’s revenue stream, it ensures that
patients are aware of the valuable and potentially life-
saving services offered. Students should be involved with
the marketing of any of the previously mentioned health
promotion programs and preventative services. Students
should be able to design marketing materials (signs, shelf
talkers, brochures, and patient handouts) including a plan
for how to inform patients about any new service or pro-
gram. Students could also develop a marketing strategy
that targets others such as caregivers, third-party payors,
and family members. Preceptors could assign readings
for students to learn more about marketing pharmacy
services.
37-39 Another valuable activity is to have stu-
dents participate in marketing the program to patients
directly. Preceptors should use this activity to have
discussion with the student about marketing, including
the difference between product and service marketing.
As another component, students could visit local physi-
cians and their practices to market new programs and
services.
Outcomes Assessment
All pharmacy services should be evaluated to determine
the outcomes and success of the program and then this in-
formation should be used for continuous quality improve-
ment. A learning activity for students could be designing an
evaluation process for the risk-assessment program or per-
forming evaluation activities such as tallying numbers of
patients, number at risk, and number of referrals. Students
20. could be involved with designing or researching available
American Journal of Pharmaceutical Education 2006; 70 (2)
Article 40.
6
evaluation tools for the program (eg, patient satisfaction
instruments).40,41
CONCLUSION
A community APPE provides an excellent opportunity
for developing and implementing wellness and disease pre-
vention activities. Additionally, preceptor involvement
with these activities provides a positive role model for
students. In turn, teaching and practicing wellness and dis-
ease prevention for the benefit of patients and student phar -
macists will help improve the professions’ capability of
making an impact on the health of the nation.
REFERENCES
1. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual
causes of death in the United States, 2000. JAMA
2004;291:1238-45.
2. U.S. Department of Health and Human Services. Healthy
People
2010: Understanding and Improving Health. 2nd ed. 2 vols.
Washington, DC: U.S. Government Printing Office;2000.
Available
at: www.healthypeople.gov. Accessed January 18, 2006.
3. Babb VJ, Babb J. Pharmacist involvement in Healthy People
2010. J Am Pharm Assoc. 2003;43:56-60.
4. Calis KA, Hutchinson LC, Elliott ME, Ives TJ, et al. Healthy
21. People 2010: challenges, opportunities, and a call to action for
America’s pharmacists. Pharmacotherapy. 2004;24:1241-94.
5. Educational Outcomes 2004. Center for Advancement of
Pharmaceutical Education. American Association of Colleges of
Pharmacy. 2004. Available at
www.aacp.org/Docs/MainNavigation/
Resources/6075_CAPE2004.pdf. Accessed February 17, 2005.
6. 2005 National Health Observances. National Health
Information
Center, Office of Disease Prevention and Health Promotion, US
Department of Health and Human Services, Washington, DC.
Available at: www.healthfinder.gov/library/nho/nho.asp.
Accessed July 11, 2005.
7. Ciardulli LM, Goode JR. Using health observances to
promote
wellness in community pharmacies. J Am Pharm Assoc.
2003;43:61-8.
8. Dombrowski SR. Pharmacist counseling on nutrition and
physical activity – part 1 of 2: understanding current guidelines.
J Am Pharm Assoc. 1999;39:479-91.
9. Dombrowski SR, Ferro LA. Pharmacist counseling on
nutrition
and physical activity – part 2 of 2: helping patients make
changes.
J Am Pharm Assoc. 1999;39:613-27.
10. Giles JT, Kennedy DT, Dunn EC, et al. Results of a
community
pharmacy-based breast cancer risk assessment and education
program. Pharmacotherapy. 2001;21:243-53.
11. Boyle TC, Coffey J, Palmer T. Men’s health initiative risk
assessment study: effect of community pharmacy-based
screening. J Am Pharm Assoc. 2004;44:569-77.
12. DeHart RM, Gonzalez EH. Osteoporosis: Point-of-Care
Testing. Ann Pharmacother. 2004;38:473-81.
13. Rosenthal WM. Implementing bone mineral density testing
in the community pharmacy. J Am Pharm Assoc. 2000;40:737-
22. 45.
14. Goode JV, Swiger K, Bluml BM. Regional osteoporosis
screening, referral, and monitoring program in community
pharmacies: findings from Project ImPACT Osteoporosis.
J Am Pharm Assoc. 2004;152-60.
15. Elliot ME, Meek PD, Kanous NL, et al. Osteoporosis
screening
by community pharmacists: use of National Osteoporosis
Foundation resources. J Am Pharm Assoc. 2002;42:101-10.
16. Tice B, Phillips CR. Implementation and evaluation of a
lipid
screening program in a large chain pharmacy. J Am Pharm
Assoc.
2002;42:413-9.
17. Tsuyuki RT, Johnson JA, Teo KK, et al. A randomized trial
of the effect of community pharmacist intervention on
cholesterol
risk management: the Study of Cardiovascular Risk Intervention
by Pharmacists (SCRIP). Arch Intern Med. 2002;162:1149-55.
18. Carter BL. Pharmaceutical Care for Hypertensive
patients. Am Pharm. 1994;NS34:54-61.
19. Park JJ, Kelly P, Carter BL, Buirgess PP. Comprehensive
pharmaceutical care in the chain setting. J Am Pharm Assoc.
1996;36:443-51.
20. Carter BL, Barnette DJ, Chrischilles E, et al. Evaluation of
hypertensive patients after care provided by community
pharmacists in a rural setting. Pharmacotherapy. 1997;17:
1274-85.
21. Magnum SA, Kraenow KR, Narducci WA. Identifying
at-risk patients through community pharmacy-based
hypertension
and stroke prevention screening projects. J Am Pharm Assoc.
23. 2003;43:50-5.
22. Zerumsky K, Steinmetz KL, Handler SM, et al. Pharmacist
detection of peripheral arterial disease through the use of
a handheld Doppler. Pharmacotherapy. 2005;25:797-802.
23. Rosenthal WM. Establishing a pharmacy-based laboratory
service. J Am Pharm Assoc. 2000;40:146-56.
24. States where pharmacists can provide immunizations.
American Pharmacists Association. Available at:
www.aphanet.org/
pharmcare/ImmunizationInformation.htm#States%20where.
Accessed July 15, 2005.
25. Guidelines for pharmacy-based immunization advocacy.
American Pharmacists Association. Available at:
www.aphanet.org/
pharmcare/immguide.html. Accessed July 15, 2005.
26. Wolfe RM, Sharp LK, Lipsky MS. Content and design
attributes
of antivaccination web sites. JAMA. 2002;287:3245-8.
27. Guide to Clinical Preventative Services 2005. United States
Preventative Health Services Task Force. Available at:
www.ahrq.gov/clinic/pocketgd.htm. Accessed July 15, 2005.
28. Mullen PD, Hershey JC, Iverson DC. Health behavior
models
compared. Soc Sci Med. 1987;24:973-81.
29. Ajzen I, Fishbein M. Understanding Attitudes and
Predicting
Social Behavior. Englewood Cliffs, NJ: Prentice Hall; 1980
30. Hudmon KS, Berger BA. Pharmacy applications of the
transtheoretical model in smoking cessation. Am J Health-Syst
Pharm. 1995;52:282-7.
31. Lange N, Tigges BB. Influence positive change with
motivational
interviewing. Nurse Pract. 2005;30:44-53.
24. 32. Kennedy DT, Small RE. Development and implementation
of
a smoking cessation clinic in a community pharmacy practice.
J Am Pharm Assoc. 2002;42:83-92.
33. Kennedy DT, Giles JT, Ghnag ZG, et al. Results of a
smoking
cessation clinic in a community pharmacy practice. J Am Pharm
Assoc. 2002;42:51-6.
34. A Clinical Practice Guideline for Treating Tobacco Use and
Dependence. US Public Health Service Report. JAMA.
2000;283:3244-54.
35. Rigotti NA. Treatment of Tobacco Use and Dependence.
N Engl J Med. 2002;346:506-12.
36. Haggerty SA, Cerulli J, Zeolla MM, Cottrell JS, Weck MB,
Faragon JJ. A Community pharmacy Target Intervention
Program
(TIP) to improve aspirin use in persons with diabetes. J Am
Pharm
Assoc. 2005;45:17-22.
American Journal of Pharmaceutical Education 2006; 70 (2)
Article 40.
7
37. Mc Donough RP, Doucette WR. Using personal selling
skills
to promote pharmacy services. J Am Pharm Assoc.
2003;43:363-72.
38. Holdford DA. Using buzz marketing to promote ideas,
services,
and products. J Am Pharm Assoc. 2004;44:387-96.
26. It was highly structured and specific in its organization and
focus of supporting points
and sub-points.
Depending on how successful you were in completing this stage
of our assignment, the
creation of your rough draft should be logical and rewarding.
Many students and writers attempt to write full paragraphs and
reports before they
have outlined and formulated specific topics and points. Not so
for you as you’ve
already crafted a detailed and focused outline with proposed
quotes and sources that
are relevant and specific.
Writing a Rough Draft
By creating a detailed outline with proposed quotes and sources
for each point, you can
begin to craft paragraphs for each section of your report.
• Each paragraph should begin with a focused topic sentence
which gives an
overview of the main idea for the entire paragraph and its
connection to your
thesis.
• Following this topic sentence, each paragraph should supply
approximately 15
sentences of supporting details which include quotes, facts,
graphics or expert
opinions that use in-text documentation in MLA formats.
• Equally important, in each paragraph you must supply your
own insights and
27. opinion which synthesize and analyze this factual information
and connect
them to the thesis. In this way, you will avoid a copy-and-paste
report – a
common mistake in report writing in which the writer merely
assembles a variety
of quotes, with or without focus, fails to analyze or synthesize
them and offers
no insights or opinion.
Also, you must strive to organize your points and material
within each paragraph.
Consider time order, cause and effect, reasons, a range of
opinions, strengths vs.
weaknesses, or distinct categories of frameworks or sources.
In addition, you must establish authority, introduce and qualify
each source from which
you quote in your paragraphs.
2
Establish Authority & Qualify Sources
In addition, you must establish authority. Introduce and qualify
each source from which
you quote in your paragraphs. Consider this quote:
“Apple has unlimited growth potential, not only in sales of its
innovative
products, but also its business model of offering a lucrative
28. platform and
charging suppliers and providers of content and applications – a
brilliant source
of ongoing revenue and profits.” (Buffett 213)
Who is Warren Buffett? Why does his opinion matter? Now
look at this example of
qualifying and introducing an expert’s opinion or qualitative
quote:
World-renowned equity expert and billionaire Warren Buffet
believes,
“Apple has unlimited growth potential, not only in sales of its
innovative
products, but also its business model of offering a lucrative
platform and
charging suppliers and providers of content and applications – a
brilliant source
of ongoing revenue and profits.”
Notice that I have qualified and introduced who Warren Buffett
is and why his opinion is
of value. Also, I documented the quote in the introductory
material of the sentence
rather than at the end in parenthesis. As with every quote I use,
I would then ensure
that I have a Works Cited page entry that begins with Buffett,
Warren and supplies the
full information for the source of this quote.
An example of qualifying, introducing and integrating statistics,
facts or quantitative
quotes:
29. According to Apple’s Annual Report, “revenues have increased
by 30% for the
quarter ending December, 2009” (23).
Again, I have documented the statistics in the introductory
material of the sentence
rather than at the end in parenthesis. However, I have included
the page number in
parenthesis at the end of the sentence. I also need to confirm
that I have a Works Cited
page entry that begins with “Annual Report – Apple” and
supplies the full information
for the source of this quote.
If I have already introduced and qualified the source earlier in
the report, I would
document the quote in parenthesis at the end of the sentence:
“Revenues have increased by 30% for the quarter ending
December, 2009”
(“Annual Report – Apple” 23).
Notice where and how quotation marks, periods and parentheses
are specifically used
and placed.
3
30. Use Correct Documentation
Again refer to your book and the online sources previously
identified to compare your
writing and formats to the MLA models for integration of
quotes and sources, in-text
documentation and Work Cited formats.
In addition, be sure to follow models in your book and online
for correctly citing and
using in-text documentation for any images, charts or graphs
you use. As with quotes,
facts or statistics which use words or numbers, the in-text
documentation you use for
images, charts and graphs should track back directly to a
specific Works Cited entry.
Avoid First-person Writing
Finally, avoid the use of “I” or “we” when writing sentences in
each paragraph which
supply your analysis, synthesis, opinion and insights.
An example using first-person writing:
I think Apple’s a great company and even though they don’t
give any dividends, I
still would buy the stock!
By avoiding first person, the revised sentence below must
synthesize and provide valid
reasons for opinions:
31. Even though Apple does not pay dividends to its shareholders,
its stock price has
increased significantly during the last decade, offering massive
profits to those
who have held shares for the long-term.
Refer to your completed Outline & Sources Integration
assignment from our previous
module.
• The 4 sections of your report should have 3 subpoints each
• In other words, you should supply 12 paragraphs for the body
of your report. (4
sections with 3 paragraphs each.)
Each paragraph should include:
• A focused topic sentence, which gives an overview of the
main of the entire
paragraph and its connection to your thesis
• Approximately 15 sentences of supporting details, which
include quotes, facts,
graphics or expert opinions that use in-text documentation in
MLA formats.
• Your own insights and opinion, which synthesize and analyze
this factual
information and connect them to the thesis.
Group Recommendation
Once all your group members have completed these body
32. paragraphs, you are ready to
write your own recommendation section which synthesizes all
the frameworks, insights,
facts, details, quotes and opinions from the previous 4 sections
and formulates your
group’s collective opinion about the company’s stock – buy,
sell or hold.
4
You may find that this section is one long paragraph or a series
of shorter paragraphs,
but your group should discuss the logic and organization of this
section.
Remember the purpose of the Group Recommendation section:
Synthesize the
research and comment on whether your group would recommend
investing in this
company. Give specific reasons for your opinions. BUY / SELL
/ HOLD
You may discover there are advantages and disadvantages,
strengths and weaknesses,
3-5 reasons, or 3-5 frameworks that seem logical as separate
paragraphs which highlight
each distinct point you are making.
Regardless of how you organize this crucial section of your
report, you must provide 1 or
more substantial paragraphs with focused topic sentences,
compelling evidence and
33. support, valuable synthesis, insights and analysis and an
articulate recommendation.
Once you have completed all the required sections for your
rough draft, refer to the
Rough Draft Rubric for your Company Report and be sure you
have proofread and
revised all sections before submitting it for my evaluation.
Required Sections for Rough Draft:
• Company Background & Current Stage in Growth Lifecycle
• Detailed Financial Information -- Microeconomics
• Industry Landscape, Trends and Competitors --
Macroeconomics
• Recent Developments, Analyst Opinions and Wall Street
Consensus
• Group’s Recommendation
• Updated Works Cited
Questions to Ask
Does your rough draft:
• Include all required sections?
• Supply sufficient organization & content?
• Effectively integrate sources, MLA formats and include your
updated works
cited?
• Follow standards for grammar & mechanics?
Make sure you communicate regularly with your group
members, especially for the
group recommendation section.
35. Paragraphs in all sections include:
• A focused topic sentence with an overview of the main idea
for the entire paragraph and
its connection to thesis
• Approximately 15 sentences of supporting details which
include quotes, facts, graphics or
expert opinions
• Writers’ insights and opinions are provided, which synthesize
and analyze researched
quantitative, qualitative and responsive information, and
connect to the thesis
• Points and material within each paragraph are logically
organized. Consider time order,
cause and effect, reasons, a range of opinions, strengths vs.
weaknesses, or distinct
categories of frameworks or sources.
SOURCE INTEGRATION, MLA FORMATS & WORKS CITED
(2.5 POINTS)
• Sources are integrated effectively establishing authority,
introducing and qualifying each
source quoted in paragraphs
• In-text documentation follows MLA formats
• Works Cited page follows MLA formats
GRAMMAR & MECHANICS (2.5 POINTS)
• Writing follows standards for effective business writing,
avoiding first person and errors
in sentence skills, mechanics, grammar and spelling
36. TOTAL POINTS: __________________
Company Report “Rough Draft” Rubric
Now that you have fully researched your company, written a
detailed outline and source review, selected the specific quotes,
graphics, and details which are quantitative, qualitative and
responsive, and created a correctly formatted and accurately
detailed Works Cited page, you are ready to compile and begin
writing the first draft of your Company Report.
Contrary to the method you may have used in writing researched
reports in the past, we will not begin by writing the introduction
or first paragraph of your report. You must first fully
collaborate and cooperate with your team members and begin
compiling the specific sections of your report -- the body. After
you have ensured that these sections are all complete and fully
developed, then your group can begin to synthesize all the
research and analysis featured in these sections to formulate and
write your group’s own recommendation section and opinion --
buy, sell or hold. In our next module, after completing this and
all the body sections of your report, your group will write an
introduction, summary, and conclusion that unify and frame
your report.
Design and create your masterpiece first – the body sections of
your report – then add a frame and packaging after – the
introduction, summary, and conclusion.
(No Group)