California Pharmacist Vol. 73, No. 3 SUMMER 2026 - Magazine - Page 21
How to use this checklist: For each activity you directly observe, rate the learner’s entrustment level and jot a brief comment. Aim for
at least 1 EPA observation per shift (or per clinic half-day), not per block day.
Recommended entrustment scale (simplified):
1 = Cannot perform, even with direct supervision
2 = Performs with close, proactive supervision and frequent prompting
3 = Performs with indirect supervision (you are available but not constantly directing)
4 = Performs independently with routine oversight only
Core patient-care EPAs (for IPPE and APPE)
EPA 1 – Collect information
Observed tasks (check all that you observed today):
• □ Obtained a focused patient history (medications, allergies, adherence, relevant medical history)
• □ Reviewed electronic medical record (EMR) for labs, vitals, problem list, and medications
• □ Identified missing or conflicting information and sought clarification
Entrustment level: 1 □ 2 □ 3 □ 4 □
Key question for preceptor:
• Can I trust this learner to independently collect the right information for a routine patient, then summarize it accurately?
EPA 2 – Assess information and identify problems
Observed tasks:
• □ Identified actual and potential drug-therapy problems
• □ Prioritized problems (e.g., safety issues before convenience issues)
• □ Interpreted key labs and vitals in the context of medication therapy
Entrustment level: 1 □ 2 □ 3 □ 4 □
Key question:
• Can I trust this learner to recognize and correctly prioritize common drug-therapy problems without me walking them through
every step?
EPA 3 – Develop and recommend a care plan
Observed tasks:
• □ Proposed evidence-based therapy changes (start/stop/change dose)
• □ Tailored recommendations to patient-specific factors (age, renal/hepatic function, comorbidities, preferences)
• □ Used guidelines or primary literature appropriately
Entrustment level: 1 □ 2 □ 3 □ 4 □
Key question:
• Can I trust this learner to propose a safe, guideline-concordant plan that I would be comfortable co-signing?
EPA 4 – Implement and document the plan
Observed tasks:
• □ Entered or proposed orders correctly (per local policies/scope)
• □ Communicated recommendations to the prescriber or care team
• □ Documented the encounter accurately in the EMR or pharmacy system
Entrustment level: 1 □ 2 □ 3 □ 4 □
Key question:
• Can I trust this learner to implement and document a plan with minimal risk of error in routine cases?
EPA 5 – Follow-up and monitor
Observed tasks:
• □ Identified appropriate monitoring parameters and time frame
• □ Checked follow-up labs/clinical outcomes and adjusted plan when needed
• □ Closed the loop (e.g., re-assessed adherence, side effects, clinical response)
Entrustment level: 1 □ 2 □ 3 □ 4 □
Key question:
• Can I trust this learner to independently ensure appropriate follow-up and monitoring for routine therapies?
California Pharmacist | vol. 73, no. 3
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