Teaching Experience Log

Name Institution Program type Funding by academic institution (any %)

Luke Dotson Lutheran Hospital 1 = PGY1 2 = No

Didactic Teaching

If any “other” responses

Type of Teaching (Select the BEST Location (Institution/Setting) If "College of Pharmacy," please Delivery (Select the Would you have completed
Date Target audience selected, please explain Time (hours)
fit) Select the BEST fit list. If "Other," describe location. BEST fit) this if not part of IPTeC?
here.

10/19/23 2 = Instruction for health profession3 = Practice setting (communit FWMEP Family Medicine Clinic 1 = In-person 2 = Healthcare professional 1 = Yes 0.5
03/14/24 2 = Instruction for health profession3 = Practice setting (communit FWMEP Family Medicine Clinic 1 = In-person 2 = Healthcare professional 1 = Yes 0.5
04/03/24 1 = Classroom-based instruction for1 = College of Pharmacy Manchester College of Pharmacy 1 = In-person 1 = Students 2 = No 1
Total 2 2 hours required

Small Group Teaching

If any “other” responses

Type of Teaching (Select the BEST Location (Institution/Setting) If "College of Pharmacy," please Delivery (Select the Would you have completed
Date Target audience selected, please explain Time (hours)
fit) Select the BEST fit list. If "Other," describe location. BEST fit) this if not part of IPTeC?
here.

Sept. 2023 2 = Discussion-based course (i.e., ca3 = Practice setting (communit Lutheran Hospital 1 = In-person 2 = Healthcare professional 1 = Yes 0.5
10/18/23 1 = Skills-based course (i.e., laborat 1 = College of Pharmacy Manchester College of Pharmacy 1 = In-person 1 = Students 2 = No 3
2/10/24 1 = Skills-based course (i.e., laborat 3 = Practice setting (communit Lutheran Hospital 1 = In-person 2 = Healthcare professional 1 = Yes 0.5
03/13/24 1 = Skills-based course (i.e., laborat 1 = College of Pharmacy Manchester College of Pharmacy 1 = In-person 1 = Students 2 = No 3

Total 7 3 hours required

Precepting/Co-precepting

Location of precepting If any “other” responses

Type of Teaching (Select the BEST Delivery (Select the Would you have completed
Date (Institution/Setting). Select Learners precepted selected, please explain Time (hours)
fit) BEST fit) this if not part of IPTeC?
the BEST fit here.

October 2023 2 = Co-precepting (contributes to p 4 = Other 1 = In-person 2 = APPE student 1 = Yes 4

January 2024 2 = Co-precepting (contributes to p 2 = Institutional 1 = In-person 2 = APPE student 1 = Yes 4
May 2024 1 = Primary preceptor (lead in desig2 = Institutional 1 = In-person 2 = APPE student 2 = No 40

Total 48 6 hours required

Experiential Didactics

If any “other” responses

Type of Teaching (Select the BEST Location (Institution/Setting) If "College of Pharmacy," please Delivery (Select the Would you have completed
Date Target audience selected, please explain Time (hours)
fit) Select the BEST fit list. If "Other," describe location. BEST fit) this if not part of IPTeC?
here.

8/17/23 1 = Topic discussion facilitation 3 = Practice setting (communit 1 = In-person 4 = More than one of the a 1 = Yes 0.5
9/14/23 3 = Journal club facilitation 3 = Practice setting (communit 1 = In-person 4 = More than one of the a 1 = Yes 1
10/10/23 7 = Other 3 = Practice setting (communit 1 = In-person 4 = More than one of the a 1 = Yes Escape Room Creation 0.75
11/08/23 7 = Other 3 = Practice setting (communit 1 = In-person 4 = More than one of the a 1 = Yes Policy Review and Practice 0.5
12/28/23 1 = Topic discussion facilitation 3 = Practice setting (communit 1 = In-person 4 = More than one of the a 1 = Yes 1
01/16/24 3 = Journal club facilitation 3 = Practice setting (communit 1 = In-person 4 = More than one of the a 1 = Yes 0.5
02/15/24 7 = Other 3 = Practice setting (communit 1 = In-person 4 = More than one of the a 1 = Yes Policy Review and Practice 0.5
3/13/24 1 = Topic discussion facilitation 3 = Practice setting (communit 1 = In-person 4 = More than one of the a 1 = Yes 0.5
4/11/24 3 = Journal club facilitation 3 = Practice setting (communit 1 = In-person 4 = More than one of the a 1 = Yes Team Competition 0.75
 Total 6 6 hours required

Other teaching experiences

If any “other” responses
Location (Institution/Setting) If "College of Pharmacy," please Delivery (Select the Would you have completed
Date Type of Teaching Target audience selected, please explain Time (hours)
Select the BEST fit list. If "Other," describe location. BEST fit) this if not part of IPTeC?
here.

11/17/23 Community - Stroke Support Group3 = Practice setting (communit Stroke survivor meeting 1 = In-person 4 = Other 2 = No Audience: stroke survivors a 1
Community - High School 5 = Other Norwell High School 1 = In-person 1 = Students 1 = Yes Audience: high school stude 2

Total 3

Total teaching time 66

1 = Classroom-bas 1 = Topic discussion facilitation 1 = College of Pharmacy 1 = In-person 1 = Yes

2 = Instruction for 2 = Topic discussion evaluation 2 = Other health professions school (outside of pharmacy) 2 = Online synchronous 2 = No
3 = Other 3 = Journal club facilitation 3 = Practice setting (community, clinic, hospital, industry, regulatory, etc.) 3 = Online asynchronous
4 = Journal club evaluation 4 = Professional conference (Great Lakes, IPA, ASHP, national event, etc)
5 = Patient case presentation lead 5 = Other
6 = Patient case presentation evaluation 1 = Students
7 = Other 1 = Community 2 = Healthcare professionals
2 = Institutional 3 = Both of the above
1 = Primary precebased course (i.e., laboratory, simulation, etc) 3 = Industry 4 = Other
2 = Co-preceptingon-based course (i.e., case studies course, etc.) 4 = Other
3 = Other
1 = PGY1 1 = IPPE student
2 = PGY2 2 = APPE student
3 = Other 3 = PGY1
4 = More than one of the above