For Long Term Care both site evaluations were done over Zoom. The first site evaluation was done with another student, and the second one alone. In the first site evaluation each of us presented a case, and 5 pharmacology cards. Then we discussed it with the site evaluator. I felt that time was valuable because I got to hear another student’s perspective. In the second site visit I presented a case, a journal article and 5 more pharmacology cards. I enjoyed that I had one site visit with another student so I could learn from the other student and one site visit by myself, because I felt with the individual attention I could speak up more. 

In the first site visit I presented a case of a 69-year-old woman with back pain who was admitted for elevated troponins. In the second visit I presented a case of a 69-year-old woman with abdominal pain and pneumonia. It was interesting to compare and contrast these two cases because even though they were the same age their medical history and acuity was different.

I enjoyed the way pharmacology cards were presented at this rotation. I was told to discuss why I chose the medication I did, its mechanism of action, indications, and important adverse effects. For example I chose alendronate, a bisphosphonate because it is used in osteoporosis which is usually a geriatric issue. There are many side effects of this medication but I chose to focus on the esophageal irritation, because it matters very much clinically, as patients need to be instructed to take it first thing in the morning on an empty stomach with a cup of water and sit upright for 30 minutes. 

The journal article I chose to present was connected to my second site visit presentation. In addition to her acute issues the patient also had a liver transplant due to HCV cirrhosis. I chose to discuss a meta analysis on treatment of HCV recurrence in patients with liver transplants, because while I was reading about my patient I found that HCV often recurs in patients with liver transplants. 

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