OSHP Preceptor of the Year Award
To recognize a pharmacist who has demonstrated excellence in precepting pharmacy students and/or pharmacy residents.
Nominee Information
Nominee Name
First Name
Last Name
Nominee Phone
*
-
Area Code
Phone Number
Nominee Email Address
*
example@example.com
How many years has this nominee been a preceptor?
How many learners has the nominee precepted over the past 2 years (i.e. IPPE, APPE, PGY1/PGY2 residents, other professions)?
Please describe how the nominee has contributed to the expansion or addition of innovative precepting/teaching within the last 5 years (examples can include innovative approaches to teaching, expansion of a student teaching service, etc.). Please attach additional evidence to support as warranted
Please describe the nominees participation in the following over the past 5 years (including years involved): 1. Participated in a residency/student information panel on teaching/precepting; 2. Presented on the subject of teaching/training/precepting at a state or national conference; 3. Been involved in a committee or taskforce involving a teaching/precepting; 4. Please describe any other relevant training advocacy opportunities
Define any teaching or precepting-related awards received by the nominee at the local, state, or national level within the last 5 years
Has this individual’s teaching/precepting ideas been published (or have been accepted and are pending publications)? Please list citation with associated link (as applicable). Please only include peer-reviewed publications
List OSHP involvement over the last 5 years. This could include membership on a specific division, volunteer efforts, etc. This does not include only OSHP membership
Please list the years the nominee has been a member of OSHP
Nominator Information
Nominator Name
*
First Name
Last Name
Nominator Employer
*
Nominator Phone
*
-
Area Code
Phone Number
Nominator Email Address
*
example@example.com
Attachments
Nominee’s CV (required)
*
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Letter of Support From Past/Current Student/Resident (IF PAST, within the last 3 years)
*
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Additional Evidence #1
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Submit
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