Pharmacy Students' Lived Experiences of Academic Difficulty and Tinto's Theory of Student Departure.

Objective. To understand students' lived experiences of academic difficulty in pharmacy school in relation to Tinto's conceptual schema of student departure. Methods. A descriptive, single case study design was chosen to explore academic difficulty in pharmacy school, and the unit of analysis (case) in this study was the experience of academic difficulty. Four students who had experienced academic difficulty in pharmacy school were recruited to participate in the study. Data sources included admissions applications, transcripts, emails to the lead researcher, and semi-structured interviews. Prior to analysis, the researchers created a coding dictionary to operationalize codes for textual analysis. Intercoder agreement was established at 97% agreement. Research validity was supported by triangulation of data, multiple researchers, and member checking. Results. Three of the four students were retained because of the synergistic reinforcement of academic and social integration based upon Tinto's schema. A fourth student was academically dismissed and departed the college, suggesting that too many social responsibilities in pharmacy college reduces time for academic integration, thereby diminishing the reciprocal potential between academic and social integration. Among the four students, seven main themes were identified: student background, goal of becoming a pharmacist, academic integration during pharmacy school, social integration during pharmacy school, retention and departure, roles and responsibilities during pharmacy school, and wellness. Conclusion. The results suggest that Tinto's theory of student departure is applicable to students' experiences of academic difficulty. These student stories suggest that early identification of student support needs may help pharmacy programs improve student retention.

Becoming more holistic: A literature review of nonacademic factors in the admissions process of colleges and schools of pharmacy and other health professions.

BACKGROUND: The expanding role of pharmacists has influenced admissions committees to consider nonacademic factors other than grade point average (GPA) and test scores and has focused more attention on holistic admissions. METHODS: Database searches were conducted in PubMed, CINAHL, ERIC, and PsychINFO using keywords, "holistic admissions", "holistic review", and "pharmacy admissions" plus "critical thinking skills", "extracurricular", "communication skills", "essay", or "interview". Overall, 64 studies were identified, 17 were excluded, and ultimately, 47 were reviewed. RESULTS: Holistic admissions is not an industry standard in pharmacy but more so in other health professions. For critical thinking skills, the Health Sciences Reasoning Test (HSRT) was not a good predictor of academic performance even though it was effective in ranking admission applicants. The California Critical Thinking Skills Test (CCTST) however, was a significant predictor for clerkship and practice-related courses. It is unclear whether pharmacy admissions committees are utilizing the Pharmacy College Admissions Test (PCAT) reading and writing scores, the interview, or other measures to evaluate communication skills. The Multiple Mini Interview (MMI) is an effective assessment tool for measuring noncognitive attributes; however, the efficacy of unstructured interviews in evaluating noncognitive skills was less clear. IMPLICATIONS: Academic measures alone are not nuanced enough to predict success throughout the entire curriculum. An integration of factors, both academic and nonacademic, would be more relevant to predict success. Critical thinking skills and extracurricular experiences may be more significant for admissions selection and admissions ranking respectively, and more predictive of academic success during didactic and experiential stages of the curriculum respectively.

APPE Evaluations are Positively Associated with MMI, Pre-pharmacy GPA and Pharmacy GPA.

Objective. To determine factors associated with advanced pharmacy practice experience (APPE) performance in the pre-pharmacy and Doctor of Pharmacy (PharmD) curriculum and establish whether performance on the multiple mini interview (MMI) independently predicts APPE evaluation scores. Methods. A multi-case MMI has been used in the admissions process since 2008. Students are scored anywhere from 1 to 7 (unsatisfactory to outstanding) on each interview. Traditional factors (GPA, PCAT, etc.) are also used in the admissions determination. Pearson product-moment correlation and ordinary least squares regression were used to explore the relationships between admissions data, pharmacy GPA, and APPE evaluation scores for the graduating classes of 2011-2014. These analyses identified which factors (pharmacy GPA, PCAT, MMI score, age, gender, rurality, resident status, degree, and underrepresented minority status) related to APPE performance. Results. Students (n=432) had a mean APPE score of 4.6; a mean MMI score of 5.5; mean pharmacy GPA, PCAT and age of 3.14, 73.2, 22.6 years, respectively. Pre-pharmacy GPA and pharmacy GPA positively correlated with mean APPE scores. MMI score demonstrated positive correlations with overall APPE score; including subcategories patient care, documentation, drug information/EBM, public health, and communication. MMI scores were positively related to overall APPE scores in the multivariable regression. Variables showing negative associations with APPE scores included a pre-pharmacy GPA of <3.0 (ref= GPA >3.5) and pharmacy school GPA of >3.0 - 3.5 and GPA 2.6 - 3.0 when compared to GPAs >3.5. Conclusion. GPA (pre-pharmacy and pharmacy) and MMI positively correlate with preceptor-rated performances in the APPE year.

Adapting Leadership Styles to Reflect Generational Differences in the Academy.

The topic of adapting one's leadership style is controversial and can generate great debate. When one considers adapting one's leadership style, the question of authenticity often bubbles to the surface. This is even more compelling in the context of generational differences in our society and workforce. How can faculty members be effective if they refuse to adapt their leadership style to students' learning styles and generational characteristics? Leadership development is an ongoing focus for the American Association of Colleges of Pharmacy (AACP) to prepare faculty for roles as future leaders in higher education while a major redistribution of generations is occurring within the workforce. These generations are molded by many factors, including the economy, significant events, technology, and education. As experienced leaders, we affirm that one's leadership styles must be honed over time and adapted to reflect generational differences in academic pharmacy among colleagues, students, alumni, and stakeholders, including patients. Current and future leaders need further education and development so that their awareness of generational characteristics prepares them to adapt their leadership styles to more effectively engage and lead people of any generation.

Desirable Skills in New Pharmacists.

OBJECTIVE: To compare survey responses between licensed pharmacists who work with or employ new graduates and graduating senior pharmacy students at a college of pharmacy. DESIGN: This was a retrospective analysis of surveys given to 2 groups of pharmacists and students. Responses to items regarding importance of desirable qualities in new pharmacists and level of preparation of new graduates were analyzed. Qualities included drug information, pharmacology, therapeutics, communication with patients/customers or health care professionals, professionalism, ethics, management, and conflict resolution. RESULTS: There was consensus between pharmacists and students regarding the importance of all items ( P > .05 for all comparisons). However, the percentage of pharmacists versus students who agreed that new graduates communicate effectively differed (86.7% vs 100%, respectively, P < .05). Of pharmacists surveyed at a career fair, 64.1% chose communication as the 1 skill that would distinguish an applicant, and retail and hospital pharmacists displayed a statistically significant ( P < .05) difference in the audience (patients/customers vs other health care professionals). CONCLUSION: Pharmacists and students agree on the knowledge and skills essential for pharmacy practice but disagree on the level of preparation for effective communication. These results support ongoing efforts to improve the development of communication skills in the professional pharmacy curriculum.

Multiple Mini-Interview Performance Predicts Academic Difficulty in the PharmD Curriculum.

Objective. To identify admissions variable prognostics for academic difficulty in the PharmD curriculum to use for admissions determinations and early identification of at-risk students. Methods. Retrospective multivariate analysis of 2008-2012 admission data were linked with academic records to identify students with academic difficulty (ie, those with Ds, Fs, delayed progression). The influence of prepharmacy grade point average (GPA), composite Pharmacy College Admission Test (PCAT) score, multiple-mini interview (MMI) score, age, credit hours, state residence, and prior degree on academic difficulty was estimated using multivariate logistic regression. Results. Students' (n=587) prepharmacy GPA, composite PCAT score, mean MMI score, and age were 3.6, 72.0, 5.5, 22.8 (SD=4.14 years), respectively. Students having a GPA <3.25, PCAT score <60th percentile, or MMI score <4.5, were approximately 12-, 7-, and 3-times more likely, respectively, to experience academic difficulty than those with a GPA ≥ 3.75, PCAT score >90, or MMI score of 5-6. Conclusion. Using GPA, PCAT, and MMI performance can predict academic difficulty and assist in the early identification of academically at-risk PharmD students.

Factors associated with health-related quality of life of student pharmacists.

OBJECTIVE: To assess the health-related quality of life (HRQoL) of student pharmacists and explore factors related to HRQoL outcomes of student pharmacists in a doctor of pharmacy (PharmD) program at a public university. METHODS: A survey instrument was administered to all student pharmacists in a PharmD program at a public university to evaluate differences and factors related to the HRQoL outcomes of first-year (P1), second-year (P2), third-year (P3), and fourth-year (P4) student pharmacists in the college. The survey instrument included attitudes and academic-related self-perception, a 12-item short form health survey, and personal information components. RESULTS: There were 304 students (68.6%) who completed the survey instrument. The average health state classification measure and mental health component scale (MCS-12) scores were significantly higher for P4 students when compared with the P1through P3 students. There was no difference observed in the physical component scale (PCS-12) scores among each of the 4 class years. Significant negative impact on HRQoL outcomes was observed in students with higher levels of confusion about how they should study (scale lack of regulation) and concern about not being negatively perceived by others (self-defeating ego orientation), while school satisfaction increased HRQoL outcomes (SF-6D, p<0.001; MCS-12, p=0.013). A greater desire to be judged capable (self-enhancing ego-orientation) and career satisfaction were positively associated with the PCS-12 scores (p<0.05). CONCLUSION: Factors associated with the HRQoL of student pharmacists were confusion regarding how to study, ego orientation, satisfaction with the chosen college of pharmacy, and career satisfaction. First-year through third-year student pharmacists had lower HRQoL as compared with P4 students and the US general population. Support programs may be helpful for students to maintain or improve their mental and overall health.

Academic help-seeking behavior among student pharmacists.

Objectives. To identify factors associated with academic help-seeking behavior among student pharmacists at a public university.Methods. Semi-structured focus group interviews were conducted to explore in depth perceptions of facilitators of and barriers to the help-seeking behavior and academic achievement of student pharmacists who had received a D or F grade in any year. A 4-part survey instrument was developed and administered to all student pharmacists and included sections for (1) attitudes and academic help-seeking behavior, (2) health status, (3) demographics, and (4) open comments. A structural equation modeling approach was used to assess relationships among domains of interest.Results. Three student focus groups noted that helpfulness of faculty members and school administrators were 2 prominent facilitators of help-seeking behavior and academic achievement. Diminished quality of life caused by stress and depression was the primary barrier to help-seeking and achievement. Three hundred four (68.6%) student pharmacists completed the survey instrument. Academic help-seeking behavior was influenced mostly by perceived academic competence and perceived faculty helpfulness. In contrast, ambivalence and perception of help-seeking as threatening were 2 factors that were negatively associated with academic help-seeking behavior.Conclusions. Academic help-seeking behavior was positively related to greater perceived academic competence and positive relationships among student pharmacists and faculty members.

Multi-institutional study of women and underrepresented minority faculty members in academic pharmacy.

OBJECTIVES: To examine trends in the numbers of women and underrepresented minority (URM) pharmacy faculty members over the last 20 years, and determine factors influencing women faculty members' pursuit and retention of an academic pharmacy career. METHODS: Twenty-year trends in women and URM pharmacy faculty representation were examined. Women faculty members from 9 public colleges and schools of pharmacy were surveyed regarding demographics, job satisfaction, and their academic pharmacy career, and relationships between demographics and satisfaction were analyzed. RESULTS: The number of women faculty members more than doubled between 1989 and 2009 (from 20.7% to 45.5%), while the number of URM pharmacy faculty members increased only slightly over the same time period. One hundred fifteen women faculty members completed the survey instrument and indicated they were generally satisfied with their jobs. The academic rank of professor, being a nonpharmacy practice faculty member, being tenured/tenure track, and having children were associated with significantly lower satisfaction with fringe benefits. Women faculty members who were tempted to leave academia for other pharmacy sectors had significantly lower salary satisfaction and overall job satisfaction, and were more likely to indicate their expectations of academia did not match their experiences (p<0.05). CONCLUSIONS: The significant increase in the number of women pharmacy faculty members over the last 20 years may be due to the increased number of female pharmacy graduates and to women faculty members' satisfaction with their careers. Lessons learned through this multi-institutional study and review may be applicable to initiatives to improve recruitment and retention of URM pharmacy faculty members.

An Objective Standardized Clinical Examination (OSCE) in an advanced nonprescription medicines course.

OBJECTIVE: To add an objective standardized clinical examination (OSCE) to a nonprescription medication elective and assess the impact on students' knowledge, skills, and satisfaction. DESIGN: A nonprescription medicine elective was altered to incorporate more active learning and skill-assessment measures. Small group recitation sessions were added to review didactic material from a prior required nonprescription medicine course, and an objective standardized clinical examination was used to assess skills. ASSESSMENT: Thirty-four students completed the 3-case OSCE with an average grade of 88%. The standardized patients expressed differences in their satisfaction with the student pharmacists' care by ranking the students' overall performance. Students' grades for the course and course evaluations were similar to the previous year. CONCLUSION: The addition of the OSCE to the elective course provided students with an enhanced mechanism for evaluation of their self-care education and skill development.

Web-based multimedia vignettes in advanced community pharmacy practice experiences.

OBJECTIVES: To evaluate the effectiveness of Web-based multimedia vignettes on complex drug administration techniques to augment the training of pharmacy students in advanced community pharmacy practice experiences. DESIGN: During the orientation for a community APPE, students were randomly assigned to either a study group or control group After they began their APPE, students in the study group were given an Internet address to access multimedia vignettes which they were required to watch to augment their training and standardize their counseling of patients in the use of inhalers and ear and eye drops. ASSESSMENT: A 12-item questionnaire was administered to students in both groups at the orientation and again on the last day of the APPE to evaluate their knowledge of counseling patients in the use of inhalers and ear and eye drops. The control group did not experience any improvement in their counseling knowledge of the research topics during their month-long experience. Students in the intervention group scored higher on their postintervention test than students in the control group (p < 0.001). CONCLUSIONS: Student learning outcomes from experiential training can be improved through the use of Web-based multimedia instructional vignettes.

Arkansas community pharmacists' opinions on providing immunizations.

OBJECTIVES: To determine community pharmacists' attitudes and knowledge on providing immunizations including perceived barriers to immunizing. The study also examined the percentage of Arkansas pharmacists providing immunizations and the utilization of student pharmacists. DESIGN: Survey. SETTING: Arkansas community pharmacies from February to March 2009. PARTICIPANTS: Community pharmacists. INTERVENTION: Mailed survey. MAIN OUTCOME MEASURES: Perceived barriers to providing immunizations, pharmacists' attitudes regarding immunizations, number of immunization-certified pharmacists, immunization administration rates within the last year, and senior student pharmacists utilization. RESULTS: A total of 350 surveys were mailed, and 129 were returned. In all, 79% of the respondents believed administering immunizations has advanced or significantly advanced the profession. Being certified and attitude toward providing immunizations were correlated; 37% of the respondents held certification to immunize, of which 77% reported immunizing within the last year. Commonly reported barriers included time (76%) followed by reimbursement and legal liability. Only half the respondents realized fourth year student pharmacists could immunize and only 33% of certified pharmacists utilized student pharmacists to immunize. CONCLUSION: Pharmacists perceive many barriers to providing immunizations. Training student pharmacists to give immunizations may not result in them providing immunizations upon graduation. Additional education on overcoming potential barriers and using senior student pharmacists to administer immunizations is needed.

Expanding experiential opportunities through patient care services: a focus on immunizations.

A new set of standards, ACPE Standards 2007, adopted by the Accreditation Council for Pharmacy Education (ACPE), required all pharmacy programs to include introductory pharmacy practice experiences (IPPEs) to represent 5% of the curriculum and advance pharmacy practice experiences (APPEs) to represent 25% of the curriculum. This required many pharmacy programs to revise their curriculum to meet these requirements. The challenge of satisfying the increased accreditation requirements along with the increased number of new pharmacy programs in the United States has resulted in increased competition for experiential sites. Drake University College of Pharmacy and Health Sciences and the University of Arkansas for Medical Sciences (UAMS) College of Pharmacy utilized innovative immunization services to help meet the ACPE Standards 2007. Drake utilized P2 and P3 students who were trained to give immunizations in an IPPE patient care elective in order to help experiential sites in their immunization efforts. Senior pharmacy students at UAMS were involved in expanding APPE opportunities by developing immunization clinics and providing immunizations at their experiential sites. Both pharmacy programs were successful in expanding experiential opportunities by focusing on immunizations. Students, preceptors, and patients all benefit from utilizing student pharmacist at experiential sites to provide patient care services.

Integrating an elective self-care experience with a required advanced pharmacy practice community experience.

The development, planning, implementation, and integration of a nonprescription medication (self-care) experience into an existing community advanced pharmacy practice experience (APPE) at the University of Arkansas for Medical Sciences College of Pharmacy is described. The APPE will provide enhanced self-care education and skill development for students in response to the new Accreditation Council for Pharmacy Education Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree, which will take effect in July 2007. A description of the Advanced Community Pharmacy Over-The-Counter APPE is provided along with insights gleaned from the faculty involved.