Assessment of Stress and Quality of Life in Non-native and Native English-speaking Pharmacy Students

Objective. To evaluate the stress and health-related quality of life experienced by native and non-native English-speaking students enrolled in a Doctor of Pharmacy (PharmD) program.Methods. This study assessed PharmD students at a single institution using a self-administered online questionnaire. The primary outcome of the study was a comparison of Perceived Stress Scale (PSS) scores. Secondary outcomes were the Medical Outcome Study SF-12 Health Questionnaire scores. An independent samples t test was conducted to compare differences between non-native and native English speakers for both primary and secondary outcomes.Results. The following three criteria were used to evaluate the language status of a student: whether the student preferred to speak English (91/113 participants), whether their primary caregiver as a child spoke English at home (63/113 participants), and whether the student usually thought in English (90/113 participants). Evaluation of the primary outcome of PSS score and secondary outcome of SF-12 mental and physical health revealed no significant differences between native and non-native English speakers based on the three language-related criteria.Conclusion. The results of this study showed that the native language spoken by a pharmacy student was not directly associated with an increase in stress or decrease in quality of life for students in a PharmD program. However, the survey results did indicate that experiencing more stress correlated with a decrease in students’ mental health-related quality of life, which indicates the need for further research to identify students at risk for a decrease in mental health-related quality of life during pharmacy education.     

Student Scientific Inquiry in the Core Curriculum

Objective. To design and implement a required student-driven research program as a capstone experience in the doctor of pharmacy (PharmD) curriculum.Design. A research proposal in the form of a competitive grant application was required for each of 65 fourth-year students in an inaugural PharmD class at Touro College of Pharmacy in New York. The focus of the proposals was on hypothesis-driven research in basic science, clinical research, health outcomes, and public health.Assessment. Students’ research proposals were graded using a standardized grading instrument. On a post-experience survey, most students rated the overall experience positively, indicating increased confidence in their research skills. About two-thirds of faculty members were satisfied with their students’ performance, and the great majority thought the experience would be useful in the students’ careers.Conclusion. The capstone research project was a positive experience for fourth-year students.     

A Survey of Pharmacy Education in Thailand

Objective. To explore the current status of pharmacy education in Thailand.Methods. The International Pharmaceutical Federation of the World Health Organization’s (FIP-WHO) Global Survey of Pharmacy Schools was used for this study. The survey instrument was distributed to the deans of the 19 faculties (colleges) of pharmacy in Thailand.Results. More than half the colleges have been in existence less than 20 years, and the government owns 80% of them. There were 2 paths of admission to study pharmacy: direct admission and central admission system. The doctor of pharmacy (PharmD) programs can be divided into 4 types. Approximately 60% of all teaching staff holds a doctoral degree. Regarding the work balance among teaching staff, around 60% focus on teaching activities, 20% focus on research, and less than 20% focus on patient care services concurrent with real practice teaching. The proportion of student time dedicated to theory, practice, and research in PharmD programs is 51.5%, 46.7%, and 1.8%, respectively. Sites owned by the colleges or by others were used for student training. Colleges followed the Office of the National Education Standards’ Internal Quality Assurance (IQA) and External Quality Assurance (EQA), and the Pharmacy Council’s Quality Assessment (ONESQA) .Conclusion. This study provides a picture of the current status of curriculum, teaching staff, and students in pharmacy education in Thailand. The curriculum was adapted from the US PharmD program with the aim of meeting the country’s needs and includes industrial pharmacy and public health tracks as well as clinical tracks. However, this transition in pharmacy education in Thailand needs to be monitored and evaluated.     

A 5-Year Analysis of Peer-Reviewed Journal Article Publications of Pharmacy Practice Faculty Members

Objectives. To evaluate scholarship, as represented by peer-reviewed journal articles, among US pharmacy practice faculty members; contribute evidence that may better inform benchmarking by academic pharmacy practice departments; and examine factors that may be related to publication rates.Methods. Journal articles published by all pharmacy practice faculty members between January 1, 2006, and December 31, 2010, were identified. College and school publication rates were compared based on public vs. private status, being part of a health science campus, having a graduate program, and having doctor of pharmacy (PharmD) faculty members funded by the National Institutes of Health (NIH).Results. Pharmacy practice faculty members published 6,101 articles during the 5-year study period, and a pharmacy practice faculty member was the primary author on 2,698 of the articles. Pharmacy practice faculty members published an average of 0.51 articles per year. Pharmacy colleges and schools affiliated with health science campuses, at public institutions, with NIH-funded PharmD faculty members, and with graduate programs had significantly higher total publication rates compared with those that did not have these characteristics (p<0.006).Conclusion. Pharmacy practice faculty members contributed nearly 6,000 unique publications over the 5-year period studied. However, this reflects a rate of less than 1 publication per faculty member per year, suggesting that a limited number of faculty members produced the majority of publications.     

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.     

Pharmacy Education in India

Pharmacy education in India traditionally has been industry and product oriented. In contrast to the situation in developed nations, graduate pharmacists prefer placements in the pharmaceutical industry. To practice as a pharmacist in India, one needs at least a diploma in pharmacy, which is awarded after only 2 years and 3 months of pharmacy studies. These diploma-trained pharmacists are the mainstay of pharmacy practice. The pharmacy practice curriculum has not received much attention. In India, there has been a surge in the number of institutions offering pharmacy degrees at various levels and a practice-based doctor of pharmacy (PharmD) degree program was started in some private institutions in 2008. However, relatively little information has been published describing the current status of complex pharmacy education of India. In this paper we describe pharmacy education in India and highlight major issues in pharmacy practice including deficiencies in curriculum. The changing face of the profession is discussed, including the establishment of the PharmD program. The information presented in this paper may stimulate discussion and critical analysis and planning, and will be of value in further adaptation of the pharmacy education to desired educational outcomes.     

Admission Variables Predictive of Academic Struggle in a PharmD Program

Objective. To characterize and describe admission variables predictive of poor grade attainment by students in 2 pathways to a doctor of pharmacy (PharmD) program.Methods. A retrospective analysis of course grades of PharmD students admitted from 2000 to 2009 (N= 1,019) in the traditional degree pathway (“1 plus 5” degree program) and the provisional pathway (admitted directly from high school) was performed.Results. Four hundred three grades of D or less were earned by 183 (18%) students. There were more grades of D or less in the first pharmacy year. Receipt of an unsatisfactory grade was associated with all Pharmacy College Admission Test (PCAT) subcategory scores, PCAT composite score, cumulative prepharmacy coursework hours, prepharmacy grade point average (GPA), prepharmacy science and math GPA, and interview score for accepted students in the traditional pathway. For students in the provisional pathway, PCAT-quantitative analysis, PCAT composite score, prepharmacy cumulative GPA, prepharmacy science and math GPA, English American College Testing (ACT) score, and composite ACT score predicted poor grades. Conclusion. Admissions committees should heed PCAT scores and GPAs, regardless of program pathway, while progression committees should focus on early program coursework when designing strategies to optimize retention.     

Educating Pharmacy Students About Underserved Populations Using Patient Speakers and Simulation Activities

Objective. To assess the impact of the Patient Voices series on Doctor of Pharmacy (PharmD) students.Methods. A series of patient speakers and integrated simulation activities focused on underserved populations, otherwise known as the Patient Voices series, was embedded into a pharmacy skills laboratory curriculum. First-year PharmD students’ self-ratings of confidence were compared on pre- and post-course surveys. Using evaluations from first-year introductory pharmacy practice experiences (IPPEs), student self-evaluation data were compared to preceptor evaluations of student performance. Open-ended responses to course evaluations from first- and second-year PharmD students and student reflections from third-year PharmD students were assessed using conventional content analysis to identify and characterize student perceptions.Results. Significant increases were observed in first-year students’ confidence to show empathy (mean, 4.2 to 4.7) and to interact with patients from underserved communities (mean, 2.2 to 4.2). Preceptor ratings of students’ empathy were consistent with the students’ self-rated abilities, while students’ self-ratings on cultural sensitivity were higher than the preceptors’ ratings. Qualitative analysis of course evaluation surveys and reflections revealed common themes identified by students, such as understanding different perspectives, increased empathy for patients, and the value of including this content in the curriculum.Conclusion. Student confidence to interact with patients from a variety of underserved populations increased following introduction of the Patient Voices series into the PharmD curriculum. Students perceived the series to be a valuable learning experience.     

Students' Health-Related Quality of Life Across the Preclinical Pharmacy Curriculum

Objectives

To examine health related quality of life (HRQOL), perceived stress, and coping skills in the 3 preclinical years of a doctor of pharmacy (PharmD) curriculum.

Methods

Health-related quality of life, perceived stress, and coping strategies were measured using the Short Form-36, Perceived Stress Scale, and Brief COPE. Average annual scores were compared across curriculum years.

Results

Two hundred thirteen students enrolled in the study. Entering students had physical and mental HRQOL scores that were similar to age-adjusted US norms. Mental HRQOL scores were significantly lower and stress significantly higher during the second year of the PharmD curriculum compared to the first year (p < 0.05). Lower mental HRQOL scores were associated with increased stress and use of maladaptive coping skills in all years of the curriculum.

Conclusion

Increased stress and reduced mental HRQOL were observed across the first 3 years of a PharmD curriculum. Methods to reduce stress and/or use of maladaptive coping skills are needed to improve students'' HRQOL throughout the pharmacy curriculum.     

Resilience and First-Year Pharmacy Students’ Academic Performance in a Pharmacy Math Course

Objective. The purpose of this study was to examine the relationship between academic resilience and academic success in Doctor of Pharmacy (PharmD) students.Methods. A cross-sectional survey using the Academic Pharmacy Resilience Scale (APRS-16) was conducted in two cohorts of first year pharmacy (P1) students (n = 374) during fall orientation in 2019 and 2020. The following data were also collected from student records: demographics, pre-pharmacy grade point average (GPA), Pharmacy Math outcome (passing or failing the course), and Pharmacy Math final numerical grade. Academic success was defined as achieving a passing grade in a Pharmacy Math course. Correlational, multiple logistic regression, and multiple linear regression analysis were conducted.Results. The survey response rate was 98.1%, and approximately 95% of participants passed Pharmacy Math. No significant correlations were found between Pharmacy Math final pass/fail outcome or Pharmacy Math final numerical grade and APRS-16 overall and subscale scores. In multiple logistic regression, neither pre-pharmacy GPA nor APRS overall scale or subscale scores were significantly associated with final Pharmacy Math outcome (passing/failing). In multiple linear regression, pre-pharmacy GPA was significantly associated with Pharmacy Math final numerical grade, but APRS-16 overall score and subscale scores were not.Conclusion. First-year pharmacy students’ performance in Pharmacy Math was not influenced by academic resilience. Studies like this one examining the relationship between pharmacy students’ resilience and academic performance are lacking. Future studies should assess whether academic resilience may affect performance in other courses as well as performance in the PharmD curriculum.     

Accommodating Pharmacy Students With Physical Disabilities During the Experiential Learning Curricula

Accommodating pharmacy students with physical disabilities during the experiential learning portion of the Doctor of Pharmacy (PharmD) curriculum can present unique challenges for pharmacy schools. The available literature regarding accommodations for pharmacy students in the experiential learning environment is sparse, leaving programs with little guidance. This commentary from the Big Ten Academic Alliance calls on the Academy to create a community of shared resources and best practice examples and offers practical suggestions for accommodating pharmacy students with mobility, vision, and auditory disabilities during introductory pharmacy practice experiences (IPPEs) and advanced pharmacy practice experiences (APPEs).     

Writing PharmD Program-Level, Ability-Based Outcomes: Key Elements for Success

A set of PharmD program curricular outcomes form the foundation of a doctor of pharmacy (PharmD) curriculum and are critical to the development of both the structure/courses of the curriculum and the assessment plan for the program. A goal for developing these outcomes is to craft a set of clear, concise, assessable statements that accurately reflect competencies of the generalist entry-level pharmacist or graduate of the first-professional doctor of pharmacy degree. This article will provide a review of one specific type of outcome, ability-based outcomes, and present a case study of how one college revised their PharmD program-level outcomes. A discussion of key elements for the successful adoption of these outcomes is also presented.     

Pharmacoeconomics Education in US Colleges and Schools of Pharmacy

Objective. To determine the extent of pharmacoeconomics education in US colleges and schools of pharmacy provided to doctor of pharmacy (PharmD) students in 2011.Methods. E-mails requesting syllabi and information about courses covering pharmacoeconomic topics were sent to all US colleges and schools of pharmacy from which PharmD students had graduated in 2011 (n=103).Results. Of 87 responding pharmacy colleges and schools, 85 provided pharmacoeconomics education in 2011. The number of hours dedicated to pharmacoeconomic-related topics varied from 2 to 60 per year (mean=20).Conclusions. Pharmacoeconomics education is provided at almost all US colleges and schools of pharmacy; however, variation in the number of teaching hours and topics covered demonstrates a lack of standardization in the PharmD curriculum. Pharmacy administrators and educators should invest more resources and tools to standardize training in this area.     

Comparison of Black Student Enrollment in US Schools and Colleges of Pharmacy,Medicine, and Dentistry

Objective. Promoting equity and diversity in health care must include increasing the population of minority health care professionals. The purpose of this study was to: evaluate changes in Black professional student enrollment in schools and colleges of pharmacy, medicine, and dentistry; determine whether significant differences exist in Black professional student enrollment among these schools; and rate schools on how well Black professional student enrollment reflects state populations and compare ratings between 2010 and 2019 (for purposes of this study, professional student refers to students enrolled in Doctor of Medicine [MD], Doctor of Pharmacy [PharmD], or Doctor of Dental Medicine [DMD]/Doctor of Dental Surgery [DDS] degree programs).Methods. Enrollment data were obtained through the American Association of Colleges of Pharmacy, Association of American Medical Colleges, and American Dental Association for fall 2010 through fall 2019. The average percentage of Black students enrolled and the rate of change over time was determined. Schools were rated on their percentage of Black students relative to the percentage of Black residents in their state. Kruskal-Wallis H test, Wilcoxon signed rank tests, and chi-square tests were performed to quantify differences in enrollment and college ratings.Results. Schools of pharmacy and medicine experienced a significant increase in Black student enrollment between 2010 and 2019, but schools of dentistry did not. Pharmacy and medical schools also had significantly greater Black student enrollment in 2019 compared to dentistry. The proportion of schools of pharmacy and medicine with failing ratings decreased between 2010 and 2019.Conclusion. To facilitate improved access and limit health and health care disparities, it is important that health professions schools and colleges reflect the diversity of the patient populations they serve. Serious and intentional efforts toward diversification, inclusivity, and equity are necessary to improve Black student enrollment.     

Measuring Achievement Goal Orientations of Pharmacy Students

Objectives. To measure the achievement goal orientations of pharmacy students attending a 3-year (accelerated) doctor of pharmacy (PharmD) program.Methods. A 16-item survey based on the Achievement Goal Questionnaire (AGQ) was administered to first-year (P1) and second-year (P2) pharmacy students at the Appalachian College of Pharmacy (ACP). Students were instructed to indicate to what degree each statement was true for them using a 7-point Likert scale (1=not true of me, 7=very true of me).Results. One hundred twenty of the 155 students (77%) completed the survey. Most students had mastery-approach, mastery-avoidance, performance-approach, and/or performance-avoidance goal orientations; few had work-avoidance goal orientations. Second-year students and male students had higher work-avoidance mean scores than did P1 students and female students (p<0.05).Conclusion. Pharmacy students were mastery- and performance-oriented learners, and most did not have work-avoidance goal orientations. Male students and P2 students had higher work-avoidance than did female students and P1 students, respectively. More longitudinal studies are needed to confirm these findings.     

Poster project to emphasize public health in the pharmacy curriculum

Objective

To implement and assess a required public health poster project in a doctor of pharmacy (PharmD) program.

Design

Third-year PharmD students collaborated in pairs to research a public health topic relating to pharmacy practice. Each student group prepared an informational poster, while receiving feedback from a faculty mentor at each stage of the project. The students presented their completed posters at a statewide pharmacy conference.

Assessment

Faculty members evaluated the posters with a grading rubric, and students completed a survey instrument that assessed the overall experience. In general, faculty members rated the class highly across all domains of the grading rubric. The class generally agreed that the poster project increased their awareness of public health issues related to pharmacy practice, overall knowledge of public health, and presentation skills.

Conclusion

The implementation of a poster project was well received by students and faculty members as an effective method for enhancing public health instruction in the PharmD program at North Dakota State University.     

Multisite Study Assessing the Effect of Cognitive Test Anxiety on Academic and Standardized Test Performance

Objective. To evaluate the degree of cognitive test anxiety (CTA) present in student pharmacists at multiple pharmacy programs in the United States and to determine if there are associations between self-reported CTA and relevant academic outcomes.Methods. All 2018-2019 advanced pharmacy practice experience (APPE) students from three US Doctor of Pharmacy (PharmD) programs (N=260) were invited to participate in the study. Participants completed a validated 37-question survey that included the Cognitive Test Anxiety Scale-2 (CTAS-2) along with demographics-related questions. Responses were analyzed using analysis of variance (ANOVA), Kruskal Wallace, and multiple linear regression where appropriate.Results. One hundred twenty-four students (48%) from the three programs participated in the study, and the individual data of 119 (46%) were included in the final analysis. Twenty-two students (18.5%) were classified as having high CTA, 41 (34.5%) as having moderate CTA, and 56 (47.1%) as having low CTA. High CTA predicted a 8.9 point lower NAPLEX total scaled score after accounting for other variables and was also correlated with lower cumulative didactic GPA, performance on the Pharmacy Curriculum Outcomes Assessment (PCOA), and increased likelihood of requiring course remediation.Conclusion. High cognitive test anxiety affects 18% of pharmacy students and may significantly impact their performance on a variety of traditional student success measures, including the NAPLEX. Pharmacy educators should consider further use and adoption of test anxiety measurements to identify and assist potentially struggling students.     

Dual degree programs at the University of Kentucky College of Pharmacy

The rapid growth and evolution of the pharmacy profession has created a wide array of opportunities for graduating pharmacists beyond traditional community pharmacy or hospital practice. Management and leadership positions in federal and state healthcare agencies, pharmaceutical companies, hospitals, retail pharmacies, academia and managed care organizations increasingly require the pharmaceutical knowledge obtained through a doctor of pharmacy (PharmD) degree combined with financial, organizational, and management skills. In these innovative positions, pharmacists are being called upon to assume responsibilities as executives and administrators in systems providing pharmacist care services to patients. To endow students with knowledge and skills required to perform the duties required in these decision-making positions, the University of Kentucky College of Pharmacy has established 3 joint degree programs: the PharmD/Master of Business Administration (PharmD/MBA), PharmD/Master of Public Administration (PharmD/MPA), and PharmD/Master of Science in Economics (PharmD/MS). This paper describes these joint degree programs.