Modeling Doctor of Pharmacy Students' Stress, Satisfaction, and Professionalism Over Time

Reducing Student Workload Through Curricular Efficiency

OBJECTIVE

This integrative review will examine the current literature assessing student workload, outcomes of increased workload and cognitive load, and approaches to evaluate and reduce student workload. Recommendations to better inform curriculum planning efforts will be presented along with a call to action to address the dilemma of student workload and curricular efficiency efforts.

FINDINGS

Literature supports that perceptions of heavy workload can influence students' approach to learning and lead to the adoption of surface learning rather than a deep approach that involves higher-order processing and critical thinking. Additionally, ongoing evidence suggests that workload expansion affects student well-being and potential burnout in professional programs, and specifically that students perceive workload as directly related to their well-being and satisfaction. Intentional planning by faculty and programs can address this issue through streamlining classroom content, reducing lecture time, and modifying preclass work to allow for efficient learning. Even if the curriculum is lecture-based, workload perceptions can be affected by developing clearer guidance to set expectations for learners, intentionality in classroom design, and creating opportunities for student engagement.

SUMMARY

Cognitive overload is multifactorial and complicated, given the increased standards of professional education accreditation and licensure requirements. As the Academy deliberately considers methods to improve curricular efficiency, there is an opportunity to focus on curriculum delivery with an appropriate balance of breadth and depth of instruction to ensure effective assessment and cognitive load.

A Mixed-Methods Exploration of the Effect of Disabling Backward Navigation on Calculations-Focused Computerized Examinations

Objective. The aim of this mixed-methods study was to examine the effect of disabled backward navigation on computerized calculation examinations in multiple courses.Methods. Student performance on comprehensive pharmacy calculation examinations before and after implementation of disabled backward navigation were compared. Deidentified data from ExamSoft were used to determine median examination scores, passing rates, and time to completion for all three attempts given on comprehensive calculation exams held in a pharmacy calculations course (PharDSci 504) and in three applied patient care laboratory courses (Pharm 531, 541, and 551). An anonymous, voluntary student survey gathered student perceptions of disabled backward navigation. Qualitative data were evaluated for thematic findings.Results. The impact of disabled backward navigation on test scores and passing rates varied by course and test attempt. Students in Pharm 541 and 551 performed significantly worse on the initial test attempt after backward navigation was disabled compared to the previous year, with no significant differences in student performance seen on the retakes. Performance in PharDSci 504 and Pharm 531 followed the opposite pattern, with no significant difference in performance for the initial tests but significantly increased performance on the retakes. The amount of time spent on examinations either significantly decreased or remained the same. Student perceptions were generally consistent across all cohorts, with at least 74% agreeing that disabling backward navigation increased examination difficulty.Conclusion. Disabling backward navigation had a mixed effect on student examination performance. This may highlight how student behaviors change as backward navigation is disabled.

Pharmacy Students' Mental Health and Resilience in COVID-19: An Assessment after One Year of Online Education

COVID-19 has impacted mental health and affected education due to the shift to remote learning. The purpose of the current study was to assess the mental health of pharmacy students one year following the onset of the pandemic. A descriptive cross-sectional questionnaire was distributed to pharmacy students. The severity of depression, anxiety, and stress was assessed by the Depression Anxiety Stress Scale (DASS-21), and resilience was assessed by the Brief Resilience Scale (BRS). COVID-19-related economic, educational, and health stressors, and students’ vaccine attitudes were surveyed. Descriptive, bivariate, and multivariable analysis were used, and a p-value of <0.05 was considered significant. A total of 561 students participated; 37% had mild-to-moderate depression, 37% had severe-to-extremely-severe anxiety, and 52% demonstrated normal stress levels. Severe depression, anxiety, and stress were associated with smoking and feeling isolated due to COVID-19. Around 40% of students had low resilience, associated with smoking, being in the third or fourth year of pharmacy study, and the consumption of caffeinated beverages. The mean score of satisfaction with online learning was 60.3 ± 21.3%. Only 5% of participants were vaccinated, of which 87% trusted the benefits of vaccines and their role in controlling the pandemic. One year after the onset of COVID-19, depression, anxiety, stress, and low resilience were observed among pharmacy students; the investigation of the long-term mental effects of the pandemic on university students is warranted.

Longitudinal analysis of PharmD program students' satisfaction and stress

INTRODUCTION

The University of Utah College of Pharmacy conducted an annual survey to gauge the relationship between multiple dimensions of students' satisfaction, and stress, with the doctor of pharmacy (PharmD) program and perceptions of future career plans.

METHODS

An online survey of professional year one (P1) through professional year four (P4) students was conducted from 2015 to 2019.

RESULTS

There were a total of 953 non-unique survey respondents. The overall response rate was 86.8%. The study population was 51% female and 49% male with a mean age of 26.7 ± 3.3 years. Students were moderately to very satisfied with the curriculum across the four years of the program. Students were highly to moderately likely to recommend the program. Likelihood to recommend the pharmacy career was similar for the P1 and second professional year 2 (P2) but declined over the four years. Students were moderately to neutrally affected by stress, highest in the P2 and third professional year. Financial issues were rated as the highest stress across the four years. Gender was not statistically associated with satisfaction, although women had higher stress impacting their health than men. Likelihood to recommend the PharmD program and pharmacy career was rated higher by younger students.

CONCLUSIONS

Student satisfaction with the PharmD program should be a priority since higher education is a service industry. Academic pharmacy should consider whether pedagogical and social mechanisms are in place to ensure that their programs are helping students manage stress and promote satisfaction.

Well-Being May Be the Missing Component of Professionalism in Pharmacy Education

Enhancing student pharmacist professionalism through co-curricular efforts has gained much attention in pharmacy education since release of the Accreditation Council for Pharmacy Education's Standards 2016. Interestingly, traditional and current definitions and attributes of professionalism do not include components of well-being; instead, the ideas of altruism and self-sacrifice predominate. However, providing students with the tools, resources, and time needed to invest in themselves to maintain their well-being is imperative as this in turn allows them to fulfill the pharmacy profession's standards of professional conduct and engagement. Although classic interpretations may seem to conflict, practicing self-care to promote personal well-being is thankfully not in opposition to being an altruistic, self-sacrificing professional. This commentary explores the interplay between the two constructs and postulates that some issues related to student pharmacists' unprofessional behavior can be linked to a lack of well-being. Therefore, pharmacy educators should consider incorporating well-being initiatives into efforts focused on refining student pharmacist professionalism.

Exploring the relationship between stress and student leadership among student pharmacists

INTRODUCTION

Previous studies show student pharmacists have a lower health-related quality of life than undergraduate students and are among the most stressed of the health profession students. The long-term effects of chronic stress on healthcare providers can lead to reduced productivity, increased turnover, and medical errors. The goal of this research was to gather information from students who participate in organizational leadership positions regarding their opinions of the benefits of the leadership positions and feelings about stress, burnout, and quality of life.

METHODS

Student pharmacists holding leadership positions were asked to complete an electronic survey. Survey questions were based on behavioral assessment instruments. Descriptive statistics were used to analyze demographic data and yes/no question responses. The Spearman Rho test was used to look for associations when comparing variables.

RESULTS

Sixty-four students completed the survey. There was a significant association between both self-reported lower quality of sleep and reduced time dedicated to leisure activities with holding concurrent positions (p = 0.021, p = 0.028, respectively). No significant relationship was found between the number of leadership positions held concurrently, satisfaction gained from those positions, professional year in pharmacy school, employment during didactic years, or self-perceived test taking performance. Student pharmacists reported taking on leadership positions in student organizations for a variety of reasons, including desire to improve skills, make connections, improve the profession, and gain experience.

CONCLUSIONS

Pharmacy faculty mentors may be able to utilize the results of this study to encourage student leaders and better understand the challenges that come with organization leadership positions.

Pharmacy student stress with transition to online education during the COVID-19 pandemic

INTRODUCTION

Pharmacy student-perceived stress may impact academic experiences. This research aimed to investigate whether there was an increase in student-perceived stress due to the COVID-19 pandemic.

METHODS

Current pharmacy students were surveyed in May 2020 at a public pharmacy school that utilizes an active learning design and follows a flipped classroom approach. In addition to measuring perceived stress, the survey measured coping behaviors, self-efficacy, and emotional status. The collected data were compared with archived data that were collected for internal use in 2018. Student's t-test analyses were used to compare 2020 with 2018 data.

RESULTS

A total of 66 students completed the 2020 survey (response rate 26.2%) and 192 students completed the 2018 survey (response rate 63.2%). On a scale from 0 (never or not applicable) to 5 (multiple times each day), average student-perceived stress was 1.75 (SD = 0.93) in 2020. This value of perceived stress presented a slight, but not statistically significant, reduction from 1.85 (SD = 1.04) in 2018. Comparing 2018 and 2020 datasets showed no significant differences in coping behavior, self-efficacy, or emotional status.

CONCLUSIONS

Based on the sample with the lower response rate that completed the survey in 2020, student-perceived stress did not increase during online, remote learning associated with the COVID-19 pandemic as compared to the sample with a higher response rate prior to the pandemic. Perhaps the COVID-19 related changes were seamless to students due to their aptitude for remote, online learning.

Burnout assessment at a college of pharmacy, college of optometry, and school of physician assistant studies

INTRODUCTION

There is limited research on burnout among students and faculty of health professions programs. This study was designed to assess burnout among students and faculty at a college of pharmacy (COP), college of optometry (COO), and school of physician assistant studies (SPAS).

METHODS

The Professional Quality of Life Scale (ProQOL) was distributed to faculty and students at Marshall B Ketchum University (MBKU) COP, COO, and SPAS. Scores for burnout, compassion satisfaction, and secondary traumatic stress were compared between programs, faculty, and students.

RESULTS

Median secondary traumatic stress scores were statistically higher for respondents (students and faculty) in the SPAS (24 [interquartile range (IQR) 17-27]) vs. respondents in the COP (20 [IQR 18-26]) and COO (19 [IQR 16-22]). Faculty had statistically higher median compassion satisfaction scores (41 [IQR 34-44]) vs. students (36 [IQR 32-40]), while students had statistically higher median burnout scale scores compared to faculty (27 [IQR 23-32] vs. 21 [IQR 17-26]). There was no difference in secondary traumatic stress between students and faculty, and there were no differences in compassion satisfaction or burnout between programs.

CONCLUSIONS

This study demonstrated that students in the COP, COO, and SPAS had higher burnout scores when compared to faculty at the study institution. These results suggest that efforts to address burnout should first focus on students. SPAS students and faculty may require specific efforts to address secondary trauma.

Education Satisfaction among Pharmacy Graduates in Sweden

Education satisfaction is considered important for development of a professional identity and to increase learning. The aim was to investigate and compare education satisfaction over time among pharmacists who have graduated from the pharmacy programs at Umeå University, Sweden. Data concerning education satisfaction were collected using an alumni survey of pharmacists who graduated between 2015 and 2018. This was compared with pharmacists graduating between 2006 and 2014. The majority of the pharmacy graduates were very satisfied with their education (96%) and thought that the programs gave them a clear professional identity (92%). No differences in education satisfaction between graduation years 2015 and 2018 and 2006 and 2014 were found. A majority of the graduates considered that the knowledge and skills acquired during their education were useful in their present job (83%). Of the graduates who thought that the studies gave them a clear professional identity, a higher proportion were satisfied with their job (p < 0.001) and thought that their work duties reflected their studies (p = 0.005). Exploring education satisfaction may help educators to further develop the education and to better prepare the students for their professional working life.