Improving and Restoring the Well-being and Resilience of Pharmacy Students during a Pandemic

Depression, anxiety, and help-seeking among Slovenian postsecondary students during the COVID-19 pandemic

Introduction

The COVID-19 pandemic has faced students with many challenges, contributing to their mental distress. This article explores the role of demographic characteristics, psychological status, year of study, and social support during the COVID-19 pandemic in explaining Slovenian university students' mental health problems and help-seeking behavior.

Methods

In February and March 2021, data were collected on 5,234 full-time Slovenian postsecondary students who were enrolled in public and concessionary independent higher education institutions. Participants completed a questionnaire, which included The Patient Health Questionnaire (PHQ-9), General Anxiety Disorder questionnaire (GAD-7), Oslo Social Support Scale (OSSS-3), and items measuring psychological status, help-seeking behavior and demographics. Data were analyzed using multiple linear regression and hypothesis testing for differences.

Results

Factors, such as gender, age, psychological status and social support, contributed to experiencing anxiety and depression among Slovenian students during the COVID-19 pandemic, with year of study additionally contributing to experiencing depression. Similarly, gender, age, psychological status and social support contributed to help-seeking behavior. Higher levels of depression and anxiety were reported by female students, students with prior mental disorders, and students with lower social support levels. Female students and students with lower social support levels reported more frequent help-seeking behaviors.

Conclusion

The results provide insight into the mental state of the Slovenian student population in the context of imposed public health measures at the end of the second COVID-19 wave in Slovenia. The findings can help identify vulnerable groups within the student population to whom we must be particularly attentive in times of crisis.

Tools for Success in Experiential Education for PharmD Students With Trauma and Adverse Childhood Events (ACEs)

In the past 5 years, new priorities for student wellness, burnout prevention, and improved mental health have become top priorities for experiential learning. Individual students' academic resilience is a critical aspect of these student factors. Self-regulatory skills like emotion regulation and executive functioning are vital underlying resilience processes. Preceptors, faculty, and administration should assess threats to academic resilience, such as adverse childhood experiences (ACEs) and trauma, to ensure students' optimal outcomes in experiential learning. This article uses the recognizing, responding, and preventing re-traumatization principles from the Substance Abuse and Mental Health Services Administration (SAMHSA) concept of a trauma-informed approach to provide tools for success for pharmacy students living with trauma and ACEs. Preceptor tools for students living with trauma and ACEs are designed to proactively recognize trauma responses, whether they occur in isolated incidences or of a chronic nature. Screening and assessment can identify students preemptively who may need extra support, resources, and tools for academic resilience. Responding to a student's disclosure with a disclosure plan will lay the groundwork for a safe and productive encounter. During the encounter, prevent re-traumatization by being up to date on sensitive and appropriate language while providing daily logistical tools for success in an experiential practice rotation. Little is known about the specific effects of ACEs on self-regulation, resilience, and executive function in Doctor of Pharmacy students. However, preceptors can provide tools to develop students' academic resilience and improve their educational outcomes in experiential learning.

A Qualitative Exploration of Health Profession Students' Experiences of Resilience and Burnout Using the Coping Reservoir Model during the COVID-19 Pandemic

Phenomenon: The Coping Reservoir Model is a useful theoretical and analytical framework through which to examine student resilience and burnout. This model conceptualizes wellbeing as a reservoir which is filled or drained through students' adaptive and maladaptive coping mechanisms. This dynamic process has the capacity to foster resilience and reduce burnout or the inverse. This study aimed to explore health profession students' coping mechanisms and their experiences of resilience and burnout during the unprecedented COVID-19 pandemic. Approach: Employing the Coping Reservoir Model, qualitative focus groups involving health profession students enrolled at Qatar University were conducted, in October 2020, to solicit their lived experiences of stress and burnout during the pandemic. The Coping Reservoir Model was used to structure the topic guide for the focus group discussion and the Framework Analysis Approach was used in the data analysis. Findings: A total of 43 participants comprised eight focus groups. Health profession students encountered myriad personal, social, and academic challenges during the pandemic which adversely impacted their wellbeing and their capacity for coping. In particular, students reported high levels of stress, internal conflict, and heavy demands on their time and energy. The shift to online learning and uncertainty associated with adapting to online learning and new modes of assessment were exacerbating factors. Students sought to replenish their coping reservoir through engagement in a range of intellectual, social, and health-promoting activities and seeking psychosocial support in their efforts to mitigate these stressors. Insights: Students in this region have traditionally been left to their own devices to deal with stress and burnout during their academic training, wherein the institutions focus exclusively on the delivery of information. This study underscores student needs and potential avenues that health profession educators might implement to better support their students, for instance the development and inclusion of longitudinal wellbeing and mentorship curricula geared to build resilience and reduce burnout. The invaluable contributions of health professionals during the pandemic warrant emphasis, as does an examination of the stress associated with these roles to normalize and justify inclusion of wellbeing and resilience modules within the curriculum. Actively engaging health profession students in university-led volunteer activities during public health crises and campaigns would provide opportunities to replenish their coping reservoirs through social engagement, intellectual stimulation, and consolidating their future professional identities.

Scoping Review of Programmatic Well-Being Interventions and Outcomes to Support Pharmacy Students

OBJECTIVES

Recent literature highlights various well-being initiatives implemented across pharmacy programs; however, there is much heterogeneity in their implementation and limited studies assessing the impact and success of these initiatives on pharmacy students' well-being. The purpose of this scoping review was to identify the effectiveness of strategies implemented by pharmacy schools to improve the well-being of pharmacy students.

FINDINGS

In total, 23 studies were included, and well-being strategies were categorized into 3 groups: organizational wellness programs, curriculum design and educational course activities, and specific relaxation or meditation activities. Strategies included yoga meditation, structured mindfulness courses, and self-directed mindfulness with digital smartphone applications. The majority of studies assessed outcomes of stress, burnout, and mindfulness, though other well-being domains such as resilience and belonging emerged. Some also assessed perceptions and acceptability of the interventions through qualitative approaches.

SUMMARY

Despite the heterogeneity of interventions and outcome measures, this review provides a comprehensive scope of well-being domains, assessment tools, interventions, and approaches targeted at pharmacy students and highlights the strongest evidence for interventions on reducing stress. Pharmacy programs can benefit from approaches at both the organization level and those fostering individual accountability by exposing students to a variety of self-help well-being strategies that develop protective factors and motivate them to sustain well-being practices themselves as a shared approach. This scoping review addresses a critical gap by gaining an understanding of the current landscape of well-being initiatives and their effectiveness to better guide pharmacy programs on strategies that are most likely to improve student well-being.

Resilience of undergraduate health sciences students during COVID-19: An integrative review

Background

COVID-19 pandemic placed pressure on global health systems, healthcare providers and undergraduate students in health sciences. Students experienced change in the teaching and learning as well as the clinical context resulting in increased stress levels. Resilience assisted students to adapt and develop competencies and effective coping mechanisms.

Aim

The purpose of this integrative review is to identify resilience of undergraduate students in health sciences during the COVID-19 pandemic.

Setting

Online platforms.

Methods

An integrative review was conducted with keywords: resilience, undergraduate students, health sciences and COVID-19. Three different searches were conducted for the time frame 2020-2022 on the relevant electronic data bases with full text articles. A total of 1665 records were identified and 49 potentially relevant articles were identified. Screening resulted in 34 articles that were analysed using the John Hopkins critical appraisal criteria.

Results

Four themes were identified: attributes of students' resilience, aspects enhancing the development of resilience, aspects hindering the development of resilience and recommendations to cultivate resilience.

Conclusion

Resilience is key to withstand the challenges in the global health system. The development of resilience in undergraduate health sciences students should be prioritised to ensure cognitive adaptability, effective coping skills and sufficient support.

Contribution

These findings can assist higher educational institutions to improve their undergraduate health science programs to cultivate resilient health care professionals.

Longitudinal assessment of pharmacy student well-being using the well-being index and 5 gears assessment

OBJECTIVE

The objective of the study was to assess the level of pharmacy student well-being during the first 2 years of their didactic education utilizing the Well-being Index (WBI) and 5 Gears assessment.

METHODS

WBI and 5 Gears data were tracked monthly for first- and second-year students enrolled at the Medical University of South Carolina College of Pharmacy from September 2019 to March 2022. Data were collected through monthly RedCap surveys, then de-identified and separated into 4 study cohorts (A-D). Data were analyzed using descriptive statistics.

RESULTS

Responses from 279 students were evaluated. WBI ratings showed variance across the first and second professional years of the program. Students also reported fluctuations in WBI throughout academic years, most often correlating with major events (scheduled breaks, COVID-19 pandemic). Similarly, the 5 Gears assessments results also changed throughout the study period, including variance within and between each academic year.

CONCLUSION

Incorporating well-being assessments into the co-curriculum has allowed us to identify when students are struggling with their well-being, provide tools and resources to help enhance their well-being, and opportunities to discuss struggles with their peers. Colleges of Pharmacy must incorporate holistic approaches to address all aspects of well-being, including consideration of how the curriculum is impacting the student experience as well as institutional approaches to well-being.

Implementation and evaluation of a pharmacy family program to foster community and inclusion

BACKGROUND AND PURPOSE

Learning communities in the form of student-faculty families in pharmacy education provide a structure to foster community and inclusion. The purpose of this work is to describe how a new Pharmacy Family (PF) program was implemented and to evaluate the impact on students.

EDUCATIONAL ACTIVITY AND SETTING

Our PF program was developed with the goals of building community, promoting a sense of belonging, providing students with opportunities to share and receive advice, and providing a venue for surveillance of student concerns. Each family was comprised of one to two faculty/instructor leaders and three to four doctor of pharmacy students from each cohort and met longitudinally over the course of the academic year. Quantitative and qualitative survey data were collected to assess student perceptions and program satisfaction.

FINDINGS

A total of 233 students (66.2%) completed the survey and the majority (66%) were satisfied with the program. Thematic analysis of open-ended questions revealed four themes that contributed to students' satisfaction ratings: meeting content, relationships, atmosphere, and timing. Students with high satisfaction frequently noted that the program fostered connections, mentoring opportunities, and a safe space to share concerns. Students that were neutral or dissatisfied frequently commented on the timing of meetings and inability to form deeper connections.

SUMMARY

Student-faculty families can be implemented to improve community and engagement within pharmacy education. Our program was most successful in providing a venue for students to share concerns. Addressing meeting times and adjusting the structure to promote community building is warranted to achieve program goals.

Self-Compassion Interventions to Target Secondary Traumatic Stress in Healthcare Workers: A Systematic Review

Healthcare professionals' wellbeing can be adversely affected by the intense demands of, and the secondary traumatic stress associated with, their job. Self-compassion is associated with positive wellbeing outcomes across a variety of workforce populations and is potentially an important skill for healthcare workers, as it offers a way of meeting one's own distress with kindness and understanding. This systematic review aimed to synthesise and evaluate the utility of self-compassion interventions in reducing secondary traumatic stress in a healthcare worker population. Eligible articles were identified from research databases, including ProQuest, PsycINFO, ScienceDirect, Google Scholar, and EBSCO. The quality of non-randomised and randomised trials was assessed using the Newcastle-Ottawa Scale. The literature search yielded 234 titles, from which 6 studies met the inclusion criteria. Four studies reported promising effects of self-compassion training for secondary traumatic stress in a healthcare population, although these did not use controls. The methodological quality of these studies was medium. This highlights a research gap in this area. Three of these four studies recruited workers from Western countries and one recruited from a non-Western country. The Professional Quality of Life Scale was used to evaluate secondary traumatic stress in all studies. The findings show preliminary evidence that self-compassion training may improve secondary traumatic stress in healthcare professional populations; however, there is a need for greater methodological quality in this field and controlled trials. The findings also show that the majority of research was conducted in Western countries. Future research should focus on a broader range of geographical locations to include non-Western countries.

Associations between depression, fear of COVID-19 infection and students' self-care measures used during the first wave of the pandemic

BACKGROUND

COVID-19 lockdown resulted in the closure of schools with associated problems. The aim of this study was to determine the associations between depression, fear of contracting COVID-19 infection and the use of self-care measures by college students during the first wave of the COVID-19 pandemic.

METHODS

This was a cross-sectional study that collected data from undergraduate and postgraduate college students 18 years and older from 152 countries between June and December 2020. Study participants were recruited through crowdsourcing using various social media platforms including Facebook, Twitter, and Instagram, WhatsApp groups and emails to participants in the collaborators' networks. The dependent variables were fear of contracting COVID-19 and depression while the independent variable was students' self-care measures. Multivariable logistic regression models were conducted to assess the associations between the dependent and independent variables.

RESULTS

Of the 2840 respondents, 1305 (46.0%) had fears of contracting COVID-19 and 599 (21.1%) reported depression. The most common self-care measures were phone calls with friends/family (60.1%) and video chat (52.8%). Learning a new skill was significantly associated with higher odds of fear of contracting COVID-19 (AOR = 1.669) and lower odds of having depression (AOR = 0.684). Talking to friends/family through video chat (AOR = 0.809) was significantly associated with lower odds of feeling depressed while spending time with pets (AOR = 1.470) and taking breaks from the news/social media (AOR = 1.242) were significantly associated with higher odds of feeling depressed. Students from lower middle-income countries (AOR = 0.330) had significantly lower odds of feeling depressed than students from low-income countries.

CONCLUSION

Self-care strategies involving social interactions were associated with less depression. Coping strategies with more cognitive demands may significantly reduce the risk of fear of COVID-19. Special attention needs to be given to students in low-income countries who have higher odds of depression during the pandemic than students from other countries.

Pharmacy student perceptions of remote learning and wellness during the pandemic: Lessons learned from a metropolitan commuter city

INTRODUCTION

The purpose of this study was to assess pharmacy student perceptions of remote learning experiences and personal well-being during the COVID-19 pandemic in a metropolitan commuter city.

METHODS

A survey was developed and sent to pharmacy students from the three pharmacy colleges in New York City in January 2021. The survey domains consisted of demographics, personal well-being, classroom experiences, and pandemic and post-pandemic preferred learning modalities and reasons.

RESULTS

From a total of 1354 students from professional years one, two, and three across the three colleges, completed responses were received from 268 students (20% response rate). More than half of the respondents (55.6%) reported a negative impact of the pandemic on their well-being. More than half of the respondents (58.6%) reported more time to study. When students were asked their preferred mode of pharmacy education delivery during the pandemic and post-pandemic, a quarter (24.5%) preferred remote learning for all courses during the pandemic, and only a quarter (26.8%) preferred traditional classrooms for all courses post-pandemic. Approximately 60% of the respondents preferred some type of remote learning post-pandemic.

CONCLUSIONS

Pharmacy student learning has been and continues to be impacted by the COVID-19 pandemic, especially for pharmacy students in New York City. This study sheds light on the remote learning experiences and preferences of pharmacy students in a commuter city. Future studies could assess pharmacy student learning experiences and preferences after return to campus.

Resilient Coping is More Important Than Previous Virtual Learning Experience: Predicting Pharmacy Student Stress During the COVID-19 Pandemic

Purpose

The COVID-19 pandemic precipitated a swift transition to online learning in medical and health sciences. This study investigated the associations of previous experience with online learning, current confidence with online learning, and resilient coping skills with perceived stress reported by pharmacy students during the emergency transition to online learning.

Methods

Undergraduate pharmacy students (N=113, response rate = 41%) completed an online, self-report, cross-sectional survey during April-June 2020. Measures included Likert items measuring prior experience and current comfort levels with online learning, the Brief Resilient Coping Scale (BRCS), and the Perceived Stress Scale 10-Item Version (PSS-10). Experience, comfort with online learning, reported scores, and internal consistency for the BRCS and PSS-10 were summarized. A linear regression model examined the associations of prior experience with online education, gender, and resilient coping with perceived stress.

Results

Of the 113 respondents (78% female, mean age 22.3 years), > 50% had only occasional prior experience with online learning, coursework, and examinations, but 63% expressed confidence with online learning. Mean PSS-10 and BRCS scores were 23.8 and 13.3, respectively, and both scales demonstrated good internal consistency (α > 0.80). BRCS score was the single predictor of the PSS-10 score (r² = 0.18, p < 0.001). Female gender was not a significant predictor (p = 0.11). A multiple regression model explained moderate variation in perceived stress (adjusted R² = 0.19).

Conclusion

PSS-10 and BRCS scores indicated moderate levels of stress and coping skills among students during online teaching. Most students had some prior exposure to online learning, coursework, and examinations. Higher resiliency scores, but not prior online learning experience, predicted lower perceived stress.

The Impact of COVID-19 on Pharmacy Student Stress During High-Stakes, Performance-Based Assessments in Skills-Based Courses

Objective. To compare stress levels of pharmacy students in high-stakes, performance-based assessments administered during skills-based laboratory courses in normal classroom environments versus pandemic classroom environments impacted by COVID-19.Methods. In 2019, prior to the start of the COVID-19 pandemic, Doctor of Pharmacy (PharmD) students' stress levels were assessed via a voluntary, paper-based survey before and after performance-based assessments. Students were given a modified version of this survey in 2020 during the pandemic. The 2019 and 2020 survey responses were compared using Wilcoxon rank sum tests.Results. Pharmacy students reported higher perceived stress levels before performance-based assessments (3.8 vs 3.5) and after performance-based assessments (2.8 vs 2.5) prior to the pandemic compared to during the pandemic. Students identified stress as negatively impacting their performance-based assessment performance in both years (3.4 vs 3.1). Students had similar interest in wellness activities in both phases.Conclusion. Colleges of pharmacy should consider implementing stress relief programs around high-stakes assessments as well as prioritizing wellness initiatives within curricula.

Subsets of the population benefitting from the pandemic: What policies and practices should be arranged to sustainably maintain beneficiaries' mental health

Here researchers have the disposition to engage in the scholarly discourse on how the pandemic adversely influenced individuals' mental health and what remedies should be exercised in response to the mental health challenges. There is a shortage of scholarly discussion about who benefitted from the occurrence of the pandemic. Mancini et al. argued that the pandemic benefitted the social and mental health functioning of a subset of the population, despite the pandemic causing considerable risks of harm to mental health. In this perspective, the author summarizes relevant findings and arguments to present which subsets of the population benefitted at school, at home, and in the workplace during the pandemic. Although COVID-19 is no longer deemed a pandemic, many by-products of the public health crisis, including the encouragement of remote work and studies, remain. In this perspective, by understanding who benefitted from the pandemic and why, the author can evaluate if any public policies formed in response to the pandemic should be kept in the long run in order to maximize individuals' mental health.

Students in Turkey During the Early Days of the COVID-19 Pandemic

This study aims to analyse the subjective well-being of university students during the early days of the COVID-19 pandemic process and to examine how students have been affected economically, psychologically and socially. Other subjects included in the scope of the study are the suitability of the physical conditions during the process of online education, the students' motivation, and their expectations towards the future. The study also analyses the connection between these factors and the subjective well-being concepts of happiness and life satisfaction. The study focuses on students of the Faculty of Economics at Marmara University in Turkey. In total, 428 students took part in the survey prepared for the study. Descriptive analyses indicate that students have been negatively affected in terms of psychological and socio-economic factors along with subjective well-being. Ordered probit models show a statistically significant relationship between a major part of these changes and subjective well-being variables.

The Role of Educators in Supporting the Mental Well-being of Postgraduate Pharmacist Distance Learners

Frontline health care professionals have experienced rapid changes to workloads and work-related pressures during the COVID-19 pandemic, resulting in anxiety, depression, and mental health stressors. For working professionals engaged in postgraduate pharmacy distance learning, access to educators was seen as a means to relay some of these stories and offload the stress caused by these unprecedented circumstances. The postgraduate pharmacy education team at De Montfort University felt a moral responsibility to provide extra support and extended their roles toward offering greater well-being support. In this commentary, we detail the emergence of this new role and offer insights into how this was fashioned and its significance for catering to the mental health needs of pharmacists. This role has largely gone undetected, and research is needed to investigate the acceptability and feasibility of such a model and its plausibility and sustainability in the long-term.

Impact of COVID-19 on Nursing Students: Factors Associated with PTSD Risk

ABSTRACT

The COVID-19 pandemic rapidly transformed nursing education, creating multiple stressors for students. The researchers in this study examined how undergraduate and graduate nursing students at a faith-based university perceived the impact of COVID-19. A multiple linear regression model explored the effect of 17 variables on the Impact of Events Scale-Revised (IES-R) scores. Anxiety level, quality of sleep, and perceived health demonstrated a statistically significant influence on IES-R scores; 27% of students had IES-R scores above 33, indicating high risk for posttraumatic stress disorder. Strategies to help address student stress and anxiety are discussed.

Exploring the Effect of Virtual Education on Student Pharmacists’ Confidence toward APPE Readiness

A drop in confidence in Advanced Pharmacy Practice Experience (APPE) readiness was observed in students in the Class of 2022 prior to starting APPEs. We aim to investigate potential causes of students’ low confidence in APPE preparedness to provide solutions and to prevent this outcome with future students. We evaluated students’ perceived confidence to start APPEs and compared this to curricular changes, employment obligations, and the impact of COVID-19 on delivery of the pre-APPE and APPE curriculum. Students’ low confidence with APPE readiness was not indicative of the following factors: (1) delivery of the didactic curriculum, (2) students’ performance in the didactic curriculum, or (3) number of summative assessments in key didactic courses. Rather, the low confidence perception may have been due to differences such as a fully remote didactic experience in the P3 year, more virtual Introductory Pharmacy Practice Experiences (IPPEs), a reduced course load in the P3 spring semester, and changes to a pre-APPE preparatory course compared to other class years. The students’ self-reported midpoint scores during their first APPE block and preceptor’s evaluations on their performance contrasted their pre-APPE perceptions. Frequent in-person and on-site skills assessments throughout the didactic curriculum seem to reinforce confidence before APPEs.

Implementing interventions to promote well-being in experiential education

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

A Scoping Review of Well-being Assessment and Interventions in Student Pharmacists

Objective. To review the literature assessing student pharmacist well-being and the impact of well-being-associated interventions.Findings. Of the 15 studies included, six assessed student pharmacist well-being while nine evaluated the impact of a well-being intervention. While various approaches exist to assessing student pharmacist well-being, the body of literature suggests, overall, that student pharmacist well-being is poor. Since well-being is multifaceted and individualized, some pharmacy schools have identified various ways to incorporate tailored well-being activities, including mindfulness, into required, elective, and cocurricular experiences within the Doctor of Pharmacy program, with varying outcomes.Summary. This review highlights the limited and variable information available on the assessment of student pharmacist well-being as well as unique strategies to incorporate well-being initiatives into Doctor of Pharmacy curricula. Schools of pharmacy should identify the well-being needs of student pharmacists through a standardized well-being assessment instrument and provide meaningful well-being resources and interventions within the curriculum. There is a growing need for faculty to invest in student pharmacist mental wellness in addition to academic success. Future accreditation standards will inform the Academy on how to advance well-being initiatives.

The Resilience of Final-Year Pharmacy Students and Aspects of the Course They Found to Be Resilience-Building

Background: This work aimed to investigate final year pharmacy students’ resilience (as determined by the CD-RISC-25 tool), whether students considered certain aspects of the course to be resilience-building, and the role of the university in developing this attribute. Methods: Following ethical approval and an invitation to participate, data were collected from consenting students at Queen’s University Belfast via a pre-piloted paper-based questionnaire. Descriptive statistics were performed. To ascertain significant differences (p < 0.05) by gender, the Welch Two Sample t-test was used for the CD-RISC-25 mean scores and the Mann-Whitney U Test and Chi-squared test for Section B data. Results: The response rate was 80.61% (79/98). The mean CD-RISC-25 score for males was higher (not significantly) than the female mean score (70.39 versus 67.18, p = 0.2355, possible score range 0−100). While 93.67% (74/79) considered the School has a responsibility to develop resilience, <20.00% availed of the free resilience building events. Activities deemed to help build resilience included being able to make mistakes in a safe environment and needing to achieve a high grade to pass assessments. Conclusions: Resilience levels among future pharmacists at Queen’s University Belfast should be improved going forward. A strategy, developed in light of conducting this research (from one institution), will now be implemented to enhance the curriculum with regard to resilience building opportunities.

The Psychological Impact of the COVID-19 Pandemic on Postsecondary Students: An Analysis of Self-Determination

The COVID-19 pandemic has put postsecondary students across the world at risk of psychological distress, negatively impacting their basic psychological well-being, including self-determination. Although the concept of self-determination has been widely discussed in literature, it is poorly understood within the context of postsecondary students during the COVID-19 pandemic. This study aimed to examine the concept of self-determination (SD) as it relates to postsecondary students amid the COVID-19 pandemic. The Rodgers' evolutionary method of concept analysis was used. PubMed, CINAHL, PsycINFO, and ERIC were electronically searched using the keywords "postsecondary students" "coronavirus pandemic" and "self-determination." The historical, legal, educational, and health science literature were investigated to generate a holistic definition of SD in the past. This analysis has identified the antecedents, attributes, and consequences of self-determination in postsecondary students during this global health crisis. This analysis adds to the knowledge base regarding the evolution, significance, and application of the concept of SD in the context of postsecondary students amidst the COVID-19 pandemic. Implications for future research were also explored, such as using strategies to promote SD in postsecondary students to develop resilience during the pandemic.

"It's Doable": International Graduate Students' Perceptions of Online Learning in the U.S. During the Pandemic

This study aims to understand the learning experiences and challenges of international students enrolled in Master's and PhD programs in various institutions who were forced to transition to online learning during the pandemic. In particular, the study explores the experiences and perceptions of seven non-native English-speaking international graduate students who came from six different countries and studied at different schools of education through phenomenological interviews. Analysis yields insight into these students' online learning experiences and identifies factors which contributed to the mixed quality of these learning experiences. Overall, students tried to adapt to the "new normal," while enduring learning and emotional challenges due to the harsh conditions of the pandemic in the United States and their home countries. Instructors' readiness for online teaching as well as the extra support provided to help students cope with the sudden transition in the learning environment were particularly important factors affecting the students' learning experiences. Our findings lead us to several recommendations for practice within graduate-level online learning environments and suggestions for further research, as well as broader considerations of what broader implications the case suggests for international education in light of digitalization.

Reflections on work-life integration post-pandemic: A perspective from pharmacy practice faculty

INTRODUCTION

The effects of COVID-19 will have a lasting impact on how work is conducted moving forward. Prior to the pandemic, work-life integration and well-being were priorities for many organizations, including pharmacy. The disruption associated with the COVID-19 pandemic pushed businesses and organizations worldwide into an era of agility and flexibility previously unknown to the majority of workplaces.

PERSPECTIVE

Increased remote work has presented both increased challenges (e.g., engagement) and opportunities (e.g., productivity). After a year of experience, this shift in the nature of how work is done has provided an opportunity to reimagine how and where work will be conducted in the future.

IMPLICATIONS

Schools and colleges of pharmacy have an opportunity to re-evaluate how academic and practice responsibilities are accomplished in regards to work life-integration and management of concurrent work and family responsibilities. Administration and faculty should foster a culture of transparency on this topic to collaboratively incorporate methods that better facilitate work-life integration moving forward.

Mental health and self-determination profiles of the diverse population of medical students in Malaysia during the COVID-19 pandemic

INTRODUCTION

Medical schools throughout the world were forced to modify their programming during the COVID-19 pandemic. In Malaysia, virtual learning plans were implemented for non-clinical programming, while clinical posting modifications were designed to meet local SOPs. The prolonged enforcement of these modifications to undergraduate medical education will have affected student experiences, including well-being. Since these feelings can relate to perceived relatedness, autonomy, and competence, it is important to identify any potential factors that may lead to reduced intrinsic motivation in students. It is also important to consider how demographic features may contribute to student perspectives, which can be studied using the unique diversity represented by Malaysian students.

METHODS

A quantitative survey was distributed to Malaysian medical students to assess their overall wellbeing, autonomy in educational decision making, student experiences, and position on changes to graduation timing. Intrinsic components were identified using Principal Component Analysis and were aligned with the three needs for self-determination, namely relatedness, autonomy, and competence. Finally, trends in responses for participants from various sub-populations were assessed using ANOVA testing.

RESULTS

Responses were collected from 442 students representing 23 accredited Malaysian medical schools. Upon validation and reliability testing, eight components were identified with themes relating to: mental health, social concerns, communication, timing of modifications, depth of learning, and student-centred learning. Of these, gender was related to mental health, student-centred learning, and delayed graduation, while stage was related to student-centred learning and delayed graduation in addition to concerns about depth of learning and timing of modifications. Interestingly, ethnicity was related to differences in opinions about delayed graduation and income was related to social concerns.

CONCLUSION

The results of this study indicate that, while students were satisfied in general with the content and delivery of their programmes given the circumstances, there is evidence to suggest negative effects on emotional wellbeing and expression of student voice, due to the modifications that were made. Additionally, these feelings related to the three motivational needs, suggesting that students were experiencing a dampened motivational profile during the pandemic. Further, motivational profiles were distinct between student sub-groups, providing insight for developing appropriate and inclusive accommodations moving forward.

Impact of the COVID-19 pandemic on faculty at research-intensive United States schools/colleges of pharmacy

INTRODUCTION

To describe the impact of the SARS-CoV-2 pandemic on teaching, research, practice, and work-life integration for pharmacy faculty at research-intensive institutions.

METHODS

An online survey related to transition to remote work, impact on faculty responsibilities, demographics, and other elements was sent to nine research-intensive United States public schools/colleges of pharmacy. Respondents were asked to describe challenges in moving to remote instruction as a result of the pandemic. The 75-item survey asked respondents to rate the degree to which factors were challenging and levels of concern with the abrupt transition. Responses were analyzed using descriptive statistics and comparison of means using paired samples t-tests between spring and fall semesters, for the types of students taught, and for faculty discipline.

RESULTS

Surveys were completed by 279 faculty (36% response rate), with 62% self-identifying as pharmacy practice faculty. The highest reported challenges were family/home responsibilities (41%), assisting children with schoolwork (28%), and availability of childcare (22%). Concerns most identified by respondents were increased workload, potential for academic dishonesty, and inability to effectively conduct hands-on activities. Practice faculty encountered barriers using telehealth and delivering virtual experiential education, while both practice and research faculty reported concerns with research progress.

CONCLUSIONS

The pandemic has led to substantial challenges and increased workload in many areas. As the pandemic persists, administration should consider reported barriers and concerns to inform expectations. Evaluation of novel instructional design, assessment methods, and best practices in the virtual learning environment is highly encouraged to ensure student competencies are met.

Social isolation and psychological distress among southern U.S. college students in the era of COVID-19

BACKGROUND

College students are at heightened risk for negative psychological outcomes due to COVID-19. We examined the prevalence of psychological distress and its association with social isolation among public university students in the southern United States.

METHODS

A cross-sectional survey was emailed to all University of North Carolina-Chapel Hill students in June 2020 and was open for two weeks. Students self-reported if they were self-isolating none, some, most, or all of the time. Validated screening instruments were used to assess clinically significant symptoms of depression, loneliness, and increased perceived stress. The data was weighted to the complete student population.

RESULTS

7,012 completed surveys were included. Almost two-thirds (64%) of the students reported clinically significant depressive symptoms and 65% were categorized as lonely. An estimated 64% of students reported self-isolating most or all of the time. Compared to those self-isolating none of the time, students self-isolating some of the time were 1.78 (95% CI 1.37, 2.30) times as likely to report clinically significant depressive symptoms, and students self-isolating most or all of the time were 2.12 (95% CI 1.64, 2.74) and 2.27 (95% CI 1.75, 2.94) times as likely to report clinically significant depressive symptoms, respectively. Similar associations between self-isolation and loneliness and perceived stress were observed.

CONCLUSIONS

The prevalence of adverse mental health indicators among this sample of university students in June 2020 was exceptionally high. University responses to the COVID-19 pandemic should prioritize student mental health and prepare a range of support services to mitigate mental health consequences as the pandemic continues to evolve.

COVID-19 Lockdown-Related Changes in Mood, Health and Academic Functioning

The COVID-19 pandemic lockdowns were accompanied by an abrupt transition from face-to-face education to online education. The aim of this study was to evaluate the impact of the COVID-19 pandemic on academic functioning and mood in Dutch pharmacy students and PhD candidates. A total of n = 341 participants completed an online survey including questions on mood and academic functioning, assessed retrospectively for before and during the COVID-19 pandemic. Overall, during COVID-19 lockdown, significantly more time was spent on academic activities, and study grades/output significantly improved. However, the overall effects were of small magnitude, and there was great variability among students, reporting either improved, unchanged or poorer academic functioning. Compared to before COVID-19, the lockdown periods were associated with significantly increased levels of stress, anxiety, depression, fatigue, and loneliness, and a significant reduction in optimism and happiness. Significant negative correlations were found between ‘performance quality’ and stress, ‘performance quality’ and fatigue, ‘study grades/output’ and stress, and between ‘study grades/output’ and fatigue. Correlations of mood and items related to academic interactions were not statistically significant. Differential effects were seen when the data was analyzed according to sex, living situation, and ethnicity, revealing that women, students living alone, and those with a migration background reported that COVID-19 lockdowns had greater negative mood effects and a more negative impact on academic functioning. Poorer sleep quality and reduced quality of life were significantly associated with reduced mood, as well as reduced academic performance quality and role satisfaction. Regression analysis revealed that being young and not having a non-Western migration background were predictors of improved performance quality. However, only being young was a significant predictor of improved study grades/output during the COVID-19 pandemic. Increased levels of stress and fatigue were significant predictors of both reduced performance quality and poorer study grades/output during the COVID-19 pandemic. In conclusion, for the sample as a whole, the transition to online education during the COVID-19 lockdown was judged as having significant positive effects on academic performance. The lockdown periods were associated with significantly reduced mood and reduced social interactions. It should be taken into account that about one third of students reported academic functioning to be poorer during the COVID-19 pandemic. This represents a substantial group of students who require more attention and guidance to make a successful transition to online education and cope with lockdown-associated stress and fatigue.

Impact of COVID-19 on graduating U.S. pharmacy students in the early epicenter of the pandemic in New York City

Objective

To describe the self-reported impact of the COVID-19 pandemic among final year student pharmacists enrolled in a Doctor of Pharmacy program in New York City during the first peak of the outbreak March through May 2020.

Methods

A required senior seminar course for graduating student pharmacists served as a conduit for faculty led monitoring of the wellbeing of the cohort through three data sources: 1) polling data regarding stress factors during a COVID-19 informational session (March 2020), 2) survey data from a 12-item COVID-19 Impact Survey developed and administered electronically in May 2020 and 3) qualitative data from reflection papers mentioning COVID-19. Descriptive statistics, bivariate analysis and thematic analysis were used to summarize data.

Results

In March, almost half of respondents (total = 185) reported high personal (47.6%) and school related stress (42.1%). Most students were participating in advanced pharmacy practice experiences (80%) and working in a pharmacy (80%). Survey data (n = 96) revealed the majority of participants perceived negative impact on their future career (69%) and reported concern for people close to them with suspected and confirmed COVID-19. One-third of participants reported knowing someone who died from COVID-19 and 8% were self-confirmed COVID-19 positive. Themes emerging from the reflection papers included: changed perspective, gained experience as a pharmacist during a pandemic, concern for loved ones, and positive outlook.

Conclusion

The COVID-19 pandemic had a significant impact on the wellbeing of a cohort of graduating student pharmacists in New York during the initial peaks of the spread in the United States. The results reinforce a need for student support during emergency situations, especially during the final year.

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In March 2020, COVID-19 blazed through New York City resulting in tremendous challenges for health professions training.

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Pharmacists remained the most accessible health profession but lacked the ability to ensure safety for student pharmacists.

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This study describes the personal experiences of student pharmacists during the peak of the pandemic.

Impact of a pilot elective course to address student pharmacist well-being

INTRODUCTION

Survey results from 2016 and 2018 at the University of Michigan College of Pharmacy highlighted mental health concerns for the student population, including struggles with depression, anxiety, and academic distress. This led to creation of a pilot well-being elective course for first year doctor of pharmacy students. This article describes how this course was assessed and adapted for the future.

METHODS

The well-being elective course used a course-specific survey and the Brief Inventory of Thriving to assess student outcomes. The course-specific survey was based upon the course objectives and the University of Michigan Common Agenda for Well-Being. Both surveys were given pre- and post-course to identify change.

RESULTS

Course survey results illustrated an improvement in student well-being over a single semester. Compared with pre-course responses, students who completed the course were significantly more likely to agree with statements indicating they had strong time management skills, resilience to manage the fluctuations of life, were able to make thoughtful choices to reduce harm and promote well-being, and overall rated their well-being as excellent. Additionally, nearly all students felt a sense of strengthened community with peers and faculty within the course, better able to recognize or refer a peer for help, and felt the course contributed to their overall well-being.

CONCLUSIONS

Implementation of this well-being elective pilot course provided students the tools and resources to improve upon their overall well-being in an effort to address anxiety, depression, and academic distress.

Adaptability, Agency, and Association to Influence Change: The Report of the 2020-21 AACP Argus Commission

EXECUTIVE SUMMARY The 2020-21 AACP Argus Commission was charged to 1) review the 2019-2020 standing committee reports; 2) describe the impact of COVID-19 on healthcare delivery with an emphasis on health equity and social justice, 3) identify strategies to work with other health professions associations to advance interprofessional education and practice, and 4) offer recommendations for activities for the Center to Accelerate Pharmacy Practice Transformation and Academic Innovation (CAPT). Two work groups divided charges 2 and 3 and provided assessments of how health care and education might change due to all we have experienced over the 12-plus months of the pandemic. A review of plans for the first year of the CAPT activities and recommendations for additional activities are included in report. The Commission has proposed two new policy statements on digital health, five recommendations for AACP and five suggestions for colleges and schools of pharmacy. The Argus Commission affirms academic pharmacy's adaptability, agency, and association to influence changes in healthcare delivery and interprofessional education and practice.

Coping, resilience, and emotional well-being in pharmacy students during the COVID-19 pandemic

Introduction

The purpose of this study was to investigate the significant contributions of coping, resilience, personal characteristics, and health behaviors on the emotional well-being of pharmacy students during the COVID-19 pandemic. COVID-19 was identified in December 2019 and declared a pandemic by the World Health Organization in March 2020. Pharmacy students may experience greater stress during this outbreak because of interruptions in classes or rotations, concerns regarding personal or family health, and social isolation from peers. These changes may result in behavior shifts, difficulty concentrating, and increased use of negative coping strategies. The extent to which these factors affect overall student well-being during a pandemic is largely unknown.

Methods

A cross-sectional study of 3 colleges of pharmacy was completed during May to July 2020 via an online, anonymous 64-item questionnaire using REDCap software. Linear regression and descriptive statistical analyses were conducted using SPSS version 26.

Results

Using the enter method, levels of coping strategies, personal resilience, and Hispanic ethnic identity explain 29% of the variance in emotional well-being scores in pharmacy students during the first months of the COVID-19 pandemic (F (2,76) = 11.785, P < .000, R² = 0.317, R^{2 adjusted} = 0.291). For this sample (N = 104), higher levels of resilience, greater use of coping strategies, and identifying as Hispanic were significant predictors of emotional well-being.

Discussion

Student mental health continues to be important, especially during crises and pandemics. Therefore, pharmacy programs should cultivate an environment that supports the emotional well-being of their students. Campus-based initiatives may be needed to encourage healthy coping behaviors and bolster students' personal resilience to better prepare them for providing front-line patient care in the future.

Graduate training during the COVID-19 pandemic: North American genetic counseling students' challenges, intolerance of uncertainty, and psychological well-being

The COVID-19 pandemic has upended genetic counseling (GC) graduate students' lives, as they have been forced to transition, manage, and acclimate to life during a pandemic. The current study is a first step in understanding their lived experiences during this historic, global event. We investigated academic and personal challenges, intolerance of uncertainty, and psychological well-being of GC students (n = 248) who trained during the pandemic (GC-COV cohort) and those who did not (GC-NoCOV cohort). Participants completed an online survey (July-September 2020) that used validated measures of Intolerance of Uncertainty and Psychological Well-Being. To assess the academic and personal challenges students experienced during GC graduate training, we developed a 43-item measure. Principal axis factoring of the items revealed categories of challenges related to the following: Academic & Professional Development, Self-Regulation & Resilience, Institutional & Program Leadership, and Financial Stability. There was no cohort difference in Psychological Well-Being. Linear mixed-effects modeling showed significant cohort differences in challenges. Multiple linear regression analyses revealed that the GC-COV cohort's Psychological Well-Being was statistically significantly predicted by Institutional & Program Leadership challenges (p = .029), Self-Regulation & Resilience challenges (p = .013), and Intolerance of Uncertainty (p = .010). For the GC-NoCOV cohort, the statistically significant predictor of Psychological Well-Being was Self-Regulation & Resilience challenges (p = .029). Our findings demonstrate that GC students training during the COVID-19 pandemic have experienced various personal, academic, and psychological disruptions and highlight a need to develop resources and implement interventions supporting students' academic development and psychological well-being.

Student Pharmacists during the Pandemic: Development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey

Background: The COVID-19 pandemic has caused innumerable changes to all aspects of human life and behavior, including academic life. This study describes the development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey among U.S. student pharmacists. The survey was administered at Doctor of Pharmacy programs in three states—Tennessee, Ohio, and Pennsylvania. Methods: The COVKAP survey—an online cross-sectional survey—was distributed to U.S. student pharmacists enrolled in three different colleges of pharmacy in three states during the fall semester of 2020. The survey was developed using literature review and Dillman’s recommendations for survey design. The COVKAP survey consisted of 23 closed and Likert-scale questions, and three open-ended questions. The research team conducted descriptive and inductive thematic analyses on the quantitative and qualitative data, respectively using SPSS (v27) and Dedoose^® software. Results: A total of 421 responses were received. Respondents were predominantly female (72%) and White (79%). The average age of respondents was 23.4 years. The qualitative analysis revealed three themes: (1) Wellbeing and mental health struggles; (2) Being part of the decision-making process; (3) Necessity of adequate protection measures. Conclusions: Preliminary study findings indicate that student pharmacists’ concerns and the challenges that they face in their academic pursuits are largely similar across the three states in this study and inform about the importance of recognizing and mitigating the impact of widespread disruption in education. This disruption provides an opportunity for pharmacy academia to examine practices and methods that can be improved upon to help students become successful practitioners.

COVID-19: A Cross-Sectional Study of Healthcare Students' Perceptions of Life during the Pandemic in the United States and Brazil

Societal influences, such as beliefs and behaviors, and their increasing complexity add to the challenges of interactivity promoted by globalization. This study was developed during a virtual global educational exchange experience and designed for research and educational purposes to assess personal social and cultural risk factors for students’ COVID-19 personal prevention behavior and perceptions about life during the pandemic, and to inform future educational efforts in intercultural learning for healthcare students. We designed and implemented a cross-sectional anonymous online survey intended to assess social and cultural risk factors for COVID-19 personal prevention behavior and students’ perceptions about life during the pandemic in public health and healthcare students in two public universities (United States n = 53; Brazil n = 55). Statistically significant differences existed between the United States and Brazil students in degree type, employment, risk behavior, personal prevention procedures, sanitization perceptions, and views of governmental policies. Cultural and social differences, risk messaging, and lifestyle factors may contribute to disparities in perceptions and behaviors of students around the novel infectious disease, with implications for future global infectious disease control.

The prevalence of depressive symptoms, anxiety symptoms and sleep disturbance in higher education students during the COVID-19 pandemic: A systematic review and meta-analysis

The COVID-19 pandemic and its accompanying infection control measures introduced significant disruptions to the routines of many higher education students around the world. It also deprived them of in-person counselling services and social support. These changes have put students at a greater risk of developing mental illness. The objective of this review is to assess the prevalence of depressive symptoms, anxiety symptoms and sleep disturbances in higher education students during the pandemic. A systematic search of English and Chinese databases was conducted current to January 1^st, 2021. The quality of included studies was evaluated using a modified Newcastle-Ottawa scale. Prevalence of depressive symptoms, anxiety symptoms and sleep disturbances were pooled using random-effects meta-analysis. Eighty-nine studies (n=1,441,828) were included. The pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances was 34%, 32% and 33%, respectively. The prevalence values differ based on geographical regions, diagnostic criteria, education level, undergraduate year of study, financial situation, living arrangements and gender. Overall, the prevalence of depressive symptoms and anxiety symptoms synthesized in this study was higher compared to pre-pandemic prevalence in similar populations. Evidently, mental health screening and intervention should be a top priority for universities and colleges during the pandemic.

Impact of a Yin Yoga and meditation intervention on pharmacy faculty and student well-being

BACKGROUND

Student pharmacists and faculty exhibit high levels of stress, independent of the current coronavirus 2019 pandemic, and their path toward wellness, including a reduction in stress and anxiety, is of the utmost importance. Yoga and meditation are proven interventions to reduce stress and anxiety and increase wellness. Yin yoga is an adaptable, quiet practice ideal for those lacking previous yoga experience, flexibility, and time.

OBJECTIVE

To evaluate the impact of a 6-week yin yoga and meditation intervention on College of Pharmacy faculty and students' stress perception, anxiety levels, and mindfulness skills.

METHODS

Faculty and students participated in a 6-week pilot program comprising a once-weekly yin yoga class followed by guided meditation. Yin yoga was selected for its quiet meditative style. Participants completed a pre- and postquestionnaire at 6 weeks and 3 and 6 months to evaluate potential changes in perceived stress scores, anxiety scores, and mindfulness skills. The questionnaire was composed of 3 self-reporting tools: Beck Anxiety Inventory (BAI), Perceived Stress Scale, and the Five Facet Mindfulness Questionnaire.

RESULTS

Twenty participants, 12 students and 8 faculty (ages 18-66 years), completed the study. Anxiety and stress scores decreased, and mindfulness increased at 6 weeks, 3 months and 6 months, with all changes reaching statistical significance. No participants reported being in the "high" category of anxiety after intervention using BAI categorical data, although this finding was not statistically significant.

CONCLUSION

Faculty and students demonstrated a reduction in stress and anxiety levels and an increase in mindfulness after a 6-week yin yoga and meditation program. Outcomes suggest that inclusion of an adaptable, meditative practice, which may easily be replicated at home, for as little as once per week for 6 weeks may reduce stress and anxiety and increase mindfulness long term. Creating a culture of wellness should be a priority for all Colleges of Pharmacy.

Measures of Burnout and Empathy in United States Doctor of Pharmacy Students: Time for a Change?

PURPOSE

To review interim data regarding longitudinal burnout and empathy levels in a single Doctor of Pharmacy class cohort.

METHODS

Students were emailed an electronic survey during their first semester and annually at the end of each academic year for a total of 3 years (2017-2020). Validated survey tools included the Jefferson Scale of Empathy (JSE) and the Maslach Burnout Inventory (MBI) student version. The JSE survey consists of 20 questions, with higher scores denoting more empathy. The MBI student version contains 3 subscales: exhaustion (higher scores are worse), cynicism (higher scores are worse) and professional efficacy (higher scores are better).

RESULTS

The median JSE score at the end of the third academic year (PY3) was 110, with females scoring significantly higher (114.5 vs. 103.5; p<0.02). A majority of the 62 students reported burn out (82.3%), scoring in the highest category for either exhaustion (76%) or cynicism (55%). A majority (66%) also reported a low or moderate professional efficacy score, a negative finding. Measures of student burnout increased after the start of the program and remained at the higher level each subsequent year (p<0.0001). In the Spring of 2020, during the COVID-19 pandemic, nearly every student had moderate or high levels of emotional exhaustion (97%) and cynicism (78%) as measured by the MBI.

CONCLUSION

This interim data suggests high degrees of pharmacy student burnout. Empathy levels remained stable throughout the duration of the study. Pharmacy schools may need to focus on reform regarding well-being and prevention of burnout.

Lessons learned from pharmacy learner and educator experiences during early stages of COVID-19 pandemic

Disclaimer

In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Purpose

To explore pharmacy learner (eg, resident, fellow) and educator (eg, residency program director, preceptor) experiences and lessons learned during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

In May 2020, attendees of the virtual Research in Education and Practice Symposium (REPS) were invited to participate in two 1-hour networking sessions. During these sessions, participants completed individual and group reflection exercises during which they were asked questions about their experiences during the initial stages of the COVID-19 pandemic. Participants who volunteered submitted their responses through an electronic survey application. Anonymous responses were coded using thematic analysis to address the research questions.

Results

Sixty-eight and 38 participants, respectively, attended the 2 networking discussions. Participant-identified professional impacts of the COVID-19 crisis included unexpected learning experiences, greater adaptability, workflow and learning interruptions, and decreased productivity. Personal impacts included a greater focus on well-being, physical and social isolation, and changes in travel plans. Participants noted positive and negative emotions including acceptance, encouragement, anxiety, stress, and frustration. The main lessons learned focused on adaptability, gratitude, and empathy. Participants indicated that they would have from foreknowledge of the anticipated duration of the pandemic, associated workflow changes, and the reliance on technology the pandemic would engender. In addition, they predicted that pharmacy practice will require changes to workflow flexibility, training expectations, the pharmacist’s role, and organizational structure.

Conclusion

The COVID-19 pandemic has positively and negatively impacted the professional and personal lives of pharmacy learners and educators, with the most notable impacts being in the areas of well-being and adaptability. Future research should explore the experiences of other workforce personnel and evaluate the long-term impact on pharmacy practice, patient outcomes, and workforce well-being and resiliency.

The coping strategies followed by university students to mitigate the COVID-19 quarantine psychological impact

Different strategies were followed to control the spread of the COVID-19 disease worldwide. Jordan declared a military-enforced curfew for three months, which successfully controlled the disease spreading. However, the curfew impacted several aspects of students’ lives and personalities. This study discusses the impact of the COVID-19 curfew restrictions on university students’ mental health, as this area was not fully discussed in previous studies. An online survey was distributed to cover the psychological symptoms and coping strategies of university students. Most of them experienced short temper, anxiety, and sleep problems. Female students expressed more psychological symptoms than males, they managed their stress by sleeping, studying, and worshiping. Whereas male students were working, exercising, and playing video games. A distinct interest was noticed among students of different ages. Young students (18–25 years) expressed unhappiness and distress-like symptoms; they advocated sleeping and playing video games. While elder students (>26 years) had anxiety, sleep problems, and short tempers, they managed their symptoms by studying, exercising, and worshiping. The curfew restrictions have negatively impacted the mental health of female and younger students more than other categories. These research outcomes will help decision-makers to implement healthy coping strategies to be followed during unusual conditions.

Leading a Digital Transformation in Pharmacy Education with a Pandemic as the Accelerant

The global COVID-19 pandemic has not only posed a challenge to education but created an opportunity to spearhead a digital transformation and the novel delivery of a Pharm.D. curriculum. The process to transform the curriculum in a sustainable and iterative manner involved multiple steps including: (1) Communication, (2) Maintaining faculty engagement, (3) Allowing outside the box thinking, (4) Providing resources and tools and (5) Creating accountability and timelines. At our institution, we have been interested in digital transformation since completing our interview of global leaders. We began our journey using the current COVID-19 pandemic as an accelerant for change. Digital transformation in any industry is not a simple undertaking. However, with planning, aligned organizational interests, consistent and regular communication, provision of resources and tools, engaging faculty and creating accountability and timelines with deliverables the implementation can be successful. When the global pandemic wanes and educational institutions commence in-person classes, having undergone the stages of digital transformation, we will be able to embrace these changes and transform education, not having to reproduce pre-pandemic educational systems.

Psychological impacts from COVID-19 among university students: Risk factors across seven states in the United States

BACKGROUND

University students are increasingly recognized as a vulnerable population, suffering from higher levels of anxiety, depression, substance abuse, and disordered eating compared to the general population. Therefore, when the nature of their educational experience radically changes-such as sheltering in place during the COVID-19 pandemic-the burden on the mental health of this vulnerable population is amplified. The objectives of this study are to 1) identify the array of psychological impacts COVID-19 has on students, 2) develop profiles to characterize students' anticipated levels of psychological impact during the pandemic, and 3) evaluate potential sociodemographic, lifestyle-related, and awareness of people infected with COVID-19 risk factors that could make students more likely to experience these impacts.

METHODS

Cross-sectional data were collected through web-based questionnaires from seven U.S. universities. Representative and convenience sampling was used to invite students to complete the questionnaires in mid-March to early-May 2020, when most coronavirus-related sheltering in place orders were in effect. We received 2,534 completed responses, of which 61% were from women, 79% from non-Hispanic Whites, and 20% from graduate students.

RESULTS

Exploratory factor analysis on close-ended responses resulted in two latent constructs, which we used to identify profiles of students with latent profile analysis, including high (45% of sample), moderate (40%), and low (14%) levels of psychological impact. Bivariate associations showed students who were women, were non-Hispanic Asian, in fair/poor health, of below-average relative family income, or who knew someone infected with COVID-19 experienced higher levels of psychological impact. Students who were non-Hispanic White, above-average social class, spent at least two hours outside, or less than eight hours on electronic screens were likely to experience lower levels of psychological impact. Multivariate modeling (mixed-effects logistic regression) showed that being a woman, having fair/poor general health status, being 18 to 24 years old, spending 8 or more hours on screens daily, and knowing someone infected predicted higher levels of psychological impact when risk factors were considered simultaneously.

CONCLUSION

Inadequate efforts to recognize and address college students' mental health challenges, especially during a pandemic, could have long-term consequences on their health and education.

The COVID‐19 pandemic and students’ mental health

In this article, authors outline the prevalence of mental health disorders among students during the pandemic, highlight common strategies embedded in campuses’ responses, and provide recommendations for campuses to support students’ mental health.

Intervention and Improved Well-Being of Basic Science Researchers During the COVID 19 Era: A Case Study

The coronavirus disease-19 (COVID-19) pandemic has affected individuals of all categories, irrespective of their geographical locations, professions, gender, or race. As a result of full or partial lock-down and stay-at-home orders, the well-being and productivity of individuals were severely affected. Since basic science research requires laboratory experiments, the work-from-home strategy hurt their productivity. In addition, the combination of decreased productivity and staying at home is likely to compromise their well-being by causing stress and anxiety. In this case study, a strategy was developed to engage researchers through listening and learning, motivation, and empowerment, using regular virtual sessions. Through these virtual sessions, research work was prioritized and coordinated, from idea conception to writing research papers and grant proposals. Perceived stress scores (PSS) and COVID-19-related stress (COVID-SS) scores were measured to evaluate general and COVID-19-induced stress, respectively, every month from March to July 2020 during the COVID-19 era. The result showed a significant improvement in both the PSS and the COVID-SS scores of the intervention group compared to the control group. In addition, while there was no/minimal change in PSS and COVID-SS scores from March to subsequent months until July for the control group, the intervention groups showed significant and consistent improvement in both scores in the intervention group. Overall, the intervention strategy showed improved well-being for basic science researchers, which was also consistent with their improved productivity during the COVID-19 era.

Investigating Mental Health of US College Students During the COVID-19 Pandemic: Cross-Sectional Survey Study

BACKGROUND

Evidence suggests that the COVID-19 pandemic has generally increased levels of stress and depression among the public. However, the impact on college students in the United States has not been well-documented.

OBJECTIVE

This paper surveys the mental health status and severity of depression and anxiety of college students in a large university system in the United States during the COVID-19 pandemic.

METHODS

An online survey was conducted among undergraduate and graduate students recruited from Texas A&M University via email. The survey consisted of two standardized scales-the Patient Health Questionnaire-9 and the General Anxiety Disorder-7-for depression and anxiety, and additional multiple-choice and open-ended questions regarding stressors and coping mechanisms specific to COVID-19.

RESULTS

Among the 2031 participants, 48.14% (n=960) showed a moderate-to-severe level of depression, 38.48% (n=775) showed a moderate-to-severe level of anxiety, and 18.04% (n=366) had suicidal thoughts. A majority of participants (n=1443, 71.26%) indicated that their stress/anxiety levels had increased during the pandemic. Less than half of the participants (n=882, 43.25%) indicated that they were able to cope adequately with the stress related to the current situation.

CONCLUSIONS

The proportion of respondents showing depression, anxiety, and/or suicidal thoughts is alarming. Respondents reported academic-, health-, and lifestyle-related concerns caused by the pandemic. Given the unexpected length and severity of the outbreak, these concerns need to be further understood and addressed.