Affective domain predictors of PharmD student pursuit of and successful matching for postgraduate pharmacy residency training.

PURPOSE: A study was conducted to identify significant associations between affective domain (AD) features identified using the Birkman Method assessment and students' likelihood to pursue and to successfully match for postgraduate residency training (PGRT), while controlling for demographic and academic variables known to impact PGRT match rates. METHODS: A retrospective analysis of 3 graduating classes of PharmD students from 2 colleges of pharmacy was performed. Data points such as PGRT match results, PGRT pursuit, student demographics, academic performance information, and AD data from the Birkman assessment were analyzed. Regression analysis was used to identify statistically significant associations between demographic, academic performance, and AD variables with both pursuit of PGRT and successful matching for PGRT. RESULTS: Data from 503 students were evaluated, with 211 (42%) pursuing PGRT. A variety of AD variables were significantly associated with pursuing PGRT and matching for PGRT. Two groups of actionable variables emerged: (1) variables associated with a lesser likelihood of pursuing PGRT but a greater likelihood of successful matching, and (2) variables associated with a greater likelihood of pursuing PGRT and a lesser likelihood of successful matching. CONCLUSION: Early identification of students' AD features along with specific interventions to promote PGRT pursuit in those less likely to pursue but more likely to match, as well as interventions to promote successful matching in students most likely to pursue but less likely to match for PGRT, is a strategy for possibly optimizing PharmD student career path planning and PGRT match success that merits further evaluation.

Investigating pharmacy students' therapeutic decision-making with respect to antimicrobial stewardship cases.

BACKGROUND: Antimicrobial stewardship programs (ASPs) play a big role in minimizing antimicrobial resistance. Pharmacists are essential members of the health care team and in order for them to fulfill roles on ASP teams and become antimicrobial stewards, they must be prepared adequately by pharmacy schools prior to entry into actual practice. Although programming has been implemented into entry-to-practice programs worldwide, little is known about how students interpret antimicrobial stewardship (AMS) data and arrive at clinical decisions. We aimed to explore students' cognitive processes and determine how they formulate therapeutic decisions when presented with AMS cases. METHODS: This was a qualitative study conducted using a case study approach, in which a sample (n=20) of pharmacy students was recruited to interpret AMS cases. Semi-structured 1-on-1 interviews were arranged with each participant. A think-aloud procedure with verbal protocol analysis was adopted to determine students' decision-making processes. Thematic analysis was used to interpret themes from the interview data. RESULTS: Two themes were interpreted from the data: students' focus and students' approach to case interpretation. Students' focus relates to external factors students consider when interpreting AMS case data and use to make and justify therapeutic decisions including patient-centered factors, drug-related factors, AMS interventions, and pharmacist's role. Students' clinical reasoning describes the approach that students use to interpret the data and the decision-making processes they employ to arrive at a clinical decision including a systematic approach versus non-systematic approach. CONCLUSIONS: Students vary in their focus and the cognitive strategies used to interpret AMS cases. Findings support the notion that clinical reasoning and decision-making should be explicitly taught in pharmacy curricula, in order to help students become aware of their own cognitive processes and decision-making abilities.

The impact of the COVID-19 pandemic on pharmacy students' personal and professional learning.

INTRODUCTION: The COVID-19 pandemic impacted both healthcare delivery and the education of healthcare students, with a shift to remote delivery of coursework and assessment alongside the expansion of the scope of practice of Alberta pharmacists. The objective of this research was to understand how the learning of pharmacy students at the University of Alberta was impacted by the COVID-19 pandemic. METHODS: A cross-sectional survey was distributed to 397 pharmacy students in years one through three. Students responded to three short-answer reflection questions: (1) how has the COVID-19 pandemic situation affected your learning; (2) from a pharmacy and pharmacy school perspective, what have you learned since the COVID-19 pandemic began; and (3) from a personal perspective, what have you learned about yourself since the COVID-19 pandemic began? A thematic analysis was undertaken of students' responses to these reflection questions. RESULTS: A total of 53 students responded to the survey (response rate 13%). Two major themes were identified across all three reflection questions, with several subthemes: remote learning (learning environment, knowledge transfer, knowledge retention, assessment) and mental health (appreciation, stress, extroversion, motivation). Adaptability, routine, professional identity, and the role of the pharmacist were also identified as less prevalent themes. CONCLUSIONS: Pharmacy students' responses led to the identification of several themes related to their learning given the changes brought about by the COVID-19 pandemic. This increased understanding of student perceptions has the potential to improve the remote delivery of education, support increased university-wide mental health resourcing, and shape pharmacy curriculum development.

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.

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.

The Impact of Transitions Related to COVID-19 on Pharmacy Student Well-being.

Objective. To characterize the impact of COVID-19 transitions on first professional year (P1) students' domain-specific and overall well-being.Methods. All P1 students (N=74) enrolled at one college of pharmacy self-reported their career, community, financial, physical, social, and overall well-being on a weekly basis from January 6 through April 27, 2020. Parametric statistical tests and effect sizes were used to compare well-being scores pre-transition and post-transition and to compare well-being scores to a previous cohort of P1 students.Results. Mean well-being scores decreased when comparing pre-transition vs post-transition scores, with effect sizes ranging from dav=.16 for financial well-being to dav=.84 for social well-being. The average percent of students that reported struggling increased by 86.1% (16.8% vs 31.2%) post-transition, and the average percent of students that reported suffering post-transition was 351% higher (1.3% vs 6%) than pre-transition.Conclusion. Pharmacy students' domain specific and overall well-being significantly decreased with COVID-19-related transitions. The percentage of students reporting struggling or suffering significantly increased post-transition.

Malaysian pharmacy students' perspectives on the virtual objective structured clinical examination during the coronavirus disease 2019 pandemic.

PURPOSE: This study investigated pharmacy students' perceptions of various aspects of virtual objective structured clinical examinations (vOSCEs) conducted during the coronavirus disease 2019 pandemic in Malaysia. METHODS: This cross-sectional study involved third- and fourth-year pharmacy students at the International Islamic University Malaysia. A validated self-administered questionnaire was distributed to students who had taken a vOSCE a week before. RESULTS: Out of the 253 students who were approached, 231 (91.3%) completed the questionnaire. More than 75% of the participants agreed that the instructions and preparations were clear and helpful in familiarizing them with the vOSCE flow. It was found that 53.2% of the respondents were satisfied with the flow and conduct of the vOSCE. However, only approximately one-third of the respondents believed that the tasks provided in the vOSCE were more convenient, less stressful, and easier to perform than those in the conventional OSCE. Furthermore, 49.7% of the students favored not having a vOSCE in the future when conducting a conventional OSCE becomes feasible again. Internet connection was reported as a problem hindering the performance of the vOSCE by 51.9% of the participants. Students who were interested in clinical pharmacy courses were more satisfied than other students with the preparation and operation of the vOSCE, the faculty support, and the allocated time. CONCLUSION: Students were satisfied with the organization and operation of the vOSCE. However, they still preferred the conventional OSCE over the vOSCE. These findings might indicate a further need to expose students to telehealthcare models.

Doctor of pharmacy student preferences for computer-based vs. paper-and-pencil testing in a, social and administrative pharmacy course.

INTRODUCTION: The use of online learning and subsequent online testing has expanded rapidly in pharmacy programs across the United States. Numerous published studies have compared online learning with traditional methods in pharmacy. However, no such studies have been published in pharmacy. This study's objective is to compare first-professional year student preferences for computer-based vs. traditional paper-and-pencil testing for a required social and administrative pharmacy class. METHODS: All students enrolled in the class were invited to complete one brief survey at the end of the semester to determine their testing preference. RESULTS: Of the 138 first-professional year students completing the survey, 79% (109 of 138) preferred computer-based testing, 9% had no preference, 6% (8 of 138) preferred paper-and-pencil testing, and the remainder (8 of 138) stated it depended on what was being tested. Ninety-one percent of students did not perceive the testing method to impact their grades. Students preferred computer-based testing over traditional paper-and-pencil as a convenient testing method (mean 4.73 vs. 3.4, P < .001), providing immediate feedback (mean 4.87 vs. 1.91, P < .001), and as a more effective testing method (mean 4.57 vs. 3.96, P < .001). CONCLUSIONS: First-professional year students preferred computer-based over traditional paper-and-pencil testing for a social and administrative science class, with the method of testing not perceived to impact grade. This finding is timely, given the recent required transitioning of all pharmacy classes and subsequent testing to an online format due to the coronavirus disease of 2019 pandemic.

What does experiential education look like in a global pandemic? Reflecting back and looking forward.

PURPOSE: The purpose of this reflection or wisdom of experience article is to describe and reflect on the impacts of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on experiential education (EE) leadership and teams. Additionally, this reflection will shift the focus from the spring 2020 environment of SARS-CoV-2 to what EE teams and college administration can learn from those experiences. Moving forward, EE teams and administrators can be better equipped to proactively plan for future emergencies. DESCRIPTION: Using the "What? So What? Now What?" model of reflection, this manuscript will broadly describe the experiences of three EE administrators and their teams during the SARS-CoV-2 pandemic. Proposed lessons learned as well as future planning strategies will be presented. ANALYSIS/INTERPRETATION: The world of education was unprepared for the SARS-CoV-2 pandemic, and most sectors were left scrambling to adjust to new models very quickly with no planning or preparation. In the realm of pharmacy education, SARS-CoV-2 caused complete disruption for pharmacy students on rotations, clinical sites, preceptors, and EE teams. In reflecting on spring 2020, much can be gained and applied to future planning efforts so that institutions can be better prepared for future crises. CONCLUSIONS/IMPLICATIONS: While still in the pandemic, schools must plan for the coming year. EE teams can work together to prepare for emergencies, craft contingency plans, and build additional capacity into their teams and available rotation offerings.

Emotions and mood swings of pharmacy students in the context of the coronavirus disease of 2019 pandemic.

INTRODUCTION: The coronavirus disease of 2019 pandemic has changed university routines affecting student mental health. The aims of this study were to survey aspects related to mental health of pharmaceutical course students considering previous and current contexts. METHODS: The Depression, Anxiety, and Stress Scale (DASS-21), Impact of Event Scale-Revised, and Brunel Mood Scale were used. DASS-21 was completed pre- and post-pandemic. The validity and reliability of the data were verified. The prevalence (95% CI) of mental health symptoms was estimated. The relationship between the time spent watching/reading the news and mean scales scores was evaluated (Pearson's correlation coefficient). RESULTS: The prevalence of depression symptoms in students pre-pandemic was 66.7% (95% CI = 65.3-68.1) and during the pandemic was 81% (95% CI = 79.8-82.2). More than 70% (95% CI = 69.8-72.6) of participants had some psychological impact as a result of the pandemic (mild: 16.7% [95% CI = 15.6-17.8]; moderate: 9.1% [95% CI = 8.2-10]; severe: 45.4% [95% CI = 43.9-46.9]). High values of tension, depressed mood, mental confusion, and anger were observed. There was a significant correlation between the time spent following the news of the pandemic and symptoms of anxiety (r = 0.356; P < .001), stress (r = 0.248; P = .014), hyperarousal (r = 0.322; P ≤ 0.001), and intrusion (r = 0.21; P = .039). CONCLUSIONS: Students are highly vulnerable to depressive symptoms and mood swings due to the pandemic. These findings deserve consideration mainly from mental health professionals, but also from managers and educators.

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

During times of stress, such as those experienced during the novel coronavirus identified in 2019 (COVID-19) pandemic, pharmacy students handle the experience differently. For some, the experience may negatively impact their sense of well-being; for others, being at home with family could actually improve their well-being. While students are completing academic work at home and after they finally return to campus, pharmacy schools need to be keenly aware of students' experiences and implement strategies to build their resilience and improve their well-being. One approach will not meet the needs of all students. Many of the challenges that pharmacy students have faced or will face when they return to the classroom are discussed along with some programs and activities that have proven successful.

The Impact of COVID-19 Through the Eyes of a Fourth-Year Pharmacy Student.

This commentary, written primarily by a recent pharmacy graduate, discusses the impact of COVID-19 on the class of 2020. Everyone has been impacted by COVID-19, but pharmacy students have been affected by and experienced COVID-19 in unique ways. This was the first class to complete pharmacy practice experiences in an online format, miss out on milestone events including graduation, and face uncertainty about becoming licensed and entering the job market in the midst of a pandemic. However, instead of discouraging them, these events have in many ways strengthened the resilience of the class of 2020. Additionally, COVID-19 has highlighted the importance of continued advocacy for the profession and articulation of the pharmacist's expanded role and value to the health care team, and inspired the class of 2020 to join the ranks of colleagues nationwide in raising awareness in these areas. Nevertheless, uncertainty over their future and that of their peers lingers as COVID-19 has forever changed pharmacy education and practice.

Sustainable Pharmacy Education in the Time of COVID-19.

Pharmacy schools and colleges worldwide are facing unprecedented challenges to ensuring sustainable education during the novel coronavirus (COVID-19) pandemic. The experiences of pharmacy educators in the Asia-Pacific region in delivering emergency remote teaching, ensuring purposeful experiential placements, supporting displaced or isolated students, and communicating with faculty members, staff members, and students are discussed. The role of this pandemic in accelerating opportunities for new models of pharmacy education across the world is also discussed.

A Paradigm Shift in US Experiential Pharmacy Education Accelerated by the COVID-19 Pandemic.

The coronavirus identified in 2019 (COVID-19) has caused dramatic disruptions in pharmacy experiential education. Administrators and programs have worked to help external preceptors, faculty members, and students cope with the new realities of virtual or remote experiences and new or increased use of telemedicine. Clear and effective lines of communication as well as well-reasoned and resourced alternative plans are necessary to help manage the current issues and prepare for future challenges. Doctor of Pharmacy programs should enhance their focus not just on the physical health and well-being of students, faculty members, and external preceptors, but also on their mental and emotional health. The full scope of the impact of the pandemic on experiential education in pharmacy is still unclear, but this situation should serve as a stimulus for innovation and rethinking the paradigm of how pharmacy programs educate and prepare students for pharmacy practice.

Facilitating Wellbeing in a Turbulent Time.

The novel coronavirus 2019 (COVID-19) pandemic has changed the way we live, work, and study. As faculty members, staff members, and students attempt to create and maintain a new normal because of this pandemic, the preservation of wellbeing becomes the responsibility of each and every one of us. The pandemic has taught us not to presume the importance of wellbeing and has allowed us time to reflect on establishing new assumptions and beliefs about how and when we work and study; how to be more efficient in our work and home responsibilities; and above all, what is most important. We must support ourselves and our students by maintaining a routine, modifying work and coursework expectations, and seeking psychosocial support if needed. Focusing on promoting wellbeing through leadership will move our institutions forward to a brighter future beyond COVID-19.

Cross-Sectional Study on Awareness and Knowledge of COVID-19 Among Senior pharmacy Students.

Extraordinary actions have been implemented in an effort to control the rapid spread of the ongoing COVID-19 epidemic in Egypt. People's adherence to control measures is influenced by their knowledge, attitudes and practices towards the disease. Therefore, in the present study we assessed pharmacy senior students' knowledge, attitudes and practices towards the COVID-19 pandemic. An online questionnaire was created and it consisted of 12 questions testing their knowledge about COVID-19 clinical characteristics, transmission routes and prevention and control steps. Among senior pharmacy students (n = 238), 70% were females and 63% were living in greater Cairo. Their main source of information included social media (70%), published articles (48%) and television (48%). The overall correct knowledge score was 83%. Most of the students displayed a good COVID-19 knowledge level (72.5% of the students). The students were least informed when trying to answer questions about hyper-coagulation, as a major cause for death in patients with severe COVID-19, and about the timings on the necessity to wear masks. Assessment of students' attitudes and practices towards COVID-19 reflected that 87% of them were confident that health care teams and scientists could win the fight against the virus. In addition, 72% of students agreed that COVID-19 will be controlled successfully. The greater the students' knowledge, the more confident they felt that COVID-19 will be controlled successfully (OR 2.2, 95% confidence interval [CI] 1.03-4.72). Good behavioral practice towards COVID-19 control was confirmed when 87% of students answered that they didn't go out to any crowded place. Females were 3.6 times (95% confidence interval [CI] 1.03-3.11) more likely to avoid going out than males. Bad behavioral practice became evident when approximately 50% of students admitted that they did not wear masks when they left their house. Therefore, more efforts should be taken to protect future pharmacists from this pandemic.

Pharmacists' readiness to deal with the coronavirus pandemic: Assessing awareness and perception of roles.

Background: The 2019 Coronavirus infection (COVID-19) caused by a novel strain of coronavirus was detected in China in December 2019, and declared a public health emergency of international concern on January 30, 2020. Community pharmacists have an important role in supporting the local health emergency preparedness and response arrangements. Objectives: To investigate pharmacists and pharmacy students' awareness and source of their information regard the management of the coronavirus pandemic, and their perspective of their role during this emergent situation. Methods: This descriptive cross-sectional online survey study was conducted in Jordan during the COVID-19 outbreak (from 15 to 30 March 2020). A validated online questionnaire addressing participants' current awareness about epidemics/pandemics and COVID-19, source of information and their perspectives of their role. Data were analyzed using statistical package for social science (SPSS). Results: Participants (n = 726) had a mean age of 26.9 (8.0) years with 71.9% females. Pharmacy students made 35.3% of the sample while the rest were pharmacists. Only 54.3% of participants believed that they got enough education about epidemics/pandemics, and 94.6% of them follow on the latest coronavirus updates on treatments, and that is mainly from the media (59.5%) followed by the World Health Organization reports (58.7%) and then the published researches (57%). Awareness score (out of 20) of pharmacists (n = 470) was significantly higher (p < 0.001) than that of students (n = 256). Better Awareness scores were also associated with higher age of participants, graduating from a public versus a private university, and attending more educational workshops. Conclusion: The majority of pharmacists and pharmacy students reported that they have a major role in the management of epidemics/pandemics through the community pharmacies but the majority follow on the latest coronavirus updates from the media. This fact rings bills considering the numerous conflicting messages publicized during the pandemic through the media.