The Complicated Middle of the Academic Deanery.

The complicated and ever-growing roles of assistant and associate deans (A-deans) can often be compared to those of middle managers. With responsibilities that are rapidly expanding and often unclear or overlapping with other personnel, A-deans may face identity crises. Additionally, because they are often not at the full professor level, they may experience difficulty achieving promotion. In this commentary, the authors call for increased awareness of the challenges associated with these roles and suggest opportunities for change. To maximize effectiveness in their roles, the Academy and colleges/schools are encouraged to explore workload/expectations for A-deans and associated reward structures, including promotion and tenure guidelines with explicit recognition for the important role(s) they play. A-deans are also encouraged to advocate for infrastructure and responsibilities that support both their academic institution and their own individual professional goals.

Validity evidence for a virtual multiple mini interview at a pharmacy program.

BACKGROUND: Numerous health professions schools have transitioned to virtual admissions interviews in recent years. While some research suggests that virtual multiple mini-interviews (vMMIs) are feasible, acceptable, and more affordable, there is a paucity of research concerning the validity of this approach. The purpose of this study was to examine the validity and reliability of vMMIs and explore differences in performance between vMMI and in-person MMIs. METHODS: Data were collected for two years of in-person MMIs and two years of vMMIs at a pharmacy program/school in the United States. An exploratory factor analysis (principal components analysis) with varimax rotation and Kaiser rule (i.e. retaining factors with eigenvalue > 1.0) was used to explore the construct validity of the vMMI data. Pearson correlation was used to examine correlations between vMMI stations and Cronbach alpha was used to determine the internal consistency of each station. Independent t-tests were used to examine differences between in-person MMI and vMMI scores. Cohen's d was used to determine effect sizes. RESULTS: Four hundred and thirty-eight (42.69%) candidates completed an in-person MMI and 588 (57.31%) completed a vMMI. Factor analysis indicated that each vMMI station formed a single factor with loads ranging from 0.86 to 0.96. The vMMI stations accounted for most of the total variance, demonstrated weak to negligible intercorrelations, and high internal consistency. Significant differences between in-person and vMMI scores were found for the teamwork-giving, teamwork-receiving, and integrity stations. Medium effect sizes were found for teamwork-giving and teamwork-receiving and a small effect size was found for integrity. CONCLUSIONS: Initial evidence suggests that the vMMI is a valid and reliable alternative to in-person MMIs. Additional research is needed to examine sources of differences in rating patterns between the two approaches and identify strategies that align with institutional priorities for recruitment and admissions.

An Exploration of the Relationship Between Pharmacy School Admission Variables and PGY1 Pharmacy Residency Program Match.

OBJECTIVE: To explore the relationship between pharmacy school admission variables and matching to a postgraduate year 1 (PGY1) pharmacy residency program. METHODS: Demographic data, academic indicators, and application review scores were collected for the 2017-2020 Doctor of Pharmacy (PharmD) graduating classes. Multiple mini-interview (MMI) scores were collected for the 2018-2020 PharmD graduating classes. Postgraduate year 1 matching data were collected for all students. Bivariate analyses were performed comparing students who matched to a PGY1 residency versus those who did not match versus those who did not pursue a residency. Logistic regression modeling was performed to explore predictors of matching to a PGY1 residency program. RESULTS: A total of 616 students were included. Bivariate analyses revealed that students who matched to a PGY1 had a higher undergraduate grade point average, higher pharmacy college admissions test composite score, were younger in age, and were more likely to identify as female. Students who matched also scored higher on MMI stations with constructs related to integrity, adaptability, critical thinking, and why pursuing our school. Logistic regression modeling found that an increase in age was associated with lower odds of matching to a PGY1 (0.88 [0.78-0.99]) and an increase in composite MMI station score was associated with higher odds of matching (1.8 [1.31-2.47]). CONCLUSION: Several pharmacy school admission variables were found to be associated with successful matching to a PGY1 residency. These findings have the potential for impact at a programmatic level when evaluating the weight of certain criteria for admission decisions and at the individual student level when providing career services support.

The Relationship Between a Multiple Mini-interview and Situational Judgment Test for Admissions.

Objective. To explore the relationship between a multiple mini-interview (MMI) and situational judgment test (SJT) designed to evaluate nonacademic constructs.Methods. A 30-question ranked-item SJT was developed to test three constructs also measured by MMIs during a pharmacy school's admissions process. First-year pharmacy students were invited to complete the SJT in fall 2020. One hundred four students took the SJT (82.5% response rate), with 97 (77% of possible participants) having MMI scores from the admissions process. Descriptive statistics and other statistical analyses were used to explore the psychometric properties of the SJT and its relationship to MMI scores.Results. Seventy-four percent of students identified as female (n=72), and 11.3% identified with an underrepresented racial identity (n=11). The average age, in mean (SD), was 21.8 (2.1) years. Students' mean (SD) scores were 85.5 (3.1) (out of 100 points) on the SJT and 6.1 (1.0) (out of 10 points) on the MMI. Principal components analysis indicated that the SJT lacked construct validity and internal reliability. However, reliability of the entire SJT instrument provided support for using the total SJT score for analysis (α=.63). Correlations between total SJT and MMI scores were weak (r p<0.29).Conclusion. Results of this study suggest that an SJT may not be a good replacement for the MMI to measure distinct constructs during the admissions process. However, the SJT may provide useful supplemental information during admissions or as part of formative feedback once students are enrolled in a program.

Increasing access to the profession: Admissions lessons learned from the pandemic.

INTRODUCTION: The disruptions induced by the COVID-19 pandemic have forced quick and significant changes to recruitment and admissions practices in colleges of pharmacy. This process has helped to identify barriers and challenges for prospective students. At the University of North Carolina Eshelman School of Pharmacy, some changes were already under consideration prior to the pandemic, such as moving to test-optional admissions and allowing remote interviews, while new considerations included offering the entire recruitment and admissions process remotely. METHODS: In 2020-2021, the decision was made to move to test-optional admissions. A separate decision was made to conduct interviews remotely. Data from the admission cycle were collected from the Pharmacy College Application Service as part of the standard admissions process and exported for analysis. Descriptive statistics (mean ±â€¯SD) were used. RESULTS: Completed applications increased by 59.1% in 2020-2021 from the previous year. Applications increased by 9.8% from underrepresented students, by 6.2% from those with a bachelor's degree, and by 8.4% by out of state students. Other admissions metrics, such as the mean grade point average (3.50) and mean Pharmacy College Admissions Test composite percentile (88%), did not change. CONCLUSIONS: The COVID-19 pandemic experience validated our perspective that we must continue to embrace change and seize opportunities to reduce barriers for prospective students to improve access to the profession. The changes that this pandemic has necessitated may help to close the gaps in accessing health professions education.

Content, costs, and characteristics of United States prepharmacy curricula.

INTRODUCTION: The objective of this study was to examine pharmacy prerequisites and estimate the costs prospective students may incur to complete those requirements. METHODS: Prepharmacy requirements for doctor of pharmacy (PharmD) degree programs in the United States (US) (n = 137) were sourced from school websites in 2018. Credit hour costs for community colleges, public four-year institutions, and private four-year institutions were collected. Chi-square and independent t-tests compared group differences. RESULTS: Schools required 66.12 ± 8.15 prerequisite credit hours (range 41 to 91  hours). All schools required one course in general chemistry and organic chemistry. A higher proportion of schools in 2018 required anatomy/physiology and statistics when compared to 2009. Estimated costs to complete prerequisites ranged from US $16,359 at a community college to US $187,800 for a bachelor's degree at a private institution. CONCLUSIONS: Trends in healthcare and education make it timely for schools to reconsider prerequisites. Renewed consideration should be given to identifying what is core to the profession and the minimum competencies students must demonstrate for entry into PharmD programs.

Evaluation of a Council Structure and Meeting Format for Pharmacy Student Government in the Co-Curriculum.

Objective. To evaluate student perceptions of a transformed pharmacy student government structure and meeting format. Methods. The structure and general assembly meeting format of the University of North Carolina at Chapel Hill (UNC) Eshelman School of Pharmacy Student Senate (ie, student government) underwent a transformation from that of a forum to that of a council in an effort to address concerns regarding limited information exchange, minimal discussion, and unengaged meeting participants. To evaluate student perceptions of the new senate council format, members who attended at least one council meeting during the academic year were asked to complete a 12-item survey evaluating interorganizational relations, communication, collaboration, and efficiencies. Descriptive statistics were used to summarize students' agreement with 10 survey items. Thematic analysis was employed to identify common themes in students' responses to the two open-ended survey items. Results. The majority of students agreed or strongly agreed that the senate council facilitated interorganizational relations (86%), communication (93%), and collaboration (86%). Ninety-three percent of respondents agreed or strongly agreed that the senate council improved efficiencies, while 96% preferred the new senate council meeting format over the previous senate meeting format. Common qualitative themes included improved engagement during council meetings because of the "no laptop" policy and facilitation of open conversation by having a roundtable format and smaller number of members in attendance. Overall, 93% of students indicated they were satisfied or highly satisfied with the new meeting format. Conclusion. Student perceptions suggest that the new senate council structure and meeting format was effective at improving interorganizational relations, communication, collaboration, and efficiencies within student body government.

An Exploration of the Relationships Between Multiple Mini-Interview Scores and Personality Traits.

Objective. To explore the relationship between pharmacy students' social and behavioral competencies assessed using multiple mini-interviews (MMIs) and their personality traits. Methods. A retrospective study was conducted using data from two Doctor of Pharmacy (PharmD) cohorts. Students' self-reported scores from an externally validated tool completed during their first professional year that assessed five personality traits (openness to experiences, conscientiousness, extraversion, agreeableness, and emotionality) were collected. Students' scores on empathy, integrity, adaptability, critical thinking, and collaboration were collected during MMIs conducted during the admissions process. Analysis of variance was used to test the homogeneity of the sample, and correlation analyses were used to determine the strength of relationships between variables. Results. When examining for associations between students' personality traits and their social and behavioral competencies measured during the MMIs, we found a few significant but very weak correlations with extraversion. Conclusion. Our results revealed weak to negligible correlations between scores on competencies measured during the MMIs and personality traits, potentially because the assessments measured different constructs.

A Five-Minute Situational Judgment Test to Assess Empathy in First-Year Student Pharmacists.

Objective. To design, implement, and evaluate the utility of a situational judgment test (SJT) to assess empathy in first-year student pharmacists as part of an end-of-year capstone experience. Methods. First-year students completed a five-minute SJT in lieu of a multiple mini interview (MMI) during the end-of-year capstone. For each SJT item, students selected the two most appropriate response options from a list of five. Various strategies to score the SJT were compared to evaluate the psychometric properties of the test. Student performance on the SJT was examined in relationship to performance on other measures, (eg, MMI stations, personality assessments, and admissions data). Results. A total of 135 first-year pharmacy students completed an average of 9.5 items. Scoring keys based on subject matter experts' and student responses demonstrated high reliability. There was a positive, weak relationship between student performance on the SJT and performance on the adaptability station used in the capstone, and an inverse, weak relationship with students' agreeableness scores. Conclusion. This study suggests that the SJT may be a feasible and efficient assessment strategy in pharmacy education. Additional research is needed to inform SJT design, implementation, and interpretation.

Identifying and Mapping Skill Development Opportunities Through Pharmacy Student Organization Involvement.

Objective. To describe a process for identifying skills that students can gain through co-curricular involvement and to map these skills to curricular outcomes. Methods. This pilot study used a mixed-methods approach involving document reviews, student involvement surveys, and focus groups/interviews to evaluate skill development opportunities in three pharmacy student organizations. Investigators reviewed key documents (eg, student organization websites, annual review forms) to identify skills emphasized by the organization. Student participants completed modified Extracurricular Involvement Inventory surveys to measure the intensity of their student organization involvement. Two student focus groups, one student leader focus group and one general student member focus group, were held for each student organization. Interviews were conducted with each student organization's faculty advisor. Data sources were triangulated to identify and map skill development opportunities to program core competencies. Results. Six of nine core competencies were identified as skills pharmacy students can develop through involvement in the pilot student organizations. All three organizations provided opportunities for members to develop communication skills and in-depth knowledge and proficient skills of the discipline of pharmacy. Two organizations provided opportunities for students to develop collaboration skills. Conclusion. A mixed-methods approach can be used to identify and map skills that students can develop through co-curricular involvement. This approach provides several advantages: objective evaluation and triangulation of skill development opportunities, evaluation of students' involvement, and identification of linkages between the co-curriculum and curriculum in the context of curricular outcomes.

Assessing the Co-Curriculum by Mapping Student Organization Involvement to Curricular Outcomes Using Mixed Methods.

Objective. To use institution-specific curricular outcomes as a framework to map skill development opportunities available through cocurricular involvement in pharmacy student organizations. Methods. Participants completed a modified Extracurricular Involvement Inventory individually to measure the intensity of their involvement in each student organization. Participants also completed the Co-Curriculum Outcomes Assessment Mapping Survey (COAMS) instrument as a group to indicate what skills (ie, curricular outcomes) they developed through involvement in a student organization and student organization activities, programs, and events, and to provide examples of these skills. Data sources were triangulated to map skill development opportunities in the co-curriculum to curricular outcomes. Results. The COAMS identified all curricular outcomes as skills students have the opportunity to develop through student organization involvement in the co-curriculum. Communication was the most common skill identified. Other common skills included professionalism and ethical behavior, collaboration and influence, and in-depth knowledge and proficient skills. A co-curriculum heat map was used to illustrate the degree to which students reported these skills were emphasized through student organization involvement in the co-curriculum. Conclusion. Evaluation of activities in the context of curricular outcomes can provide a more comprehensive understanding of how the co-curriculum complements the curriculum, thereby complying with accreditation expectations. Cocurricular mapping provides valuable information regarding student skill development opportunities to multiple stakeholders (eg, students, faculty, curriculum leadership). This process can be applied to diverse programs, adapted to measure institution-specific experiences, and measure various constructs of interest.

Design and evaluation of a two-phase learner-centered new student orientation program.

BACKGROUND AND PURPOSE: To identify student perceptions associated with a learner-centered, multi-stage, flipped, new student orientation for a doctor of pharmacy (PharmD) program. EDUCATIONAL ACTIVITY AND SETTING: First-year PharmD students over three years (2012-2014) were engaged in a two-phase learner-centered orientation process designed to allow students to customize the transition experience. After orientation, students completed a survey to assess programming and their perceptions of readiness to begin the PharmD program. Utilizing student feedback, the orientation program evolved each year to better meet the needs of incoming students. FINDINGS: In 2014, 78.9% of students felt confident in their ability to transition to the PharmD program after orientation, an increase from 55.7% in 2012 when the changes in orientation were first implemented. Additionally, student perceptions of readiness to transition to the PharmD program improved each year. DISCUSSION AND SUMMARY: Implementation of a learner-centered, flipped, new student orientation may improve students' perceptions of readiness for study and decrease anxiety of transitioning to a PharmD program. Additionally, it may be an effective tool for increasing orientation program efficiency, while improving student engagement.

Using the multiple mini interview as an assessment strategy within the first year of a health professions curriculum.

BACKGROUND: The multiple mini-interview (MMI) is a common assessment strategy used in student selection. The MMI as an assessment strategy within a health professions curriculum, however, has not been previously studied. This study describes the integration of a 5-station MMI as part of an end-of-year capstone following the first year of a health professions curriculum. The goal of the capstone MMI was to assess professional competencies of students and to offer formative feedback to prepare students for their upcoming clinical practice experiences. The purpose of this study was to evaluate the psychometric properties of an MMI integrated into a health professions curriculum. METHODS: Five capstone MMI stations were designed to each evaluate a single construct assessed by one rater. A principal component analysis (PCA) was used to evaluate the structure of the model and its ability to distinguish 5 separate constructs. A Multifaceted Rasch Measurement (MFRM) model assessed student performance and estimated the sources of measurement error attributed to 3 facets: student ability, rater stringency, and station difficulty. At the conclusion, students were surveyed about the capstone MMI experience. RESULTS: The PCA confirmed the MMI reliably assessed 5 unique constructs and performance on each station was not strongly correlated with one another. The 3-facet MFRM analysis explained 58.79% of the total variance in student scores. Specifically, 29.98% of the variance reflected student ability, 20.25% reflected rater stringency, and 8.56% reflected station difficulty. Overall, the data demonstrated an acceptable fit to the MFRM model. The majority of students agreed the MMI allowed them to effectively demonstrate their communication (80.82%), critical thinking (78.77%), and collaboration skills (70.55%). CONCLUSIONS: The MMI can be a valuable assessment strategy of professional competence within a health professions curriculum. These findings suggest the MMI is well-received by students and can produce reliable results. Future research should explore the impact of using the MMI as a strategy to monitor longitudinal competency development and inform feedback approaches.

Validity and reliability of an application review process using dedicated reviewers in one stage of a multi-stage admissions model.

INTRODUCTION: With increased emphasis placed on non-academic skills in the workplace, a need exists to identify an admissions process that evaluates these skills. This study assessed the validity and reliability of an application review process involving three dedicated application reviewers in a multi-stage admissions model. METHODS: A multi-stage admissions model was utilized during the 2014-2015 admissions cycle. After advancing through the academic review, each application was independently reviewed by two dedicated application reviewers utilizing a six-construct rubric (written communication, extracurricular and community service activities, leadership experience, pharmacy career appreciation, research experience, and resiliency). Rubric scores were extrapolated to a three-tier ranking to select candidates for on-site interviews. Kappa statistics were used to assess interrater reliability. A three-facet Many-Facet Rasch Model (MFRM) determined reviewer severity, candidate suitability, and rubric construct difficulty. RESULTS: The kappa statistic for candidates' tier rank score (n = 388 candidates) was 0.692 with a perfect agreement frequency of 84.3%. There was substantial interrater reliability between reviewers for the tier ranking (kappa: 0.654-0.710). Highest construct agreement occurred in written communication (kappa: 0.924-0.984). A three-facet MFRM analysis explained 36.9% of variance in the ratings, with 0.06% reflecting application reviewer scoring patterns (i.e., severity or leniency), 22.8% reflecting candidate suitability, and 14.1% reflecting construct difficulty. DISCUSSION AND CONCLUSIONS: Utilization of dedicated application reviewers and a defined tiered rubric provided a valid and reliable method to effectively evaluate candidates during the application review process. These analyses provide insight into opportunities for improving the application review process among schools and colleges of pharmacy.

Computer-Assisted Decision Support for Student Admissions Based on Their Predicted Academic Performance.

Objective. To develop predictive computational models forecasting the academic performance of students in the didactic-rich portion of a doctor of pharmacy (PharmD) curriculum as admission-assisting tools. Methods. All PharmD candidates over three admission cycles were divided into two groups: those who completed the PharmD program with a GPA ≥ 3; and the remaining candidates. Random Forest machine learning technique was used to develop a binary classification model based on 11 pre-admission parameters. Results. Robust and externally predictive models were developed that had particularly high overall accuracy of 77% for candidates with high or low academic performance. These multivariate models were highly accurate in predicting these groups to those obtained using undergraduate GPA and composite PCAT scores only. Conclusion. The models developed in this study can be used to improve the admission process as preliminary filters and thus quickly identify candidates who are likely to be successful in the PharmD curriculum.

Candidate Evaluation Using Targeted Construct Assessment in the Multiple Mini-Interview: A Multifaceted Rasch Model Analysis.

Construct: A 7-station multiple mini-interview (MMI) circuit was implemented and assessed for 214 candidates rated by 37 interviewers (N = 1,498 ratings). The MMI stations were designed to assess 6 specific constructs (adaptability, empathy, integrity, critical thinking, teamwork [receiving instruction], teamwork [giving instruction]) and one open station about the candidate's interest in the school. BACKGROUND: Despite the apparent benefits of the MMI, construct-irrelevant variance continues to be a topic of study. Refining the MMI to more effectively measure candidate ability is critical to improving our ability to identify and select candidates that are equipped for success within health professions education and the workforce. APPROACH: Each station assessed a single construct and was rated by a single interviewer who was provided only the name of the candidate and no additional information about the candidate's background, application, or prior academic performance. All interviewers received online and in-person training in the fall prior to the MMI and the morning of the MMI. A 3-facet multifaceted Rasch measurement analysis was completed to determine interviewer severity, candidate ability, and MMI station difficulty and examine how the model performed overall (e.g., rating scale). RESULTS: Altogether, the Rasch measures explained 62.84% of the variance in the ratings. Differences in candidate ability explained 45.28% of the variance in the data, whereas differences in interviewer severity explained 16.09% of the variance in the data. None of the interviewers had Infit or Outfit mean-square scores greater than 1.7, and only 2 (5.4%) had mean-square scores less than 0.5. CONCLUSIONS: The data demonstrated acceptable fit to the multifaceted Rasch measurement model. This work is the first of its kind in pharmacy and provides insight into the development of an MMI that provides useful and meaningful candidate assessment ratings for institutional decision making.

Relationship between Student Pharmacist Decision Making Preferences and Experiential Learning.

Objective. To determine if student pharmacists' preferences towards experiential and rational thinking are associated with performance on advanced pharmacy practice experiences (APPEs) and whether thinking style preference changes following APPEs. Methods. The Rational Experiential Inventory (REI), a validated survey of thinking style, was administered to student pharmacists before starting APPEs and re-administered after completing APPEs. APPE grades were compared to initial REI scores. Results. Rational Experiential Inventory scores remained consistent before and after APPEs. Overall, APPE grades were independent of REI scores. In a regression model, the REI experiential score was a significant negative predictor of hospital APPE grades. Conclusion. These findings suggest that overall APPE performance is independent of decision-making preference, and decision-making style does not change following immersion into APPEs. Instead of targeting teaching strategies towards a specific decision-making style, preceptors may use pedagogical approaches that promote sound clinical decision-making skills through critical thinking and reflection.

The Multiple Mini-Interview as an Admission Tool for a PharmD Program Satellite Campus.

Objective. To assess the multiple mini-interview (MMI) as an admission tool for a satellite campus. Methods. In 2013, the MMI was implemented as part of a new admissions model at the UNC Eshelman School of Pharmacy. From fall 2013 to spring 2015, 73 candidates were interviewed by 15 raters on the satellite campus in Asheville, North Carolina. A many-facet Rasch measurement (MFRM) with three facets was used to determine the variance in candidate ratings attributable to rater severity, candidate ability, and station difficulty. Candidates were surveyed to explore their perceptions of the MMI. Results. Rasch measures accounted for 48.3% of total variance in candidate scores. Rater severity accounted for 9.1% of the variance, and candidate ability accounted for 36.2% of the variance. Eighty percent of survey respondents (strongly) agreed that interviewers got to know them based on questions they answered.Conclusion. This study suggests that the MMI is a useful and valid tool for candidate selection at a satellite campus.

Limited Predictive Utility of Admissions Scores and Objective Structured Clinical Examinations for APPE Performance.

OBJECTIVE: To examine the relationship between admissions, objective structured clinical examination (OSCE), and advanced pharmacy practice experience (APPE) scores. METHODS: Admissions, OSCE, and APPE scores were collected for students who graduated from the doctor of pharmacy (PharmD) program in spring of 2012 and spring of 2013 (n=289). Pearson correlation was used to examine relationships between variables, and independent t test was used to compare mean scores between groups. RESULTS: All relationships among admissions data (undergraduate grade point average, composite PCAT scores, and interview scores) and OSCE and APPE scores were weak, with the strongest association found between the final OSCE and ambulatory care APPEs. Students with low scores on the final OSCE performed lower than others on the acute care, ambulatory care, and community APPEs. CONCLUSION: This study highlights the complexities of assessing student development of noncognitive professional skills over the course of a curriculum.