250469462 American Journal of Pharmaceutical Education 7 1
Vol ume 78, Issue 7, 2014
I SSN: 0002-9459
About AJPE
The American Journal of Pharmaceutical Education (AJPE) is the official publication of the
American Association of Colleges of Pharmacy (AACP). Its purpose is to document and advance
pharmaceutical education in the United States and Internationally. The Journal considers material
in all areas related to pharmaceutical education. Through open-access Internet publication the
Journal intends to take full advantage of the electronic medium; this includes the publication of
articles with multimedia features, encompassing 3D graphics, video, interactive figures and
databases, and sound. The Journal Editor is Joseph T. DiPiro, Professor and Executive Dean at
the South Carolina Colege of Pharmacy.
The electronic Journal will be issued quarterly. In addition, a year-end print volume will be made
available to AACP member institutions and to others upon request for a nominal fee. Access to
the electronic Journal will not be restricted by password.
The Journal accepts unsolicited manuscripts that have not been published and are not under
consideration for publication elsewhere. All manuscripts are subject to peer review and approval
by the Editor before publication. Authors must prepare manuscripts to conform to the Journal
style. Authors are not assessed page charges for publication. All reports and papers presented at
the Annual Meeting of the AACP, as well as manuscripts accepted for publication, become the
property of AACP. All requests for reassignment of the above rights should be directed to the
Editor.
Referees are assigned by the Editor with the advice of the Editorial Board as needed.
Manuscripts are processed on line by the Editor, Editorial Assistant, and the American
Association of Pharmaceutical Scientists using a computer-based tracking system that relies on
keyword selection and automatic time lines for review. The electronic submission and review
process is intended to expeditiously complete the publication process using electronic
communication between the editorial office, editors, referees, and authors. Once an article is
accepted, a final version is sent to the author for approval by email. The article is published on
the AJPE web site shortly thereafter. All expressions of opinion and statements of supposed fact
appearing in the Journal are not to be
regarded as necessarily expressing the policy or views of the Editor or of AACP.
Articles appearing in the Journal are indexed in: PubMed/Medline; Current Contents, Education;
Current Contents, Life Sciences; International Pharmaceutical Abstracts; Current Index to
Journals in Education; and by PROQuest and EBSCO.
The Journal has been published continuously since 1937. Past Editors of the Journal were:
Rufus A. Lyman, University of Nebraska 1937-1955
Melvin R. Gibson, Washington State University 1956-1960
C. Boyd Granberg, Drake University 1961-1974
Marvin M. Malone, University of the Pacific 1975-1979
George H. Cocolas, University of North Carolina 1980-2002
Editorial Office
The Journal office is located on the University of South Carolina campus in Columbia. Address all
communications concerning manuscripts to the Editorial office. Mailing address and contact
information is as follows:
Address:
American Journal of Pharmaceutical Education
715 Sumter St.
Columbia, SC 29208
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Fax:
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803-777-3097
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The business office is located at the AACP office. Mailing address and contact information is as
follows:
Address:
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Phone:
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Copyright © 2011, American Association of Colleges of Pharmacy, 1426 Prince Street,
Alexandria, VA 22314. All rights reserved.
Editorial Board-AJPE
Joseph T. DiPiro, PharmD
Editor, South Carolina College of Pharmacy
Gayle A. Brazeau, PhD
Associate Editor, University of New England
Jack E. Fincham, PhD
Associate Editor, University of Missouri - Kansas City
Claire Anderson, PhD, BPharm
International Associate Editor, University of Nottingham, United Kingdom
Naser Alsharif, PhD
Creighton University
Zubin Austin, PhD
University of Toronto
Alicia Bouldin, PhD
The University of Mississippi
Eric Boyce, PharmD
University of the Pacific
Susan Burton
South Africa
Shelley Chambers, PhD
Washington State University
Sudip K. Das, PhD
Butler University
Patrick J. Davis, PhD
University of Texas-Austin
Gary E. DeLander, PhD
Oregon State University
JoLaine R. Draugalis, PhD
University of Oklahoma
Catherine A. Elstad, PhD
Washington State University
Deborah Harper-Brown, PharmD
Chicago State University
Mohamed Azmi Ahmad Hassali
University Sains Malaysia
Monica Holiday-Goodman, PhD
University of Toledo
Peter Hurd, PhD
St. Louis College of Pharmacy
Harold Kirschenbaum, PharmD
Long Island University
Jennifer Marriott
Monash University
Susan Meyer, PhD
University of Pittsburgh
Adam Persky, PhD
University of North Carolina
Anna Ratka, PharmD, PhD
Texas A&M University
Frank Romanelli, PharmD, MPH
University of Kentucky
Amy Seybert, PharmD
University of Pittsburgh
Brent Fox, PhD
Auburn University
Stuart Haines, PharmD
University of Maryland
Cecilia Plaza, PharmD, PhD
AACP Liaison
Vol ume 78, Issue 7, 2014
I SSN: 0002-9459
Contents
VIEWPOINTS
1.
Turning the World of Pharmacy Education into a Global Community
Through Sharing
Claire AndersonClaire Anderson, Jennifer L. MarriottJennifer L. Marriott,
Joana CarrasqueiraJoana Carrasqueira, Tina P. BrockTina P. Brock,
Timothy RennieTimothy Rennie, Andreia F. BrunoAndreia F. Bruno,
Ian BatesIan Bates
1-2
SPECIAL ARTICLES
2.
Complex Issues Affecting Student Pharmacist Debt
3-6
Jeff CainJeff Cain, Tom CampbellTom Campbell, Heather Brennan CongdonHeather Brennan
Congdon, Kim HancockKim Hancock, Megan KaunMegan Kaun, Paul R. LockmanPaul R.
Lockman, R. Lee EvansR. Lee Evans
RESEARCH
3.
A Three-Year Study of the Impact of Instructor Attitude, Enthusiasm, and
Teaching Style on Student Learning in a Medicinal Chemistry Course
Naser Z. AlsharifNaser Z. Alsharif, Yongyue QiYongyue Qi
4.
Identifying Achievement Goals and Their Relationship to Academic
20-27
Achievement in Undergraduate Pharmacy Students
Saleh AlrakafSaleh Alrakaf, Erica SainsburyErica Sainsbury, Grenville RoseGrenville Rose,
Lorraine SmithLorraine Smith
5.
Self-Efficacy and Self-Esteem in Third-Year Pharmacy Students
Mark L. YorraMark L. Yorra
6.
Investigating the Relationship Between Pharmacy Students’ Achievement
33-38
Goal Orientations and Preferred Teacher Qualities
Saleh AlrakafSaleh Alrakaf, Erica SainsburyErica Sainsbury, Grenville RoseGrenville Rose,
Lorraine SmithLorraine Smith
7-19
28-32
INSTRUCTIONAL DESIGN AND ASSESSMENT
7.
Long-term Effectiveness of Online Anaphylaxis Education for Pharmacists
39-49
Sandra M SalterSandra M Salter, Sandra ValeSandra Vale, Frank M SanfilippoFrank M Sanfilippo,
Richard LohRichard Loh, Rhonda M CliffordRhonda M Clifford
8.
A Physical Assessment Skills Module on Vital Signs
50-56
Christine LeongChristine Leong, Christopher LouizosChristopher Louizos, Grace FrankelGrace
Frankel, Sheila NgSheila Ng, Harris IacovidesHarris Iacovides, Jamie FalkJamie Falk, Drena
DunfordDrena Dunford, Kelly BrinkKelly Brink, Nancy KleimanNancy Kleiman, Christine
DavisChristine Davis, Robert RenaudRobert Renaud
9.
Student Self-Screening for Methicillin-Resistant Staphylococcus Aureus
57-63
(MRSA) Nasal Colonization in Hand Hygiene Education
Tia LumTia Lum, Kristin PicardoKristin Picardo, Theresa WestbayTheresa Westbay, Amber
BarnelloAmber Barnello, Lynn FineLynn Fine, Jill LavigneJill Lavigne
10.
Using Curriculum Mapping to Engage Faculty Members in the Analysis
64-72
of a Pharmacy Program
Sheryl ZelenitskySheryl Zelenitsky, Lavern VercaigneLavern Vercaigne, Neal M. DaviesNeal M.
Davies, Christine DavisChristine Davis, Robert RenaudRobert Renaud, Cheryl KristjansonCheryl
Kristjanson
11.
Improved Knowledge Retention Among Clinical Pharmacy Students
Using an Anthropology Classroom Assessment Technique
Heather P. WhitleyHeather P. Whitley, Jason M. PartonJason M. Parton
73-82
12.
An Active Learning Complementary and Alternative Medicine Session
in a Self-Care Therapeutics Class
Melissa J. MattisonMelissa J. Mattison, Eric C. NemecEric C. Nemec
83-86
13.
A Multiyear Analysis of Team-Based Learning in a Pharmacotherapeutics Course 87-95
June Felice JohnsonJune Felice Johnson, Edward BellEdward Bell,
Michelle BottenbergMichelle Bottenberg, Darla EastmanDarla Eastman,
Sarah GradySarah Grady, Carrie KoenigsfeldCarrie Koenigsfeld, Erik MakiErik Maki, Kristin
MeyerKristin Meyer, Chuck PhillipsChuck Phillips, Lori SchirmerLori Schirmer
American Journal of Pharmaceutical Education 2014; 78 (7) Article 1.
VIEWPOINTS
Turning the World of Pharmacy Education into a Global Community
Through Sharing
Claire Anderson, PhD, BPharm,ab Jennifer L. Marriott, PhD, BPharm,b Joana Carrasqueira, MPharm,b
Tina P. Brock, EdD, MS,b Timothy Rennie, PhD, MPharm,b Andreia F. Bruno, PhD, MPharm,b Ian Bates,
PhD, BPharmb
a
b
Associate Editor, American Journal of Pharmaceutical Education
University of Nottingham, Nottingham, United Kingdom
Barriers to delivering quality pharmacy education in
developing countries have been identified as limited infrastructure, access to teaching resources, academic staff
development, and research capacity.1 In 2010, the International Pharmaceutical Federation (FIP) and the United
Nations Educational, Scientific and Cultural Organization (UNESCO) signed an agreement to develop a FIP
UNESCO-UNITWIN Global Pharmacy Education Development (GPhED) program. The GPhED network
strives to raise the standard of education globally and incorporate best practices through shared resources, expertise, and experience. UNESCO and FIP consider one of
the essential factors favoring development in the field of
professional competence the exchange of experience and
knowledge between universities and other learning institutions. Additionally, collaborative practice by university
teachers, researchers, and administrators from different
regions across the world could benefit the entire professional community.
The aims of the FIP UNESCO-UNITWIN program
are global higher education and its development, with
a special interest in African nations and low-income countries, empowerment of women as pharmaceutical scientists
and academics, sustainable health workforce development,
academic capacity building, quality assurance, and accreditation standards, which are all compatible with the overarching aims of UNESCO.2,3 Objectives of the program
include promotion of an integrated system of research,
training, information, and documentation in the field of
pharmacy education through “Centres of Excellence,”
which will facilitate intra-regional cooperation.
Sharing in all areas is the key and to this end the
GPhED program is currently developing three areas of
activity that focus on sharing of teaching and learning
resources, pharmaceutical education expertise and experience, and research capacity.
Resource sharing within the program is being facilitated through SABER (Sharing and Building Educational
Resources), an online platform (www.saber.monash.edu)
from which resources can be downloaded, used, and shared
internationally between academic institutions to improve
teaching and learning. Enhanced pharmacy education creates better pharmacists, but creating high-quality student
learning resources takes time and money. Sharing educational resources makes sense so students can benefit and
learn more, especially in a global profession such as pharmacy where teaching needs are often similar. Sharing and
collaborating creates and strengthens partnerships based
on goodwill and a shared commitment to educational excellence. The SABER platform is a place to share, discover, acquire, and re-purpose resources for pharmacy
education. It also encourages the collaborative creation
of new content. SABER is available to educators in pharmacy schools around the world, hosting quality-assured
educational resources and providing a trustworthy source
of relevant and current material. Being multi-tiered, it
allows various access levels for a broad range of users.
SABER’s intuitive interface allows users to quickly
find existing assets, and up-to-date social-networking
tools let them build peer networks to adapt resources
and create new material. The site is administered by
Monash University on behalf of the GPHeED network
and is accessible to all for free. Under a Creative Commons license, SABER enables academics anywhere in
the world to share something as simple as an image or a
PowerPoint presentation, to large purpose-designed teaching programs in areas relating to pharmacy and pharmaceutical science. The success of SABER depends on
academics contributing resources they have developed
to share via the database.
Another important component in the GPhED program is the formation of the African Centre of Excellence
in Pharmacy Education. Ideally, the Centre will facilitate
Corresponding Author: Claire Anderson, PhD, BPharm,
University of Nottingham, University Park, Nottingham
NG7 2RD, United Kingdom. E-mail: Claire.Anderson@
Nottingham.ac.uk
1
American Journal of Pharmaceutical Education 2014; 78 (7) Article 1.
the sharing of ideas, skills, resources, and good practice,
including staff exchange for skills and capacity building.
The Centre will provide a forum for discussion and debate
on trends and developments in pharmacy education, facilitated by network partners, including NGOs and professional agencies, and coordinated by the founding
partners. Africa was chosen to establish the first FIP
UNESCO-UNITWIN Centre of Excellence because the
region is in great need of a pharmacy workforce and lacks
educational resources for universities.4
A recent meeting of the 5 founding partner countries –
Ghana, Namibia, Nigeria, Uganda and Zambia – was held
in Lusaka, Zambia to determine the future activities of the
Centre. Five domains for the Centre of Excellence were
determined (communication, capability, quality, innovation, and clinical). Each founding partner agreed to take
the lead in one of these domains and coordinate projects or
activities within them. The founding partners developed
and agreed to a communications strategy and will contribute to advocacy, local network building, and communications to ensure the wider success of the Centre of
Excellence. Proposed projects of the Centre include a survey of African colleges and schools of pharmacy to establish a database of academic capacity and expertise to
facilitate intra-regional sharing of expertise through a visiting academic program. Another project is the development of a “Lab-box” of basic laboratory equipment to
improve students’ ability to undertake laboratory experiments to support their learning of basic science concepts.
The Centre of Excellence will invite additional countries
to become part of the centre to expand its activities and
provide a broader base of communication and support in
the region. Centre of Excellence activities will also seek
to promote gender equality and empowerment for women
academics and scientists in collaborative research and
policy development.
The GPhED hopes to foster international collaborative research by having prospective research students
complete a higher degree in their home university in
Africa under the guidance of a local supervisor and an
experienced international researcher with expertise in
the chosen research area. The hope is that the arrangement
of shared supervision will enable collaboration in policy
synthesis and strategic development, with a focus on international development issues and sustainable practitioner development policies. Public health or service
delivery projects are favored by the African universities
due to the limited laboratory facilities available, but such
projects will contribute relevant health data in the country
and increase the capacity for improved health programs
and delivery of pharmacy services.
The FIP UNESCO-UNITWIN Global Pharmacy Education Development network is in the nascent stages of
development, but through the goodwill, enthusiasm, and
support of academics across the globe, sharing educational resources, expertise, and experience through such
networks will facilitate the provision of quality pharmacy
education in developing countries.
REFERENCES
1. FIPEd Global Education Report 2013 http://www.fip.org/
educationreports. Accessed June 30, 2014.
2. UNESCO 2008-2009 Biennium Priorities (34 C/5): http://www.
unesco.org/science/doc/SC_34_C5.pdf. Accessed June 30, 2014.
3. UNESCO 2008-2013 Mid-term Strategy (34 C/4): http://unesdoc.
unesco.org/images/0014/001499/149999e.pdf. Accessed June 30, 2014.
4. FIP Global Pharmacy Workforce Report https://www.fip.org/
static/fipeducation/2012/FIP-Workforce-Report-2012/?
page5hr2012. Accessed June 30, 2014.
2
American Journal of Pharmaceutical Education 2014;78(7) Article 2.
SPECIAL ARTICLES
Complex Issues Affecting Student Pharmacist Debt
Jeff Cain, EdD, MS,a Tom Campbell, PharmD,b Heather Brennan Congdon, PharmD,c
Kim Hancock, PhD,d Megan Kaun, PharmD,e Paul R. Lockman, PhD,f and R. Lee Evans, PharmDg
a
College of Pharmacy, University of Kentucky, Lexington, Kentucky
College of Pharmacy, Lipscomb University, Nashville, Tennessee
c
School of Pharmacy, University of Maryland, Baltimore, Maryland
d
College of Pharmacy, Ferris State University, Big Rapids, Michigan
e
College of Pharmacy and Pharmaceutical Sciences, The University of Toledo, Toledo, Ohio
f
School of Pharmacy, West Virginia University, Morgantown, West Virginia
g
Harrison School of Pharmacy, Auburn University, Auburn, Alabama
b
Submitted November 25, 2013; accepted January 26, 2014; published September 15, 2014.
It is time for colleges and schools of pharmacy to examine and confront the rising costs of pharmacy
education and the increasing student loan debt borne by graduates. These phenomena likely result from
a variety of complex factors. The academy should begin addressing these issues before pharmacy education
becomes cost-prohibitive for future generations. This paper discusses some of the more salient drivers of cost
and student debt load and offers suggestions that may help alleviate some of the financial pressures.
Keywords: student loan, debt, tuition, higher education
higher education funding over the last several years. At first,
most public institutions absorbed state funding reductions
through spending cuts and efficiency measures. However,
after those means were exhausted, the only major recourse
to fund educational activity was through tuition increases,
effectively shifting more of the costs to students.2 In 2008,
31.6% of revenue used to cover public higher education
operating expenses came from tuition, compared to 42.4%
in 2012.3After inflation adjustments, annual tuition at 4-year
public colleges has increased by $1,850, or 27%, since the
2007-08 school year.2 Compounded over several semesters,
the increased tuition adds substantially to the total cost of
higher education for an individual and is a primary factor for
increased student debt.4
INTRODUCTION
The rising cost of higher education in the United
States is a disturbing trend. Pharmacy school tuition and
resulting student indebtedness have risen significantly
over the last decade.1 Initial assumptions typically suggest that the responsibility for increased student loan debt
belongs to students. However, we assert that rising tuition
and student debt is a multifaceted, complex issue that has
origins within the academy, the accreditation process,
federal and state governments, universities, and finally
student and faculty culture. Reducing or even maintaining
current cost levels for pharmacy education and concomitant student debt will not be straightforward, easy, or
without controversy, but it is imperative that the academy
confront the issues before they worsen. In this paper, we
discuss some of the more notable influences on cost and
student debt load and suggest potential actions that may
allay the financial burdens.
GOVERNMENT ISSUES
Government regulation of loan eligibility, loan
amounts, interest rates, repayment structures, loan deferment eligibility, and government loan forgiveness programs all impact the total cost of student loan debt.
Student loan interest rates arguably have the single largest impact on student loan debt. On July 1, 2013, interest
rates on certain types of loans doubled because Congress
failed to prevent an expiration of subsidies.5 The federal
government, as opposed to the borrower, pays interest
accrued on subsidized loans during periods of eligible
deferment. This change to subsidized loans had the
potential to nearly double the total payment amount of
REDUCED STATE SUPPORT OF HIGHER
EDUCATION
Faced with financial pressures from the recent economic recession, state legislatures have significantly reduced
Corresponding Author: Jeff Cain, EdD, MS, Department of
Pharmacy Practice & Science, University of Kentucky
College of Pharmacy, 789 South Limestone, Lexington, KY
40536-0596. Tel: 859-257-4429. Fax: 859-257-7297.
E-mail: jeff.cain@uky.edu
3
American Journal of Pharmaceutical Education 2014;78(7) Article 2.
a loan. However, in August 2013, Congress passed a bipartisan deal to lower interest rates and tie them to market rates. Although this legislation has led to immediate
relief for many borrowers, it will not protect future borrowers in a stronger economy when interest rates may
rise to as much as 9.5% for graduate and professional
students.6
Another factor affecting pharmacy graduates is recent
change to federal regulations that no longer require lenders
to place student loans into forbearance for a pharmacy residency or fellowship. The new regulation states that only
medical and dental residencies qualify for mandatory loan
forbearance.7 While this has a smaller effect on student
debt, it could cause some pharmacy students to opt out of
postgraduate training because of inability to afford or unwillingness to make loan payments.
part because of the extensive and often redundant governmental, funding agency, and accreditation requirements, institutions and schools now employ large
numbers of non–instructional staff members to develop
and/or maintain technical systems and to capture, track,
record, analyze, and report data (financial, assessment,
accreditation, etc.) for accountability purposes. These
increases in staff members have been disproportionate
to increases in student enrollment.10 In 2007, after
adjusting for increased student enrollment, it took
13.1% more employees than it did in 1993 to educate
the same number of students.11 While accountability is
a necessary and desirable aspect of public institutions,
the financial effects of maintaining it are potentially
borne, at least partially, by students through rising tuition and fees.
STUDENT PERSONAL FINANCE
AWARENESS AND KNOWLEDGE
CURRICULAR ISSUES
The time required to earn a degree and the student’s/
potential applicant’s ability to earn money throughout an
educational career are often important factors for selection of a major. Faculty members set the standards of
what, how much, and how in depth the educational process will be throughout the degree program. From a student’s perspective on financing an education, the
educational and experiential schedules of pharmacy
school may limit their ability to earn income while in
school. Furthermore, some curricula seem to focus too
much on delivering an increasing amount of content instead of focusing on more selective content paired with
better instructional strategies. One of the more difficult
questions that pharmacy educators need to ask themselves
is: “Can we design effective curricula that is delivered
more quickly and/or more efficiently (without sacrificing
quality), saving students either money or time?” The higher
education landscape is shifting, with more attention to
widespread online delivery12 and reconsideration of the
credit hour as a metric for student abilities.13 Calls are
being made to reduce the cost of medical education14 and
pharmacy school administrators should be doing the same
for pharmacy education.
Preprofessional requirements have also grown by
525% from 2006 to 2011 in the number of pharmacy programs requiring 3 years of prerequisite courses or a bachelor’s degree, versus 2 years of courses for admittance.15
There is currently no consensus regarding the ideal length
or content for prepharmacy curricula.16 While theoretically
the more undergraduate work that entering students have
completed, the more mature and better equipped they will
be for pharmacy school, this potentially comes at the cost of
another year of educational expenses and the effective loss
of a year’s salary.
Students and their families must accept personal
responsibility for aspects of their financial future. While
factors pertaining to tuition, salaries, and job prospects
are out of their control, students do make choices that
affect their education-related debt. Some students engage in lifestyles that significantly exceed their income
while in college, purchasing, for example, automobiles,
clothing, and electronic devices, and even taking elaborate vacations.8As a result, student debt extends beyond
school-related financial aid to include additional credit
card debt. In 2009, a study by Sallie Mae found that 84%
of undergraduates have at least one credit card and 50%
of undergrads have 4 or more credit cards and use these
because they have insufficient savings or financial aid to
cover all of their expenditures. Furthermore, 68% of
college students have charged items to their credit cards
knowing they did not have sufficient funds to pay the bill.
The long-term effects of financing these discretionary
purchases can result in student loan and credit card debt
considerably higher than what is necessary. Most students are aware that this is a problem, with 84% of undergraduate students stating they want more education
on financial management topics.9
INCREASED PERSONNEL FOR
ADMINISTRATIVE AND TECHNICAL
TASKS
Higher education has traditionally been a laborintensive profession, primarily because of the specialized set of faculty skills and expertise. In recent years,
however, the bulk of labor costs have begun to shift away
from faculty toward managerial, technical, and support
staff.10 In addition to other types of support staff and in
4
American Journal of Pharmaceutical Education 2014;78(7) Article 2.
principles to students prior to graduation, but some students
may already be deep in debt before those lessons are taught.
We propose 5 recommendations that the academy could
employ to minimize this problem.
(1) Integrate required financial management coursework into the curriculum. This coursework needs
to be employed early (preferably within the first
year of the doctor of pharmacy program) so that
the principles can be employed throughout the
student’s educational career. Curriculum should focus on designing and living within a budget, avoiding unnecessary debt and overuse of credit cards,
managing financial aid in a responsible manner, and
obtaining financial advice for postgraduate loan repayment, insurance coverage, and timing of large
purchases.
(2) Designate an appropriate faculty/staff member or
external expert to provide ongoing financial counseling to students throughout their educational career. Access to financial aid offices varies among
college campuses, and even in the best of scenarios,
those services may lack the scope of counseling that
students need related to financial management. A
designated counselor who can build a level of trust
with students might encourage a more open line of
communication with and a more receptive response
from students.
(3) Inform all students of the Federal Student Loan
Forgiveness Program, which forgives student debt
after a period of service. To qualify for the program, students must work for a public institution
for 10 years (nonconsecutive) and make 10 years’
worth of qualifying payments. All remaining student debt will be forgiven after the 10 years.25
Pharmacists who take advantage of this program
can potentially reduce their student debt by tens of
thousands of dollars.
(4) Encourage national pharmacy organizations to
provide financial management programming at
association meetings that student pharmacists attend. Programming should include student-tostudent teaching and best practices (ie, roundtable
discussions), allowing students to share what has
worked as well as mistakes to avoid.
(5) Encourage administrators at colleges and schools
of pharmacy to assess their institution to ensure
that students are not overburdened by the cost of
their education. This might necessitate scrutiny of
tuition models and internal operations to determine
if students are paying only their fair share. At the
university level, use of technology should be explored to reduce staff numbers and time necessary
ARMS RACE FOR FACILITIES AND
RESOURCES
Recent significant expansion of pharmacy education
has led to competitive student recruitment based more
and more on reputation. Factors that enhance reputation
(buildings, technology, student amenities) are all costly,
thereby incentivizing an academic “arms race” to see who
can spend the most money.17 Colleges and schools of pharmacy are not immune and are continually seeking every
possible edge in attracting the highest quality students. A
National Bureau of Economic Research working paper
reported that college students place a high value on consumption amenities such as student activities, dormitories,
and sports.18 The recent addition and enhancement of
student services to include social, emotional, and career
counseling has also accounted for spending growth.19,20
Institutional marketing and recruitment strategies now
highlight key amenities such as technology, cutting edge
pedagogical approaches, and state-of-the-art facilities in
order to attract students to their programs.21 However, even
if these amenities are deemed necessary, the price tag associated with new infrastructures, technology implementation, and student services is substantial, driving the cost of
an education even higher with little to no evidence that
learning is improved. Moreover, higher education might
benefit if every institution ceased the expansion of facilities,
athletics, and student amenities. Unfortunately, market
forces perpetuate continued escalation, and no institution
can unilaterally withdraw from this arms race without putting itself at risk of falling behind.22
RECOMMENDATIONS
A Center for College Affordability policy paper has
been released that offers systemic methods universities can
use to make education more affordable (such as reforming
financial aid, digitizing academic libraries, and streamlining redundant programs) and reverse the trend of rising
costs.17 We offer some additional recommendations for
the academy to consider.
While public funding of higher education will not
likely revert completely to previous levels, the academy
must continue to lobby for federal and state support. Without pressure, state and federal legislatures may reduce financial allocations even further. Additionally, lobbying
efforts should be directed toward securing adequate financial aid funding for students, particularly grants and low
interest loans.
As mentioned previously, many students today
struggle with increased loan balances and significant
debt related to unwise personal financial management.
Many colleges and schools of pharmacy offer personal finance courses23,24 or provide brief financial management
5
American Journal of Pharmaceutical Education 2014;78(7) Article 2.
to comply with accreditation and other accountability demands. Extracurricular amenities should
be closely scrutinized and avoided if they result in
additional costs to students without providing
added value to their professional education. Additionally, the curriculum (including prepharmacy)
should be analyzed to determine if students are
loaded with coursework that adds little value to
their overall degree and their ability to practice
pharmacy. This type of scrutiny may be a painful
process for faculty members, but it could result in
a much more streamlined and effective curriculum.
While fraught with numerous issues, there are also
intriguing possibilities for collaboration within the
academy with regard to sharing educational content online. We encourage the American Association of Colleges of Pharmacy to explore potential
content sharing mechanisms that create pedagogical efficiencies. Pharmacy educators have the responsibility as faculty members of not acting out of
self-interest, but in providing the best and most
economical education to students.
for College Affordability and Productivity. http://www.
centerforcollegeaffordability.org/uploads/Trends_LaborForce.pdf.
Accessed November 4, 2013.
11. Greene JP, Kisida B, Mills J. Administrative bloat at American
universities: the real reason for high hosts in higher education.
Goldwater Institute Policy Report No. 239. August 17, 2010. http://
goldwaterinstitute.org/sites/default/files/Administrative%20Bloat.
pdf. Accessed September 3, 2013.
12. Pirani J. A compendium of MOOC perspectives, research, and
resources. Educause Rev. http://www.educause.edu/ero/article/
compendium-mooc-perspectives-research-and-resources. Published
November 4, 2013. Accessed November 6, 2013.
13. Carnegie Foundation for the Advancement of Teaching. Carnegie
Foundation for the Advancement of Teaching receives funding to
rethink the Carnegie Unit. http://www.carnegiefoundation.org/
newsroom/press-releases/carnegie-foundation-receives-fundingrethink-the-carnegie-unit. Decmeber 2012. Accessed Nov 4, 2013.
14. Asch DA, Nicholson S, Vujici M. Are we in a medical education
bubble market? N Engl J Med. 2013;369:1973-1975. http://www.
nejm.org/doi/pdf/10.1056/NEJMp1310778. Accessed November 18,
2013.
15. Gleason B, Siracuse M, Moniri N, Birnie C, Okamoto C, Crouch
M. Evolution of preprofessional pharmacy curricula. Am J Pharm
Educ. 2013;77(5):Article 95.
16. Broedel-Zaugg K, Buring SM, Shanker N, et al. Academic
pharmacy administrators’ perceptions of core requirements for entry
into professional pharmacy programs. Am J Pharm Educ. 2008;72(3):
Article 52.
17. Vedder R, Gillen A, Bennett D, et al. 25 ways to reduce the cost
of college. Center for College Affordability and Productivity; http://
www.centerforcollegeaffordability.org/uploads/25Ways_to_
Reduce_the_Cost_of_College.pdf. Accessed November 18, 2013.
18. Jacob B, McCall B, Stange KM. College as country club: do
colleges cater to students’ preferences for consumption. The National
Bureau of Economic Research. http://www.nber.org/papers/w18745.
pdf. Accessed November 5, 2013.
19. Jaschik S. The spending side of the equation. Inside Higher Educ.
http://www.insidehighered.com/news/2008/05/01/spending.
Accessed November 4, 2013.
20. Davis Educational Foundation. An inquiry into the rising cost of
higher education: Summary of responses from seventy college and
university presidents. http://www.davisfoundations.org/site/
documents/AnInquiryintotheRisingCostofHigherEducation_003.pdf.
Accessed November 12, 2013.
21. National Public Radio. What’s driving college costs higher?
http://www.npr.org/2012/06/26/155766786/whats-driving-collegecosts-higher. Accessed November 4, 2013.
22. Winston G. The positional arms race in higher education.
Educause. http://net.educause.edu/ir/library/pdf/ffp0103s.pdf.
Accessed November 5, 2013.
23. Fox J, Bartholomae S, Trombitas K. Evaluating financial
education programs. In: Durband DB, Britt SL, eds. Student
Financial Literacy. Springer, US; 2012:141-166.
24. Chui MA. An elective course in personal finance for health care
professionals. Am J Pharm Educ. 2009;73(1):Article 6.
25. Federal Student Aid, The US Department of Education. Federal
student aid: public service loan forgiveness. http://studentaid.ed.gov/
repay-loans/forgiveness-cancellation/charts/public-service. Accessed
May 5, 2013.
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1. Cain J, Campbell T, Congdon HB, et al. Pharmacy student debt
and return on investment of a pharmacy education: issues for the
academy. Am J Pharm Educ. 2014;78(1):Article 5.
2. Oliff P, Palacios V, Johnson I, Leachman M. Recent deep state
higher education cuts may harm students and the economy for years
to come. http://www.cbpp.org/cms/?fa5view&id53927. Accessed
September 9, 2013.
3. State Higher Education Executive Officers. State Higher
Education Finance: FY 2012. http://www.sheeo.org/sites/default/
files/publications/SHEF%20FY%2012-20130322rev.pdf. Accessed
September 10, 2013.
4. Macy A, Terry N. The determinants of student college debt.
Southwest Econ Rev. 2007;34(1):15-25.
5. Nawaguna E. Congress finally votes to cut student loan interest
rates. Reuters. July 31, 2013http://www.reuters.com/article/2013/07/
31/us-usa-studentloans-rates-idUSBRE96U1G220130731. Accessed
November 1, 2013.
6. Johnson J. Obama signs student loan interest rate legislation into
law. The Washington Post. August 9, 2013. http://articles.
washingtonpost.com/2013-08-09/politics/41223761_1_interest-ratesplus-loans-graduate-students. Accessed November 1, 2013.
7. Federal Student Aid, The US Department of Education. Federal
student aid: deferment and forbearance.http://studentaid.ed.gov/
repay-loans/deferment-forbearance. Accessed May 5, 2013.
8. Roberts JA, Jones ELI. Money attitudes, credit card use, and
compulsive buying among American college students. J Consumer
Aff. 2001;35(2):213-240.
9. Sallie Mae. How undergraduate students use credit cards: Sallie
Mae’s national study of usage rates and trends. http://static.
mgnetwork.com/rtd/pdfs/20090830_iris.pdf. Accessed Oct 4, 2013.
10. Bennett DL. Trends in the higher education labor force:
identifying changes in worker composition and productivity. Center
6
American Journal of Pharmaceutical Education 2014;78(7) Article 3.
RESEARCH
A Three-Year Study of the Impact of Instructor Attitude,
Enthusiasm, and Teaching Style on Student Learning in a
Medicinal Chemistry Course
Naser Z. Alsharif, PharmD, PhD, and Yongyue Qi, MS
School of Pharmacy and Health Professions, Creighton University Medical Center, Omaha, Nebraska
Submitted August 9, 2013; accepted January 20, 2014; published September 15, 2014.
Objective. To determine the effect of instructor attitude, enthusiasm, and teaching style on learning for
distance and campus pharmacy students.
Methods. Over a 3-year period, distance and campus students enrolled in the spring semester of a medicinal
chemistry course were asked to complete a survey instrument with questions related to instructor attitude,
enthusiasm, and teaching style, as well as items to measure student intrinsic motivation and vitality.
Results. More positive responses were observed among distance students and older students. Gender did
not impact student perspectives on 25 of the 26 survey questions. Student-related items were significantly
correlated with instructor-related items. Also, student-related items and second-year cumulative grade point
average were predictive of students’ final course grades. Instructor enthusiasm demonstrated the highest
correlation with student intrinsic motivation and vitality.
Conclusion. While this study addresses the importance of content mastery and instructional methodologies, it focuses on issues related to instructor attitude, instructor enthusiasm, and teaching style,
which all play a critical role in the learning process. Thus, instructors have a responsibility to
evaluate, reevaluate, and analyze the above factors to address any related issues that impact the
learning process, including their influence on professional students’ intrinsic motivation and vitality,
and ability to meet educational outcomes.
Keywords: instructor enthusiasm, science courses, medicinal chemistry, student learning, intrinsic motivation,
vitality, teaching
Key to this relationship is having instructors who can
unlock the “dormant energy” inside their students and
instill vitality in how students pursue the learning process.9-13 The instructor has to use strategies in the classroom that are student-centered and challenging, and that
put the responsibility on the student as much as on the
instructor to enhance student engagement in learning.14-16
The Center for the Advancement of Pharmacy Education
(CAPE) Educational Outcomes 2013 called for “the inclusion of an affective domain that would address personal
and professional skills, attitudes, and attributes required
for the delivery of patient-centered care.”17
By assessing student intrinsic motivation and vitality, both of which can impact student affective domain,
this study conducted at the School of Pharmacy and
Health Professions, Creighton University, analyzed the
implications of instructor-related factors such as attitude, enthusiasm, and teaching style on student learning.
The study addresses this topic from the perspective of 2
student cohorts (campus and distance pathway students)
enrolled in a required Chemical Basis of Drug Action
INTRODUCTION
The art of teaching is a continuous journey to find the
right combination of pedagogy, instructional methodologies, and more recently, technology to help students
learn.1-6 Student evaluations have always been an important
tool to gauge how students perceive the classroom environment and the learning process.1-6 Over the years, one theme
that seems to be prevalent in student evaluations is how
instructors’ demeanor, behavior, and/or attitude in the classroom affect student learning.5,7 This focus is in contrast to
pharmacy educators’ sometimes elaborate emphasis on innovative learning theories, lecture notes, and classroom activities to bring clinical relevance to course content.
A relationship has been identified between instructor
enthusiasm and students’ intrinsic motivation to learn.8-12
Corresponding Author: Naser Z. Alsharif, PharmD, PhD,
School of Pharmacy and Health Professions, Department of
Pharmacy Sciences, Creighton University Medical Center,
2500 California Plaza, Omaha, NE 68178. Tel: 402-280-1857.
Fax: 402-280-1883. E-mail: nalshari@creighton.edu.
7
American Journal of Pharmaceutical Education 2014;78(7) Article 3.
course in the second year of the doctor of pharmacy
(PharmD) curriculum.
less than 0.05 was considered significant. An exempt status
for the study was obtained from the Creighton University
Institutional Review Board.
METHODS
RESULTS
A convenience sample that included distance
(n5187) and campus (n5285) pathway students at
Creighton University was used for the study.18 Both cohorts were registered for the required Chemical Basis of
Drug Action course in the spring semester of 2011, 2012, or
2013. This 2-credit hour course, taught in the second year
of the curriculum, is delivered concurrently with pharmacology and follows completion of course work in biochemistry, physiology, pathology, anatomy, pharmaceutics, and
communication skills. The campus students were required
to attend class. The distance students, who were located
throughout the country, followed the same course syllabus,
learning objectives, lesson outline, and course activities as
did the campus students.18 Distance students viewed
videos of classroom lectures that were made available to
them within 2 hours after each class. The course instructor
was a tenured professor who had taught the course for 20
years.
A department instructor evaluation tool that had been
used for more than 15 years was administered to the students at the end of the spring semester in each of the years
of the study. The survey instrument also included studyspecific instructor-related items that addressed the course
instructor’s attitude, enthusiasm, and teaching style (ie,
items that were not related to instructional techniques).
The survey items were adopted from several studies that
addressed instructor enthusiasm, student intrinsic motivation, and student vitality.10,13,19 Although most of the
items were rated using a 5-point Likert scale, students also
were asked to provide written responses. Both the quantitative and qualitative sets of data were analyzed.
Statistical analysis included descriptive statistics and
independent t test for comparing mean evaluation scores
between pathways, age groups, and genders. Mean evaluation scores also were compared between students whose
grade point average (GPA) ranked in the upper 40% of
their class (approximately 70% of the students, Group 1)
and those whose GPA ranked in the lower 60% (Group 2),
as well as by students’ first-year cumulative GPA, secondyear cumulative GPA, and first- and second-year cumulative GPA. Pearson correlation analysis was conducted to
address the association between instructor and studentrelated items. In the multiple regression model, the course
score was treated as a response variable while first- and
second-year cumulative GPA, age, student-related items,
pathway, and gender were treated as predictor variables.
All statistical analyses were conducted using SAS, version
9.3 (SAS Institute Inc, Gary, North Carolina). A p value
The study involved 187 (39.6%) distance students
and 285 (60.4%) campus students who were admitted to
the PharmD program at Creighton University in 2009,
2010, and 2011. The average age for distance students
was 33.1 years, and for campus students, 24.8 years (Table 1). The response rate was approximately 100% because it was incorporated into the required end-of-class
instructor evaluation. There were 180 (38.1%) male students and 292 (61.9%) female students. Distance students’ average prerequisite GPA (Pre-GPA), first-year
cumulative GPA, and second-year cumulative GPA were
3.5, 3.6, and 3.3, respectively, while these variables for
campus students were 3.4, 3.4, and 3.2, respectively.
Almost all campus (93%) and distance students
(84%) strongly agreed or agreed that the instructor related
to them and other students in a manner that promoted
mutual respect. In addition, 96% of the distance students
and 81% of the campus students indicated that they
strongly agreed or agreed that the instructor demonstrated
interest in their success. Further, 94% of the distance
students and 87% of the campus students indicated that
they strongly agreed or agreed that the instructor demonstrated professionalism in interaction with them or other
students (Table 2). An independent t test for comparing
mean evaluation scores showed a significant difference
between the distance students and the campus students
(p,0.001) for all the items related to instructor attitude
(Table 2), with significantly higher ratings given by distance students. The majority of the distance students were
older than 27 years (average age 33.1 years, Table 1), and
the majority of the campus students were 27 years of age
or younger (average age 24.8 years, Table 1). Overall, age
was a significant factor (p,0.001) in all items related to
instructor attitude (Table 3).
There was a difference in the ratio of male to female
students between the distance and campus students in the
admitted classes of 2009, 2010, and 2011 (Table 1), with
a higher ratio of female to male students in the distance
classes. The t test analysis for gender did not demonstrate
any significant difference in student responses for any of
the instructor-related items except for question 19 (“provides different ways to learn the content,” p,0.05), or for
the student-related items.
Instructor enthusiasm was measured based on responses to general questions and to questions related
to verbal and nonverbal behaviors (Tables 2 and 3). With
regard to the instructor enthusiasm general question
8
American Journal of Pharmaceutical Education 2014;78(7) Article 3.
Table 1. Student Demographics
Demographics
Age
Campus
Distance
Gender
Campus
Male, %
Female, %
Distance
Male, %
Female, %
Pre-GPA
Campus
Distance
Pa
CGPA1
Campus
Distance
Pa
CGPA2
Campus
Distance
Pa
CGPA12
Campus
Distance
Pa
2009
Admitted Year
2011
2010
Three Year Average
25.6 (N5107)
32.8 (N566)
24.9 (N577)
33.1 (N555)
23.9 (N5101)
33.5 (N566)
24.8 (N5285)
33.1 (N5187)
44.9
55.1
41.6
58.4
47.5
55.5
44.9
55.1
19.7
80.3
36.4
63.6
28.8
71.2
27.8
72.2
3.4
3.5
0.004
3.4
3.5
0.006
3.4
3.5
0.13
3.4
3.5
0.001
3.5
3.7
,0.001
3.3
3.5
0.002
3.4
3.6
0.005
3.1
3.4
0.002
3.1
3.1
0.96
3.3
3.3
0.66
3.12
3.3
0.048
3.3
3.5
,0.001
3.2
3.3
0.16
3.4
3.5
0.06
3.3
3.4
,0.001
3.4
3.6
,0.001
Abbreviations: Pre-GPA5prerequisite grade point average; CGPA5first-year cumulative grade point average; CGPA25second-year cumulative
grade point average; CGPA125first- and second-year cumulative grade point average.
a
p value as determined by independent t test.
items, the distance students (96%) and campus students
(89%) strongly agreed or agreed with the statement that
the instructor demonstrated a passionate interest in the
topic. Also, 97% of the distance students and 87% of
the campus students strongly agreed or agreed with the
statement that the instructor demonstrated mastery of the
topic. When asked about their agreement with the statement that the instructor was “full of energy” when teaching, 99% of the distance students and 94% of the campus
students strongly agreed or agreed with it. Further, the
distance students (80% and 77%, respectively) and the
campus students (58% and 50%, respectively) strongly
agreed or agreed with the statements that the instructor
“enhanced my motivation for the pharmacy program” and
that the instructor “enhanced my motivation for medicinal
chemistry” (Table 2). Again, independent t test for comparing mean evaluation scores showed sig
I SSN: 0002-9459
About AJPE
The American Journal of Pharmaceutical Education (AJPE) is the official publication of the
American Association of Colleges of Pharmacy (AACP). Its purpose is to document and advance
pharmaceutical education in the United States and Internationally. The Journal considers material
in all areas related to pharmaceutical education. Through open-access Internet publication the
Journal intends to take full advantage of the electronic medium; this includes the publication of
articles with multimedia features, encompassing 3D graphics, video, interactive figures and
databases, and sound. The Journal Editor is Joseph T. DiPiro, Professor and Executive Dean at
the South Carolina Colege of Pharmacy.
The electronic Journal will be issued quarterly. In addition, a year-end print volume will be made
available to AACP member institutions and to others upon request for a nominal fee. Access to
the electronic Journal will not be restricted by password.
The Journal accepts unsolicited manuscripts that have not been published and are not under
consideration for publication elsewhere. All manuscripts are subject to peer review and approval
by the Editor before publication. Authors must prepare manuscripts to conform to the Journal
style. Authors are not assessed page charges for publication. All reports and papers presented at
the Annual Meeting of the AACP, as well as manuscripts accepted for publication, become the
property of AACP. All requests for reassignment of the above rights should be directed to the
Editor.
Referees are assigned by the Editor with the advice of the Editorial Board as needed.
Manuscripts are processed on line by the Editor, Editorial Assistant, and the American
Association of Pharmaceutical Scientists using a computer-based tracking system that relies on
keyword selection and automatic time lines for review. The electronic submission and review
process is intended to expeditiously complete the publication process using electronic
communication between the editorial office, editors, referees, and authors. Once an article is
accepted, a final version is sent to the author for approval by email. The article is published on
the AJPE web site shortly thereafter. All expressions of opinion and statements of supposed fact
appearing in the Journal are not to be
regarded as necessarily expressing the policy or views of the Editor or of AACP.
Articles appearing in the Journal are indexed in: PubMed/Medline; Current Contents, Education;
Current Contents, Life Sciences; International Pharmaceutical Abstracts; Current Index to
Journals in Education; and by PROQuest and EBSCO.
The Journal has been published continuously since 1937. Past Editors of the Journal were:
Rufus A. Lyman, University of Nebraska 1937-1955
Melvin R. Gibson, Washington State University 1956-1960
C. Boyd Granberg, Drake University 1961-1974
Marvin M. Malone, University of the Pacific 1975-1979
George H. Cocolas, University of North Carolina 1980-2002
Editorial Office
The Journal office is located on the University of South Carolina campus in Columbia. Address all
communications concerning manuscripts to the Editorial office. Mailing address and contact
information is as follows:
Address:
American Journal of Pharmaceutical Education
715 Sumter St.
Columbia, SC 29208
Editorial Office:
Fax:
803-777-3096
803-777-3097
Business Office
The business office is located at the AACP office. Mailing address and contact information is as
follows:
Address:
727 King Street, Alexandria, VA 22314
Phone:
703-739-2330
Fax:
703-836-8982
Copyright © 2011, American Association of Colleges of Pharmacy, 1426 Prince Street,
Alexandria, VA 22314. All rights reserved.
Editorial Board-AJPE
Joseph T. DiPiro, PharmD
Editor, South Carolina College of Pharmacy
Gayle A. Brazeau, PhD
Associate Editor, University of New England
Jack E. Fincham, PhD
Associate Editor, University of Missouri - Kansas City
Claire Anderson, PhD, BPharm
International Associate Editor, University of Nottingham, United Kingdom
Naser Alsharif, PhD
Creighton University
Zubin Austin, PhD
University of Toronto
Alicia Bouldin, PhD
The University of Mississippi
Eric Boyce, PharmD
University of the Pacific
Susan Burton
South Africa
Shelley Chambers, PhD
Washington State University
Sudip K. Das, PhD
Butler University
Patrick J. Davis, PhD
University of Texas-Austin
Gary E. DeLander, PhD
Oregon State University
JoLaine R. Draugalis, PhD
University of Oklahoma
Catherine A. Elstad, PhD
Washington State University
Deborah Harper-Brown, PharmD
Chicago State University
Mohamed Azmi Ahmad Hassali
University Sains Malaysia
Monica Holiday-Goodman, PhD
University of Toledo
Peter Hurd, PhD
St. Louis College of Pharmacy
Harold Kirschenbaum, PharmD
Long Island University
Jennifer Marriott
Monash University
Susan Meyer, PhD
University of Pittsburgh
Adam Persky, PhD
University of North Carolina
Anna Ratka, PharmD, PhD
Texas A&M University
Frank Romanelli, PharmD, MPH
University of Kentucky
Amy Seybert, PharmD
University of Pittsburgh
Brent Fox, PhD
Auburn University
Stuart Haines, PharmD
University of Maryland
Cecilia Plaza, PharmD, PhD
AACP Liaison
Vol ume 78, Issue 7, 2014
I SSN: 0002-9459
Contents
VIEWPOINTS
1.
Turning the World of Pharmacy Education into a Global Community
Through Sharing
Claire AndersonClaire Anderson, Jennifer L. MarriottJennifer L. Marriott,
Joana CarrasqueiraJoana Carrasqueira, Tina P. BrockTina P. Brock,
Timothy RennieTimothy Rennie, Andreia F. BrunoAndreia F. Bruno,
Ian BatesIan Bates
1-2
SPECIAL ARTICLES
2.
Complex Issues Affecting Student Pharmacist Debt
3-6
Jeff CainJeff Cain, Tom CampbellTom Campbell, Heather Brennan CongdonHeather Brennan
Congdon, Kim HancockKim Hancock, Megan KaunMegan Kaun, Paul R. LockmanPaul R.
Lockman, R. Lee EvansR. Lee Evans
RESEARCH
3.
A Three-Year Study of the Impact of Instructor Attitude, Enthusiasm, and
Teaching Style on Student Learning in a Medicinal Chemistry Course
Naser Z. AlsharifNaser Z. Alsharif, Yongyue QiYongyue Qi
4.
Identifying Achievement Goals and Their Relationship to Academic
20-27
Achievement in Undergraduate Pharmacy Students
Saleh AlrakafSaleh Alrakaf, Erica SainsburyErica Sainsbury, Grenville RoseGrenville Rose,
Lorraine SmithLorraine Smith
5.
Self-Efficacy and Self-Esteem in Third-Year Pharmacy Students
Mark L. YorraMark L. Yorra
6.
Investigating the Relationship Between Pharmacy Students’ Achievement
33-38
Goal Orientations and Preferred Teacher Qualities
Saleh AlrakafSaleh Alrakaf, Erica SainsburyErica Sainsbury, Grenville RoseGrenville Rose,
Lorraine SmithLorraine Smith
7-19
28-32
INSTRUCTIONAL DESIGN AND ASSESSMENT
7.
Long-term Effectiveness of Online Anaphylaxis Education for Pharmacists
39-49
Sandra M SalterSandra M Salter, Sandra ValeSandra Vale, Frank M SanfilippoFrank M Sanfilippo,
Richard LohRichard Loh, Rhonda M CliffordRhonda M Clifford
8.
A Physical Assessment Skills Module on Vital Signs
50-56
Christine LeongChristine Leong, Christopher LouizosChristopher Louizos, Grace FrankelGrace
Frankel, Sheila NgSheila Ng, Harris IacovidesHarris Iacovides, Jamie FalkJamie Falk, Drena
DunfordDrena Dunford, Kelly BrinkKelly Brink, Nancy KleimanNancy Kleiman, Christine
DavisChristine Davis, Robert RenaudRobert Renaud
9.
Student Self-Screening for Methicillin-Resistant Staphylococcus Aureus
57-63
(MRSA) Nasal Colonization in Hand Hygiene Education
Tia LumTia Lum, Kristin PicardoKristin Picardo, Theresa WestbayTheresa Westbay, Amber
BarnelloAmber Barnello, Lynn FineLynn Fine, Jill LavigneJill Lavigne
10.
Using Curriculum Mapping to Engage Faculty Members in the Analysis
64-72
of a Pharmacy Program
Sheryl ZelenitskySheryl Zelenitsky, Lavern VercaigneLavern Vercaigne, Neal M. DaviesNeal M.
Davies, Christine DavisChristine Davis, Robert RenaudRobert Renaud, Cheryl KristjansonCheryl
Kristjanson
11.
Improved Knowledge Retention Among Clinical Pharmacy Students
Using an Anthropology Classroom Assessment Technique
Heather P. WhitleyHeather P. Whitley, Jason M. PartonJason M. Parton
73-82
12.
An Active Learning Complementary and Alternative Medicine Session
in a Self-Care Therapeutics Class
Melissa J. MattisonMelissa J. Mattison, Eric C. NemecEric C. Nemec
83-86
13.
A Multiyear Analysis of Team-Based Learning in a Pharmacotherapeutics Course 87-95
June Felice JohnsonJune Felice Johnson, Edward BellEdward Bell,
Michelle BottenbergMichelle Bottenberg, Darla EastmanDarla Eastman,
Sarah GradySarah Grady, Carrie KoenigsfeldCarrie Koenigsfeld, Erik MakiErik Maki, Kristin
MeyerKristin Meyer, Chuck PhillipsChuck Phillips, Lori SchirmerLori Schirmer
American Journal of Pharmaceutical Education 2014; 78 (7) Article 1.
VIEWPOINTS
Turning the World of Pharmacy Education into a Global Community
Through Sharing
Claire Anderson, PhD, BPharm,ab Jennifer L. Marriott, PhD, BPharm,b Joana Carrasqueira, MPharm,b
Tina P. Brock, EdD, MS,b Timothy Rennie, PhD, MPharm,b Andreia F. Bruno, PhD, MPharm,b Ian Bates,
PhD, BPharmb
a
b
Associate Editor, American Journal of Pharmaceutical Education
University of Nottingham, Nottingham, United Kingdom
Barriers to delivering quality pharmacy education in
developing countries have been identified as limited infrastructure, access to teaching resources, academic staff
development, and research capacity.1 In 2010, the International Pharmaceutical Federation (FIP) and the United
Nations Educational, Scientific and Cultural Organization (UNESCO) signed an agreement to develop a FIP
UNESCO-UNITWIN Global Pharmacy Education Development (GPhED) program. The GPhED network
strives to raise the standard of education globally and incorporate best practices through shared resources, expertise, and experience. UNESCO and FIP consider one of
the essential factors favoring development in the field of
professional competence the exchange of experience and
knowledge between universities and other learning institutions. Additionally, collaborative practice by university
teachers, researchers, and administrators from different
regions across the world could benefit the entire professional community.
The aims of the FIP UNESCO-UNITWIN program
are global higher education and its development, with
a special interest in African nations and low-income countries, empowerment of women as pharmaceutical scientists
and academics, sustainable health workforce development,
academic capacity building, quality assurance, and accreditation standards, which are all compatible with the overarching aims of UNESCO.2,3 Objectives of the program
include promotion of an integrated system of research,
training, information, and documentation in the field of
pharmacy education through “Centres of Excellence,”
which will facilitate intra-regional cooperation.
Sharing in all areas is the key and to this end the
GPhED program is currently developing three areas of
activity that focus on sharing of teaching and learning
resources, pharmaceutical education expertise and experience, and research capacity.
Resource sharing within the program is being facilitated through SABER (Sharing and Building Educational
Resources), an online platform (www.saber.monash.edu)
from which resources can be downloaded, used, and shared
internationally between academic institutions to improve
teaching and learning. Enhanced pharmacy education creates better pharmacists, but creating high-quality student
learning resources takes time and money. Sharing educational resources makes sense so students can benefit and
learn more, especially in a global profession such as pharmacy where teaching needs are often similar. Sharing and
collaborating creates and strengthens partnerships based
on goodwill and a shared commitment to educational excellence. The SABER platform is a place to share, discover, acquire, and re-purpose resources for pharmacy
education. It also encourages the collaborative creation
of new content. SABER is available to educators in pharmacy schools around the world, hosting quality-assured
educational resources and providing a trustworthy source
of relevant and current material. Being multi-tiered, it
allows various access levels for a broad range of users.
SABER’s intuitive interface allows users to quickly
find existing assets, and up-to-date social-networking
tools let them build peer networks to adapt resources
and create new material. The site is administered by
Monash University on behalf of the GPHeED network
and is accessible to all for free. Under a Creative Commons license, SABER enables academics anywhere in
the world to share something as simple as an image or a
PowerPoint presentation, to large purpose-designed teaching programs in areas relating to pharmacy and pharmaceutical science. The success of SABER depends on
academics contributing resources they have developed
to share via the database.
Another important component in the GPhED program is the formation of the African Centre of Excellence
in Pharmacy Education. Ideally, the Centre will facilitate
Corresponding Author: Claire Anderson, PhD, BPharm,
University of Nottingham, University Park, Nottingham
NG7 2RD, United Kingdom. E-mail: Claire.Anderson@
Nottingham.ac.uk
1
American Journal of Pharmaceutical Education 2014; 78 (7) Article 1.
the sharing of ideas, skills, resources, and good practice,
including staff exchange for skills and capacity building.
The Centre will provide a forum for discussion and debate
on trends and developments in pharmacy education, facilitated by network partners, including NGOs and professional agencies, and coordinated by the founding
partners. Africa was chosen to establish the first FIP
UNESCO-UNITWIN Centre of Excellence because the
region is in great need of a pharmacy workforce and lacks
educational resources for universities.4
A recent meeting of the 5 founding partner countries –
Ghana, Namibia, Nigeria, Uganda and Zambia – was held
in Lusaka, Zambia to determine the future activities of the
Centre. Five domains for the Centre of Excellence were
determined (communication, capability, quality, innovation, and clinical). Each founding partner agreed to take
the lead in one of these domains and coordinate projects or
activities within them. The founding partners developed
and agreed to a communications strategy and will contribute to advocacy, local network building, and communications to ensure the wider success of the Centre of
Excellence. Proposed projects of the Centre include a survey of African colleges and schools of pharmacy to establish a database of academic capacity and expertise to
facilitate intra-regional sharing of expertise through a visiting academic program. Another project is the development of a “Lab-box” of basic laboratory equipment to
improve students’ ability to undertake laboratory experiments to support their learning of basic science concepts.
The Centre of Excellence will invite additional countries
to become part of the centre to expand its activities and
provide a broader base of communication and support in
the region. Centre of Excellence activities will also seek
to promote gender equality and empowerment for women
academics and scientists in collaborative research and
policy development.
The GPhED hopes to foster international collaborative research by having prospective research students
complete a higher degree in their home university in
Africa under the guidance of a local supervisor and an
experienced international researcher with expertise in
the chosen research area. The hope is that the arrangement
of shared supervision will enable collaboration in policy
synthesis and strategic development, with a focus on international development issues and sustainable practitioner development policies. Public health or service
delivery projects are favored by the African universities
due to the limited laboratory facilities available, but such
projects will contribute relevant health data in the country
and increase the capacity for improved health programs
and delivery of pharmacy services.
The FIP UNESCO-UNITWIN Global Pharmacy Education Development network is in the nascent stages of
development, but through the goodwill, enthusiasm, and
support of academics across the globe, sharing educational resources, expertise, and experience through such
networks will facilitate the provision of quality pharmacy
education in developing countries.
REFERENCES
1. FIPEd Global Education Report 2013 http://www.fip.org/
educationreports. Accessed June 30, 2014.
2. UNESCO 2008-2009 Biennium Priorities (34 C/5): http://www.
unesco.org/science/doc/SC_34_C5.pdf. Accessed June 30, 2014.
3. UNESCO 2008-2013 Mid-term Strategy (34 C/4): http://unesdoc.
unesco.org/images/0014/001499/149999e.pdf. Accessed June 30, 2014.
4. FIP Global Pharmacy Workforce Report https://www.fip.org/
static/fipeducation/2012/FIP-Workforce-Report-2012/?
page5hr2012. Accessed June 30, 2014.
2
American Journal of Pharmaceutical Education 2014;78(7) Article 2.
SPECIAL ARTICLES
Complex Issues Affecting Student Pharmacist Debt
Jeff Cain, EdD, MS,a Tom Campbell, PharmD,b Heather Brennan Congdon, PharmD,c
Kim Hancock, PhD,d Megan Kaun, PharmD,e Paul R. Lockman, PhD,f and R. Lee Evans, PharmDg
a
College of Pharmacy, University of Kentucky, Lexington, Kentucky
College of Pharmacy, Lipscomb University, Nashville, Tennessee
c
School of Pharmacy, University of Maryland, Baltimore, Maryland
d
College of Pharmacy, Ferris State University, Big Rapids, Michigan
e
College of Pharmacy and Pharmaceutical Sciences, The University of Toledo, Toledo, Ohio
f
School of Pharmacy, West Virginia University, Morgantown, West Virginia
g
Harrison School of Pharmacy, Auburn University, Auburn, Alabama
b
Submitted November 25, 2013; accepted January 26, 2014; published September 15, 2014.
It is time for colleges and schools of pharmacy to examine and confront the rising costs of pharmacy
education and the increasing student loan debt borne by graduates. These phenomena likely result from
a variety of complex factors. The academy should begin addressing these issues before pharmacy education
becomes cost-prohibitive for future generations. This paper discusses some of the more salient drivers of cost
and student debt load and offers suggestions that may help alleviate some of the financial pressures.
Keywords: student loan, debt, tuition, higher education
higher education funding over the last several years. At first,
most public institutions absorbed state funding reductions
through spending cuts and efficiency measures. However,
after those means were exhausted, the only major recourse
to fund educational activity was through tuition increases,
effectively shifting more of the costs to students.2 In 2008,
31.6% of revenue used to cover public higher education
operating expenses came from tuition, compared to 42.4%
in 2012.3After inflation adjustments, annual tuition at 4-year
public colleges has increased by $1,850, or 27%, since the
2007-08 school year.2 Compounded over several semesters,
the increased tuition adds substantially to the total cost of
higher education for an individual and is a primary factor for
increased student debt.4
INTRODUCTION
The rising cost of higher education in the United
States is a disturbing trend. Pharmacy school tuition and
resulting student indebtedness have risen significantly
over the last decade.1 Initial assumptions typically suggest that the responsibility for increased student loan debt
belongs to students. However, we assert that rising tuition
and student debt is a multifaceted, complex issue that has
origins within the academy, the accreditation process,
federal and state governments, universities, and finally
student and faculty culture. Reducing or even maintaining
current cost levels for pharmacy education and concomitant student debt will not be straightforward, easy, or
without controversy, but it is imperative that the academy
confront the issues before they worsen. In this paper, we
discuss some of the more notable influences on cost and
student debt load and suggest potential actions that may
allay the financial burdens.
GOVERNMENT ISSUES
Government regulation of loan eligibility, loan
amounts, interest rates, repayment structures, loan deferment eligibility, and government loan forgiveness programs all impact the total cost of student loan debt.
Student loan interest rates arguably have the single largest impact on student loan debt. On July 1, 2013, interest
rates on certain types of loans doubled because Congress
failed to prevent an expiration of subsidies.5 The federal
government, as opposed to the borrower, pays interest
accrued on subsidized loans during periods of eligible
deferment. This change to subsidized loans had the
potential to nearly double the total payment amount of
REDUCED STATE SUPPORT OF HIGHER
EDUCATION
Faced with financial pressures from the recent economic recession, state legislatures have significantly reduced
Corresponding Author: Jeff Cain, EdD, MS, Department of
Pharmacy Practice & Science, University of Kentucky
College of Pharmacy, 789 South Limestone, Lexington, KY
40536-0596. Tel: 859-257-4429. Fax: 859-257-7297.
E-mail: jeff.cain@uky.edu
3
American Journal of Pharmaceutical Education 2014;78(7) Article 2.
a loan. However, in August 2013, Congress passed a bipartisan deal to lower interest rates and tie them to market rates. Although this legislation has led to immediate
relief for many borrowers, it will not protect future borrowers in a stronger economy when interest rates may
rise to as much as 9.5% for graduate and professional
students.6
Another factor affecting pharmacy graduates is recent
change to federal regulations that no longer require lenders
to place student loans into forbearance for a pharmacy residency or fellowship. The new regulation states that only
medical and dental residencies qualify for mandatory loan
forbearance.7 While this has a smaller effect on student
debt, it could cause some pharmacy students to opt out of
postgraduate training because of inability to afford or unwillingness to make loan payments.
part because of the extensive and often redundant governmental, funding agency, and accreditation requirements, institutions and schools now employ large
numbers of non–instructional staff members to develop
and/or maintain technical systems and to capture, track,
record, analyze, and report data (financial, assessment,
accreditation, etc.) for accountability purposes. These
increases in staff members have been disproportionate
to increases in student enrollment.10 In 2007, after
adjusting for increased student enrollment, it took
13.1% more employees than it did in 1993 to educate
the same number of students.11 While accountability is
a necessary and desirable aspect of public institutions,
the financial effects of maintaining it are potentially
borne, at least partially, by students through rising tuition and fees.
STUDENT PERSONAL FINANCE
AWARENESS AND KNOWLEDGE
CURRICULAR ISSUES
The time required to earn a degree and the student’s/
potential applicant’s ability to earn money throughout an
educational career are often important factors for selection of a major. Faculty members set the standards of
what, how much, and how in depth the educational process will be throughout the degree program. From a student’s perspective on financing an education, the
educational and experiential schedules of pharmacy
school may limit their ability to earn income while in
school. Furthermore, some curricula seem to focus too
much on delivering an increasing amount of content instead of focusing on more selective content paired with
better instructional strategies. One of the more difficult
questions that pharmacy educators need to ask themselves
is: “Can we design effective curricula that is delivered
more quickly and/or more efficiently (without sacrificing
quality), saving students either money or time?” The higher
education landscape is shifting, with more attention to
widespread online delivery12 and reconsideration of the
credit hour as a metric for student abilities.13 Calls are
being made to reduce the cost of medical education14 and
pharmacy school administrators should be doing the same
for pharmacy education.
Preprofessional requirements have also grown by
525% from 2006 to 2011 in the number of pharmacy programs requiring 3 years of prerequisite courses or a bachelor’s degree, versus 2 years of courses for admittance.15
There is currently no consensus regarding the ideal length
or content for prepharmacy curricula.16 While theoretically
the more undergraduate work that entering students have
completed, the more mature and better equipped they will
be for pharmacy school, this potentially comes at the cost of
another year of educational expenses and the effective loss
of a year’s salary.
Students and their families must accept personal
responsibility for aspects of their financial future. While
factors pertaining to tuition, salaries, and job prospects
are out of their control, students do make choices that
affect their education-related debt. Some students engage in lifestyles that significantly exceed their income
while in college, purchasing, for example, automobiles,
clothing, and electronic devices, and even taking elaborate vacations.8As a result, student debt extends beyond
school-related financial aid to include additional credit
card debt. In 2009, a study by Sallie Mae found that 84%
of undergraduates have at least one credit card and 50%
of undergrads have 4 or more credit cards and use these
because they have insufficient savings or financial aid to
cover all of their expenditures. Furthermore, 68% of
college students have charged items to their credit cards
knowing they did not have sufficient funds to pay the bill.
The long-term effects of financing these discretionary
purchases can result in student loan and credit card debt
considerably higher than what is necessary. Most students are aware that this is a problem, with 84% of undergraduate students stating they want more education
on financial management topics.9
INCREASED PERSONNEL FOR
ADMINISTRATIVE AND TECHNICAL
TASKS
Higher education has traditionally been a laborintensive profession, primarily because of the specialized set of faculty skills and expertise. In recent years,
however, the bulk of labor costs have begun to shift away
from faculty toward managerial, technical, and support
staff.10 In addition to other types of support staff and in
4
American Journal of Pharmaceutical Education 2014;78(7) Article 2.
principles to students prior to graduation, but some students
may already be deep in debt before those lessons are taught.
We propose 5 recommendations that the academy could
employ to minimize this problem.
(1) Integrate required financial management coursework into the curriculum. This coursework needs
to be employed early (preferably within the first
year of the doctor of pharmacy program) so that
the principles can be employed throughout the
student’s educational career. Curriculum should focus on designing and living within a budget, avoiding unnecessary debt and overuse of credit cards,
managing financial aid in a responsible manner, and
obtaining financial advice for postgraduate loan repayment, insurance coverage, and timing of large
purchases.
(2) Designate an appropriate faculty/staff member or
external expert to provide ongoing financial counseling to students throughout their educational career. Access to financial aid offices varies among
college campuses, and even in the best of scenarios,
those services may lack the scope of counseling that
students need related to financial management. A
designated counselor who can build a level of trust
with students might encourage a more open line of
communication with and a more receptive response
from students.
(3) Inform all students of the Federal Student Loan
Forgiveness Program, which forgives student debt
after a period of service. To qualify for the program, students must work for a public institution
for 10 years (nonconsecutive) and make 10 years’
worth of qualifying payments. All remaining student debt will be forgiven after the 10 years.25
Pharmacists who take advantage of this program
can potentially reduce their student debt by tens of
thousands of dollars.
(4) Encourage national pharmacy organizations to
provide financial management programming at
association meetings that student pharmacists attend. Programming should include student-tostudent teaching and best practices (ie, roundtable
discussions), allowing students to share what has
worked as well as mistakes to avoid.
(5) Encourage administrators at colleges and schools
of pharmacy to assess their institution to ensure
that students are not overburdened by the cost of
their education. This might necessitate scrutiny of
tuition models and internal operations to determine
if students are paying only their fair share. At the
university level, use of technology should be explored to reduce staff numbers and time necessary
ARMS RACE FOR FACILITIES AND
RESOURCES
Recent significant expansion of pharmacy education
has led to competitive student recruitment based more
and more on reputation. Factors that enhance reputation
(buildings, technology, student amenities) are all costly,
thereby incentivizing an academic “arms race” to see who
can spend the most money.17 Colleges and schools of pharmacy are not immune and are continually seeking every
possible edge in attracting the highest quality students. A
National Bureau of Economic Research working paper
reported that college students place a high value on consumption amenities such as student activities, dormitories,
and sports.18 The recent addition and enhancement of
student services to include social, emotional, and career
counseling has also accounted for spending growth.19,20
Institutional marketing and recruitment strategies now
highlight key amenities such as technology, cutting edge
pedagogical approaches, and state-of-the-art facilities in
order to attract students to their programs.21 However, even
if these amenities are deemed necessary, the price tag associated with new infrastructures, technology implementation, and student services is substantial, driving the cost of
an education even higher with little to no evidence that
learning is improved. Moreover, higher education might
benefit if every institution ceased the expansion of facilities,
athletics, and student amenities. Unfortunately, market
forces perpetuate continued escalation, and no institution
can unilaterally withdraw from this arms race without putting itself at risk of falling behind.22
RECOMMENDATIONS
A Center for College Affordability policy paper has
been released that offers systemic methods universities can
use to make education more affordable (such as reforming
financial aid, digitizing academic libraries, and streamlining redundant programs) and reverse the trend of rising
costs.17 We offer some additional recommendations for
the academy to consider.
While public funding of higher education will not
likely revert completely to previous levels, the academy
must continue to lobby for federal and state support. Without pressure, state and federal legislatures may reduce financial allocations even further. Additionally, lobbying
efforts should be directed toward securing adequate financial aid funding for students, particularly grants and low
interest loans.
As mentioned previously, many students today
struggle with increased loan balances and significant
debt related to unwise personal financial management.
Many colleges and schools of pharmacy offer personal finance courses23,24 or provide brief financial management
5
American Journal of Pharmaceutical Education 2014;78(7) Article 2.
to comply with accreditation and other accountability demands. Extracurricular amenities should
be closely scrutinized and avoided if they result in
additional costs to students without providing
added value to their professional education. Additionally, the curriculum (including prepharmacy)
should be analyzed to determine if students are
loaded with coursework that adds little value to
their overall degree and their ability to practice
pharmacy. This type of scrutiny may be a painful
process for faculty members, but it could result in
a much more streamlined and effective curriculum.
While fraught with numerous issues, there are also
intriguing possibilities for collaboration within the
academy with regard to sharing educational content online. We encourage the American Association of Colleges of Pharmacy to explore potential
content sharing mechanisms that create pedagogical efficiencies. Pharmacy educators have the responsibility as faculty members of not acting out of
self-interest, but in providing the best and most
economical education to students.
for College Affordability and Productivity. http://www.
centerforcollegeaffordability.org/uploads/Trends_LaborForce.pdf.
Accessed November 4, 2013.
11. Greene JP, Kisida B, Mills J. Administrative bloat at American
universities: the real reason for high hosts in higher education.
Goldwater Institute Policy Report No. 239. August 17, 2010. http://
goldwaterinstitute.org/sites/default/files/Administrative%20Bloat.
pdf. Accessed September 3, 2013.
12. Pirani J. A compendium of MOOC perspectives, research, and
resources. Educause Rev. http://www.educause.edu/ero/article/
compendium-mooc-perspectives-research-and-resources. Published
November 4, 2013. Accessed November 6, 2013.
13. Carnegie Foundation for the Advancement of Teaching. Carnegie
Foundation for the Advancement of Teaching receives funding to
rethink the Carnegie Unit. http://www.carnegiefoundation.org/
newsroom/press-releases/carnegie-foundation-receives-fundingrethink-the-carnegie-unit. Decmeber 2012. Accessed Nov 4, 2013.
14. Asch DA, Nicholson S, Vujici M. Are we in a medical education
bubble market? N Engl J Med. 2013;369:1973-1975. http://www.
nejm.org/doi/pdf/10.1056/NEJMp1310778. Accessed November 18,
2013.
15. Gleason B, Siracuse M, Moniri N, Birnie C, Okamoto C, Crouch
M. Evolution of preprofessional pharmacy curricula. Am J Pharm
Educ. 2013;77(5):Article 95.
16. Broedel-Zaugg K, Buring SM, Shanker N, et al. Academic
pharmacy administrators’ perceptions of core requirements for entry
into professional pharmacy programs. Am J Pharm Educ. 2008;72(3):
Article 52.
17. Vedder R, Gillen A, Bennett D, et al. 25 ways to reduce the cost
of college. Center for College Affordability and Productivity; http://
www.centerforcollegeaffordability.org/uploads/25Ways_to_
Reduce_the_Cost_of_College.pdf. Accessed November 18, 2013.
18. Jacob B, McCall B, Stange KM. College as country club: do
colleges cater to students’ preferences for consumption. The National
Bureau of Economic Research. http://www.nber.org/papers/w18745.
pdf. Accessed November 5, 2013.
19. Jaschik S. The spending side of the equation. Inside Higher Educ.
http://www.insidehighered.com/news/2008/05/01/spending.
Accessed November 4, 2013.
20. Davis Educational Foundation. An inquiry into the rising cost of
higher education: Summary of responses from seventy college and
university presidents. http://www.davisfoundations.org/site/
documents/AnInquiryintotheRisingCostofHigherEducation_003.pdf.
Accessed November 12, 2013.
21. National Public Radio. What’s driving college costs higher?
http://www.npr.org/2012/06/26/155766786/whats-driving-collegecosts-higher. Accessed November 4, 2013.
22. Winston G. The positional arms race in higher education.
Educause. http://net.educause.edu/ir/library/pdf/ffp0103s.pdf.
Accessed November 5, 2013.
23. Fox J, Bartholomae S, Trombitas K. Evaluating financial
education programs. In: Durband DB, Britt SL, eds. Student
Financial Literacy. Springer, US; 2012:141-166.
24. Chui MA. An elective course in personal finance for health care
professionals. Am J Pharm Educ. 2009;73(1):Article 6.
25. Federal Student Aid, The US Department of Education. Federal
student aid: public service loan forgiveness. http://studentaid.ed.gov/
repay-loans/forgiveness-cancellation/charts/public-service. Accessed
May 5, 2013.
REFERENCES
1. Cain J, Campbell T, Congdon HB, et al. Pharmacy student debt
and return on investment of a pharmacy education: issues for the
academy. Am J Pharm Educ. 2014;78(1):Article 5.
2. Oliff P, Palacios V, Johnson I, Leachman M. Recent deep state
higher education cuts may harm students and the economy for years
to come. http://www.cbpp.org/cms/?fa5view&id53927. Accessed
September 9, 2013.
3. State Higher Education Executive Officers. State Higher
Education Finance: FY 2012. http://www.sheeo.org/sites/default/
files/publications/SHEF%20FY%2012-20130322rev.pdf. Accessed
September 10, 2013.
4. Macy A, Terry N. The determinants of student college debt.
Southwest Econ Rev. 2007;34(1):15-25.
5. Nawaguna E. Congress finally votes to cut student loan interest
rates. Reuters. July 31, 2013http://www.reuters.com/article/2013/07/
31/us-usa-studentloans-rates-idUSBRE96U1G220130731. Accessed
November 1, 2013.
6. Johnson J. Obama signs student loan interest rate legislation into
law. The Washington Post. August 9, 2013. http://articles.
washingtonpost.com/2013-08-09/politics/41223761_1_interest-ratesplus-loans-graduate-students. Accessed November 1, 2013.
7. Federal Student Aid, The US Department of Education. Federal
student aid: deferment and forbearance.http://studentaid.ed.gov/
repay-loans/deferment-forbearance. Accessed May 5, 2013.
8. Roberts JA, Jones ELI. Money attitudes, credit card use, and
compulsive buying among American college students. J Consumer
Aff. 2001;35(2):213-240.
9. Sallie Mae. How undergraduate students use credit cards: Sallie
Mae’s national study of usage rates and trends. http://static.
mgnetwork.com/rtd/pdfs/20090830_iris.pdf. Accessed Oct 4, 2013.
10. Bennett DL. Trends in the higher education labor force:
identifying changes in worker composition and productivity. Center
6
American Journal of Pharmaceutical Education 2014;78(7) Article 3.
RESEARCH
A Three-Year Study of the Impact of Instructor Attitude,
Enthusiasm, and Teaching Style on Student Learning in a
Medicinal Chemistry Course
Naser Z. Alsharif, PharmD, PhD, and Yongyue Qi, MS
School of Pharmacy and Health Professions, Creighton University Medical Center, Omaha, Nebraska
Submitted August 9, 2013; accepted January 20, 2014; published September 15, 2014.
Objective. To determine the effect of instructor attitude, enthusiasm, and teaching style on learning for
distance and campus pharmacy students.
Methods. Over a 3-year period, distance and campus students enrolled in the spring semester of a medicinal
chemistry course were asked to complete a survey instrument with questions related to instructor attitude,
enthusiasm, and teaching style, as well as items to measure student intrinsic motivation and vitality.
Results. More positive responses were observed among distance students and older students. Gender did
not impact student perspectives on 25 of the 26 survey questions. Student-related items were significantly
correlated with instructor-related items. Also, student-related items and second-year cumulative grade point
average were predictive of students’ final course grades. Instructor enthusiasm demonstrated the highest
correlation with student intrinsic motivation and vitality.
Conclusion. While this study addresses the importance of content mastery and instructional methodologies, it focuses on issues related to instructor attitude, instructor enthusiasm, and teaching style,
which all play a critical role in the learning process. Thus, instructors have a responsibility to
evaluate, reevaluate, and analyze the above factors to address any related issues that impact the
learning process, including their influence on professional students’ intrinsic motivation and vitality,
and ability to meet educational outcomes.
Keywords: instructor enthusiasm, science courses, medicinal chemistry, student learning, intrinsic motivation,
vitality, teaching
Key to this relationship is having instructors who can
unlock the “dormant energy” inside their students and
instill vitality in how students pursue the learning process.9-13 The instructor has to use strategies in the classroom that are student-centered and challenging, and that
put the responsibility on the student as much as on the
instructor to enhance student engagement in learning.14-16
The Center for the Advancement of Pharmacy Education
(CAPE) Educational Outcomes 2013 called for “the inclusion of an affective domain that would address personal
and professional skills, attitudes, and attributes required
for the delivery of patient-centered care.”17
By assessing student intrinsic motivation and vitality, both of which can impact student affective domain,
this study conducted at the School of Pharmacy and
Health Professions, Creighton University, analyzed the
implications of instructor-related factors such as attitude, enthusiasm, and teaching style on student learning.
The study addresses this topic from the perspective of 2
student cohorts (campus and distance pathway students)
enrolled in a required Chemical Basis of Drug Action
INTRODUCTION
The art of teaching is a continuous journey to find the
right combination of pedagogy, instructional methodologies, and more recently, technology to help students
learn.1-6 Student evaluations have always been an important
tool to gauge how students perceive the classroom environment and the learning process.1-6 Over the years, one theme
that seems to be prevalent in student evaluations is how
instructors’ demeanor, behavior, and/or attitude in the classroom affect student learning.5,7 This focus is in contrast to
pharmacy educators’ sometimes elaborate emphasis on innovative learning theories, lecture notes, and classroom activities to bring clinical relevance to course content.
A relationship has been identified between instructor
enthusiasm and students’ intrinsic motivation to learn.8-12
Corresponding Author: Naser Z. Alsharif, PharmD, PhD,
School of Pharmacy and Health Professions, Department of
Pharmacy Sciences, Creighton University Medical Center,
2500 California Plaza, Omaha, NE 68178. Tel: 402-280-1857.
Fax: 402-280-1883. E-mail: nalshari@creighton.edu.
7
American Journal of Pharmaceutical Education 2014;78(7) Article 3.
course in the second year of the doctor of pharmacy
(PharmD) curriculum.
less than 0.05 was considered significant. An exempt status
for the study was obtained from the Creighton University
Institutional Review Board.
METHODS
RESULTS
A convenience sample that included distance
(n5187) and campus (n5285) pathway students at
Creighton University was used for the study.18 Both cohorts were registered for the required Chemical Basis of
Drug Action course in the spring semester of 2011, 2012, or
2013. This 2-credit hour course, taught in the second year
of the curriculum, is delivered concurrently with pharmacology and follows completion of course work in biochemistry, physiology, pathology, anatomy, pharmaceutics, and
communication skills. The campus students were required
to attend class. The distance students, who were located
throughout the country, followed the same course syllabus,
learning objectives, lesson outline, and course activities as
did the campus students.18 Distance students viewed
videos of classroom lectures that were made available to
them within 2 hours after each class. The course instructor
was a tenured professor who had taught the course for 20
years.
A department instructor evaluation tool that had been
used for more than 15 years was administered to the students at the end of the spring semester in each of the years
of the study. The survey instrument also included studyspecific instructor-related items that addressed the course
instructor’s attitude, enthusiasm, and teaching style (ie,
items that were not related to instructional techniques).
The survey items were adopted from several studies that
addressed instructor enthusiasm, student intrinsic motivation, and student vitality.10,13,19 Although most of the
items were rated using a 5-point Likert scale, students also
were asked to provide written responses. Both the quantitative and qualitative sets of data were analyzed.
Statistical analysis included descriptive statistics and
independent t test for comparing mean evaluation scores
between pathways, age groups, and genders. Mean evaluation scores also were compared between students whose
grade point average (GPA) ranked in the upper 40% of
their class (approximately 70% of the students, Group 1)
and those whose GPA ranked in the lower 60% (Group 2),
as well as by students’ first-year cumulative GPA, secondyear cumulative GPA, and first- and second-year cumulative GPA. Pearson correlation analysis was conducted to
address the association between instructor and studentrelated items. In the multiple regression model, the course
score was treated as a response variable while first- and
second-year cumulative GPA, age, student-related items,
pathway, and gender were treated as predictor variables.
All statistical analyses were conducted using SAS, version
9.3 (SAS Institute Inc, Gary, North Carolina). A p value
The study involved 187 (39.6%) distance students
and 285 (60.4%) campus students who were admitted to
the PharmD program at Creighton University in 2009,
2010, and 2011. The average age for distance students
was 33.1 years, and for campus students, 24.8 years (Table 1). The response rate was approximately 100% because it was incorporated into the required end-of-class
instructor evaluation. There were 180 (38.1%) male students and 292 (61.9%) female students. Distance students’ average prerequisite GPA (Pre-GPA), first-year
cumulative GPA, and second-year cumulative GPA were
3.5, 3.6, and 3.3, respectively, while these variables for
campus students were 3.4, 3.4, and 3.2, respectively.
Almost all campus (93%) and distance students
(84%) strongly agreed or agreed that the instructor related
to them and other students in a manner that promoted
mutual respect. In addition, 96% of the distance students
and 81% of the campus students indicated that they
strongly agreed or agreed that the instructor demonstrated
interest in their success. Further, 94% of the distance
students and 87% of the campus students indicated that
they strongly agreed or agreed that the instructor demonstrated professionalism in interaction with them or other
students (Table 2). An independent t test for comparing
mean evaluation scores showed a significant difference
between the distance students and the campus students
(p,0.001) for all the items related to instructor attitude
(Table 2), with significantly higher ratings given by distance students. The majority of the distance students were
older than 27 years (average age 33.1 years, Table 1), and
the majority of the campus students were 27 years of age
or younger (average age 24.8 years, Table 1). Overall, age
was a significant factor (p,0.001) in all items related to
instructor attitude (Table 3).
There was a difference in the ratio of male to female
students between the distance and campus students in the
admitted classes of 2009, 2010, and 2011 (Table 1), with
a higher ratio of female to male students in the distance
classes. The t test analysis for gender did not demonstrate
any significant difference in student responses for any of
the instructor-related items except for question 19 (“provides different ways to learn the content,” p,0.05), or for
the student-related items.
Instructor enthusiasm was measured based on responses to general questions and to questions related
to verbal and nonverbal behaviors (Tables 2 and 3). With
regard to the instructor enthusiasm general question
8
American Journal of Pharmaceutical Education 2014;78(7) Article 3.
Table 1. Student Demographics
Demographics
Age
Campus
Distance
Gender
Campus
Male, %
Female, %
Distance
Male, %
Female, %
Pre-GPA
Campus
Distance
Pa
CGPA1
Campus
Distance
Pa
CGPA2
Campus
Distance
Pa
CGPA12
Campus
Distance
Pa
2009
Admitted Year
2011
2010
Three Year Average
25.6 (N5107)
32.8 (N566)
24.9 (N577)
33.1 (N555)
23.9 (N5101)
33.5 (N566)
24.8 (N5285)
33.1 (N5187)
44.9
55.1
41.6
58.4
47.5
55.5
44.9
55.1
19.7
80.3
36.4
63.6
28.8
71.2
27.8
72.2
3.4
3.5
0.004
3.4
3.5
0.006
3.4
3.5
0.13
3.4
3.5
0.001
3.5
3.7
,0.001
3.3
3.5
0.002
3.4
3.6
0.005
3.1
3.4
0.002
3.1
3.1
0.96
3.3
3.3
0.66
3.12
3.3
0.048
3.3
3.5
,0.001
3.2
3.3
0.16
3.4
3.5
0.06
3.3
3.4
,0.001
3.4
3.6
,0.001
Abbreviations: Pre-GPA5prerequisite grade point average; CGPA5first-year cumulative grade point average; CGPA25second-year cumulative
grade point average; CGPA125first- and second-year cumulative grade point average.
a
p value as determined by independent t test.
items, the distance students (96%) and campus students
(89%) strongly agreed or agreed with the statement that
the instructor demonstrated a passionate interest in the
topic. Also, 97% of the distance students and 87% of
the campus students strongly agreed or agreed with the
statement that the instructor demonstrated mastery of the
topic. When asked about their agreement with the statement that the instructor was “full of energy” when teaching, 99% of the distance students and 94% of the campus
students strongly agreed or agreed with it. Further, the
distance students (80% and 77%, respectively) and the
campus students (58% and 50%, respectively) strongly
agreed or agreed with the statements that the instructor
“enhanced my motivation for the pharmacy program” and
that the instructor “enhanced my motivation for medicinal
chemistry” (Table 2). Again, independent t test for comparing mean evaluation scores showed sig