Purpose The types of teaching experiences offered in academia in pharmacy residency programs affiliated with or offered through colleges of pharmacy throughout the United States were evaluated.
Methods Two 15-item questionnaires were developed, one for programs that offer a concentrated rotation in academia and one for programs that offer longitudinal opportunities in academia. These questionnaires were developed to assess the activities incorporated into the different learning experiences, the number of residents completing concentrated rotations, the residency director’s perception of the benefit to the residents, and barriers that exist for institutions that do not offer concentrated rotations. The questionnaires were distributed electronically to pharmacy residency directors at academic medical centers and colleges of pharmacy in the University HealthSystem Consortium listserver. The responses were analyzed with descriptive statistics.
Results Of the 154 institutions identified for survey distribution, 86 were academic medical centers and 68 were colleges of pharmacy and affiliated programs. Program directors from 99 institutions completed a questionnaire (response rate, 64.3%), representing 434 postgraduate year 1 (PGY1) and 290 postgraduate year 2 (PGY2) residency positions. Thirty-six percent (n = 36) of respondents offered a concentrated rotation in academia, and 64% (n = 63) offered longitudinal opportunities in academia. Sixty-six institutions offered a teaching certificate program; however, it was mandatory in only 42% of programs.
Conclusion The majority of PGY1 and PGY2 residency programs surveyed did not offer concentrated rotations in academia but did offer longitudinal opportunities for residents to gain teaching experience. The majority of programs that did not offer these experiences did want formal training on how to provide these opportunities.
Results of a 2010 survey by the American Association of Colleges of Pharmacy (AACP) indicated that there were 374 vacant or lost faculty positions and that nearly 50% of those positions were in clinical science or pharmacy practice areas.1 While this number is down from previous years, it still reflects the continued demand for pharmacy faculty. The survey results also revealed that almost 33% of positions remained vacant due to the lack of qualified candidates in the applicant pool.
In 2002, an AACP task force identified the need for more formal, intensive structured programs to develop teaching skills in all pharmacy residents and recommended colleges and schools of pharmacy provide these learning opportunities.2 The task force identified several barriers that may prevent new pharmacists from choosing a career in academia. Of these, lack of adequate preparation was identified as a primary barrier. Although residency programs may involve didactic teaching and research or other scholarly activities, graduating residents are often not prepared for rigorous faculty positions. To address this issue, the task force recommended that colleges and schools of pharmacy be a part of accredited graduate pharmacy education and offer formal training of residents for academia. Recommended areas of focus within residency training included teaching, research design, and grant writing. Schools and colleges of pharmacy were encouraged to provide these opportunities to residency programs to further develop the skills needed in academia positions. According to the task force, all residents should be trained as educators, because most will—at a minimum—be involved in serving as preceptors and in providing inservice education to other health care professionals.
Building on the goals set forth by the task force, the American College of Clinical Pharmacy National Residency Advisory Committee convened in 2009 to create recommendations for developing residents into effective educators.3 Recommendations included standardization of programming, development of self-learning and self-assessment tools, increased training for preceptors in the area of educational principles and methods, and the utilization of distance-learning technology.
McNatty et al.4 conducted a survey of former residents from pharmacy residency programs accredited by the American Society of Health-System Pharmacists (ASHP) during 2003–06 and found that respondents who had the greatest exposure to lectures, problem-based learning or small groups, seminars, and preceptors were more likely to fill faculty positions. Current literature shows that these experiences appear to prepare residents for careers in academia with the ultimate goal of filling the growing need for faculty members in schools and colleges of pharmacy.
The primary objective of this study was to determine the amount and types of rotations offered in academia at pharmacy residency programs affiliated with or offered through U.S. colleges of pharmacy.
An electronic questionnaire was distributed through Qualtrics (Provo, UT) to the University HealthSystem Consortium (UHC) residency preceptor listserver and via e-mail obtained from the ASHP residency directory during May and June 2010. All members of the listserver were invited to participate. There were no exclusion criteria. Programs were e-mailed directly if they were identified from the ASHP residency directory as being affiliated with a college of pharmacy and not a member of the UHC listserver. A 15-item questionnaire was developed for programs that offer a concentrated rotation in academia, and a separate 15-item questionnaire was developed for programs that offer longitudinal opportunities in academia. These questionnaires were developed to assess (1) the activities and topic discussions incorporated into the different learning experiences, (2) the number of residents completing concentrated rotations, (3) the perceived benefit of the experience to the residents, and (4) barriers that exist in institutions that do not offer concentrated rotations. In addition, demographic data about the programs were collected, including the number and type of postgraduate year 1 (PGY1) and 2 (PGY2) residents and programs and geographic location. The responses were evaluated with descriptive analysis.
Of the 154 residency programs (86 academic medical centers and 68 colleges of pharmacy and affiliated programs) identified as eligible to participate, 99 program directors (64.3%) returned a completed questionnaire. The types of programs represented are listed in Table 1. The majority of respondents were from residency programs in the Southeast (n = 30, 30%) and Midwest (n = 18, 18%). Thirty-six percent (n = 36) of respondents’ institutions offered a concentrated rotation in academia, and 64% (n = 63) offered longitudinal opportunities in academia. Slightly more than half of the programs (n = 53, 54%) did not receive any funding from colleges of pharmacy, while 13% of programs (n = 13) received full funding and 33% (n = 33) received partial funding from colleges of pharmacy. Of the 63 institutions that offered longitudinal opportunities only, 56% (n = 35) reported receiving no funding from a college of pharmacy. Of the 36 respondents whose institutions offered a concentrated rotation in academia, 15 received funding from a college of pharmacy (6 full funding, 9 partial funding).
Residencies with a concentrated rotation in academia
Of the 36 programs that offered a concentrated academic rotation, 26 (72%) also offered a teaching certificate program. The certificate program was required by only 10 programs (38%). Specific experiences completed by residents during the academic rotation are listed in Table 2, as are specific topic discussions that were included in the experience. The majority of experiences provided opportunities for residents to be involved with didactic lectures and participate in the preceptorship of students.
Programs varied in their response about which level of residency is offered the academic rotation. Twenty-eight percent of programs (n = 10) offered the experience to PGY1 residents only, 17% (n = 6) offered the experience to PGY2 residents only, and 56% (n = 20) offered the experience to both PGY1 and PGY2 residents. Of the 6 programs that offered the experience to PGY2 residents only, half (n = 3) did not have PGY1 residents at their institution.
Only 5 programs (14%) had offered an academic rotation for more than 10 years, while the academic rotation had been offered for 7–10 years by 4 programs (11%), for 4–6 years by 13 programs (36%), and for 1–3 years by 7 programs (19%). For another 7 programs (19%), 2010 was the first year the rotation was offered. Of the programs offering a concentrated rotation in academia (n = 36), 10 programs indicated that 12 or more residents had completed an academic rotation, 6 reported 8–11 residents, 6 reported 4–7 residents, and 12 reported 1–3 residents had completed an academic rotation; 2 programs reported that no residents had completed the rotation. Twenty-three programs (64%) had fewer than 25% of their graduates pursue careers in academia; however, 6 programs (17%) indicated that 76–100% of their graduates sought a career in academia after completing the residency.
Program directors were asked to evaluate the importance of specific goals of the academic rotation at their institution on a scale of 1 to 5, with 5 being extremely important and 0 being not important at all (Table 3). The median response of 4 indicated that these goals were very important to the academic rotation.
Residencies with longitudinal opportunities in academia
Of the 63 residency programs that offered only longitudinal opportunities to experience academia, 90% (n = 57) had never provided the experience. However, 63% (n = 40) did offer a teaching certificate program. The certificate program was required for 18 programs (45%). Specific longitudinal academic experiences offered to residents during their residency year are listed in Table 4.
The majority of respondents’ institutions (n = 42, 67%) that offered longitudinal experiences planned to continue to offer their current experiences in a longitudinal format, and 33% indicated that they would like to offer a concentrated academic experience in the future. In addition, 59% of programs indicated that they would be interested in receiving information on how to develop and offer an academic rotation. When asked to describe the format in which respondents would like this information to be provided, the results were as follows: ASHP workshop (51%), live continuing-education program (49%), handbook (44%), roundtable discussion (33%), and e-mail or webinars (26%).
A total of 38 respondents (60%) indicated that barriers currently exist that prevent them from offering a concentrated academic rotation. The most common limitations to offering an academic rotation included not enough time to incorporate the rotation due to other required rotations, no dedicated preceptor in academia available, residents had not requested or expressed interest, financial constraints, and time away from the practice site or patient care activities, as well as the distance from the pharmacy school.
Pharmacy faculty shortages may be partly due to difficulty with retention of current faculty members, an increased demand from new colleges of pharmacy, and a lack of an adequate supply of new faculty members. In a survey of pharmacy students, residents, and new faculty members, Shaeffer and colleagues5 found that respondents who were exposed to teaching opportunities, including small group and classroom activities as well as participation in professional writing, were more likely to be interested in faculty positions. In the survey conducted by McNatty and colleagues,4 those residents whose program was affiliated with a school or college of pharmacy were significantly more likely to have been exposed to teaching opportunities during their training. There was also a trend toward the pursuit of faculty positions by residents who had formal training in teaching. The majority (63%) of respondents in that survey stated that more teaching experiences during their residency would have been beneficial. Of those respondents who had chosen careers in academia, 66% indicated that the residency training had adequately prepared them for the teaching position. Clark et al.6 conducted a survey of community pharmacy residents and their preceptors or directors, assessing various reasons for and against accepting faculty positions. One of the most common reasons stated in this survey for not pursuing a career in academia was lack of preparedness. Although more than half of the residents surveyed when entering the community pharmacy residency stated that their preliminary job preference was academia, fewer than 8% actually accepted faculty positions as their first job. Influential factors cited by those who chose careers in academia included positive teaching experiences and mentorship. Residents who did not pursue academia listed the following as factors influencing their decision: lack of interest (44%), geographic location (35%), and not feeling prepared (18%). Less common deterrents included a dislike of teaching experiences (12%) and undesirable salary (9%).
In 2007, DiPiro7 credited schools and colleges of pharmacy with advancing the practice of pharmacy in the past three decades, mainly through promoting the development of clinical pharmacy practice. DiPiro emphasized the significant effect on health care that academic pharmacy has had and can continue to have by being involved with residency training.
While some residency programs do currently offer teaching certificates, often incorporating didactic and small group teaching as well as the creation of a teaching portfolio, not all require or incorporate a formalized rotation in academia. Slazak and Zurick8 reported on a practice-based learning experience with a four-week elective rotation in academia for PGY1 and PGY2 pharmacy residents. All seven participants stated that the rotation was a valuable experience, and five pursued careers in academia. At this time, in surveyed programs both concentrated and longitudinal experiences are being utilized to expose residents to the various aspects of teaching. However, not all programs offer concentrated rotational experiences in academia or require teaching certificate programs.
In the current study, two surveys were developed and distributed to obtain responses by program directors who do and those who do not currently offer concentrated rotational experiences in academia. This method allowed for the acquisition of information regarding perceived barriers to providing experiences by those who offer only longitudinal academia experiences. It is important to note that these perceived barriers to offering experiences in academia included lack of time and available preceptors, while very few respondents stated lack of importance or challenging experience as deterrents. The majority of respondents whose institutions offered only longitudinal experiences were interested in learning how to offer a concentrated rotational experience. A benefit to having responses by those who do not offer concentrated experiences is that methods to overcome these obstacles can be investigated. Furthermore, respondents provided insight into their preferred methods of learning about how to incorporate experiences in academia, which can be used in potential future educational sessions to expand these programs.
As for those programs that offered experiences in academia, the results of our study are similar to McNatty et al.,4 showing lecturing and precepting as two of the most common activities. However, our study found that evaluating student examinations or presentations and item writing were common activities, reported by over 75% of respondents. These results seem to further validate prior research and reports that indicated that exposure to various activities within academia may stimulate residents’ interest in pursuing careers in academia.4–6,8 Similar to the findings in other reports, of those institutions that offered a rotation in academia, the average response indicated a perceived benefit with regard to preparation not only for a career in academia but also improvement with regard to various skills in and outside the classroom, reflecting the broad benefits of these experiences.
This study had several limitations, including a lack of direct resident input and the potential for more than one respondent per institution. Some programs had more than one residency program (PGY1 and PGY2). In addition, responder bias could have occurred, as the representative from each institution provided an individual opinion that may not reflect that of all participants in the program. Furthermore, as an anonymous survey, it is unknown whether the characteristics of responding and nonresponding program directors were similar. Therefore, results may not be extrapolated for all residency programs.
The majority of PGY1 and PGY2 residency programs surveyed did not offer concentrated rotations in academia but did offer longitudinal opportunities for residents to gain teaching experience. The majority of programs that did not offer these experiences did want formal training on how to provide these opportunities.
The authors have declared no potential conflicts of interest.
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