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Student pharmacists' perceptions of community pharmacy residency programs
Research Notes
Student pharmacists’ perceptions of community pharmacy residency programs Manasi V. Datar, Erin R. Holmes, Alex J. Adams, and Samuel F. Stolpe
Abstract Objectives: To compare penultimate-year (next-to-last) and final-year student pharmacists’ perceptions of the educational value of community pharmacy residency programs (CPRPs) and to compare student pharmacists’ perceptions of the educational value of CPRPs and health-system residency programs (HSRPs). Methods: A self-administered online survey was sent to administrators at 119 Accreditation Council for Pharmacy Education–accredited schools of pharmacy for ultimate distribution to penultimate- and final-year student pharmacists. The survey included demographic measures and a 20-item residency program “perceived value of skill development” scale developed for this study. Results: 1,722 completed surveys were received and analyzed. Penultimate-year students attributed greater value to CPRPs more frequently than final-year students. Students more often attributed higher value to CPRPs for skills related to business management, practice management, and medication therapy management, while they attributed higher value to HSRPs for skills related to teaching, research, and clinical knowledge. Conclusion: The results of this study suggest students’ perceived value of CPRPs may be related to their year of pharmacy school and the pharmacy practice skill in question. Keywords: Residencies, community pharmacy residency programs, student pharmacists. J Am Pharm Assoc. 2013;53:193–197. doi: 10.1331/JAPhA.2013.12107
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or decades, community pharmacy residency programs (CPRPs) have honed pharmacy graduates’ clinical and practice management skills and have served as a means of integrating and sustaining innovative patient care services in community pharmacies.1 Different from postgraduate year 1 (PGY1) health-system residency programs (HSRPs), which focus on training pharmacists to provide and integrate pharmacy services into the hospital and health-system settings, PGY1 CPRPs focus on training pharmacists to provide a variety of patient care services in the community setting.1 Fewer CPRP positions are available (125) relative to HSRPs (>2,000), especially considering that there are more than 60,000 community pharmacies in the country compared with approximately 5,800 registered hospitals.1 As stakeholders consider expanding the number of available CPRPs, evaluating student pharmacists’ perceptions of CPRPs may facilitate and inform their efforts. A review of the literature showed that the perceptions of CPRPs of residency preceptor directors,2 current and former residents,3 schools of pharmacy,4 and community practice sites with and without residency programs4 have been assessed. However, student pharmacists’ perceptions of CPRPs have not been addressed. The findings of this study may provide insight for stakeholders considering expansion of the current number of CPRPs, as well as assist current CPRP coordinators in addressing or educating students about skill sets for which students perceive little value is garnered from CPRPs. Study findings also may guide pharmacy educators, pharmacists, residency program directors, and preReceived May 21, 2012, and in revised form November 16, 2012. Accepted for publication December 21, 2012. Manasi V. Datar, MS, is a graduate student; and Erin R. Holmes, PharmD, PhD, is Assistant Professor, School of Pharmacy, University of Mississippi, University, MS. Alex J. Adams, PharmD, is Director of Foundation Programs, National Association of Chain Drug Stores Foundation, Arlington, VA. Samuel F. Stolpe, PharmD, was Executive Resident, National Association of Chain Drug Stores Foundation, Arlington, VA, at the time this study was conducted; he is currently Adjunct Professor, College of Pharmacy, Howard University, Washington, DC; and Associate Director, Quality Initiatives, Pharmacy Quality Alliance, Springfield, VA. Correspondence: Erin R. Holmes, PharmD, PhD, 233 Faser Hall, School of Pharmacy, University of Mississippi, University, MS 38677. Fax: 662-915-5102. E-mail: erholmes@ olemiss.edu Funding: Research grant from the National Association of Chain Drug Stores Foundation. Acknowledgments: To Lynette Bradley-Baker, Director of Professional Alliance Development, American Association of Colleges of Pharmacy, for support and assistance in disseminating the survey. Previous presentation: APhA–APPM Presentation Merit Award recipient, APhA Annual Meeting & Exposition, March 9–12, 2012, New Orleans, LA.
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Research Notes
ceptors in reinforcing the value of CPRPs or clarifying student perceptions or misconceptions.
Objectives The objectives of this study were to (1) compare penultimate-year (next-to-last) and final-year student pharmacists’ perceptions of the educational value of CPRPs and (2) compare students’ perceptions of the educational value of CPRPs and HSRPs.
Methods Investigators developed a self-administered Web-based survey that included demographic measures and a 20-item residency program “perceived value of skill development” scale, through which respondents were asked to rate the value of each item (Table 1). Items were developed using relevant residency program literature3–5 and investigator input. The survey was reviewed for comprehensiveness and clarity by a convenience sample of student pharmacists before receiving institutional review board exemption. Penultimate- and final-year student pharmacists in the 119 Accreditation Council for Pharmacy Education–accredited schools of pharmacy at the time of data collection (April 2011) were recruited for participation. To initiate data collection, a preliminary e-mail was distributed by the American Association of Colleges of Pharmacy to its Council of Faculties, Experiential Education Section, and Student Services Personnel Special Interest Group e-mail distribution lists. The e-mail outlined the objective of the study and informed recipients that a subsequent e-mail would contain a survey for distribution to penultimate- and final-year student pharmacists. Five days later, the email containing the survey link and cover letter was sent to the same recipients. The following week, a reminder e-mail was sent, in which recipients were asked to forward the e-mail to students who had not completed the survey. Mann-Whitney U tests were used to assess differences in perceptions of CPRPs between penultimateand final-year students, while chi-square tests were used to compare differences in CPRP and HSRP perceptions among all respondents.
Results A total of 1,722 completed surveys were received from student pharmacists in 55 pharmacy schools (46% school response rate), 25 of which are affiliated with a CPRP program (based on the American Society of Health-System Pharmacists PGY1 Community Residency Directory).6 The mean (±SD) age of respondents was 26 ± 4.3 years. Most respondents were women (71%) and final-year students (64%). Of students surveyed, 88% and 57% reported some type of experience in chain and independent pharmacy settings, respectively. Table 1 provides a comparison of penultimate- and final-year students’ perceptions of the value of CPRPs 194 JAPhA | 5 3 :2 | M AR/AP R 2013
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on 20 skill development items. Penultimate-year students more often attributed greater value to CPRPs than final-year students. Some of these attributions of greater value were statistically significant, whereas others were not significant. The only CPRP skill development item rated to be more valuable by final-year students was the “development of research skills” item. Table 2 provides a comparison of all respondents’ perceptions of CPRPs and HSRPs. Depending on individual skill development items, students more frequently attributed higher value to either CPRPs or HSRPs. For example, students attributed more value to CPRPs for developing skills in medication therapy management, practice management, business management, innovative pharmacy services, prevention and wellness programs, patient education, patient contact and interaction, and drug distribution. More value was attributed to HSRPs for developing skills in disease management, quality patient care, using advances in technology, teaching, research, clinical knowledge, drug information, medical/professional writing, giving formal presentations, and opportunities in elective rotations and employment. Although the results are not provided in tabular form, students from CPRP-affiliated schools more often attributed higher—though not always statistically significantly higher—value ratings to CPRPs compared with students who were not from CPRP-affiliated schools. Similarly, students with experience in the independent pharmacy setting consistently attributed higher—though not always statistically significantly higher—value ratings to CPRPs compared with students with experience in other settings.
Discussion Depending on individual skill development items, students more frequently attributed higher value to either CPRPs or HSRPs. Given the differing foci of CPRPs and HSRPs, some of these findings may not be surprising. Findings that raise concern (such as lower values attributed to research skill development in CPRPs compared with HSRPs) may beckon CPRP stakeholders to engage in efforts to clarify student perceptions. For example, students from CPRP-affiliated schools often attributed higher ratings to CPRP skill development items than students from non–CPRP-affiliated schools. This may suggest that exposure to CPRPs influences student perceptions of CPRPs. Schools of pharmacy that are not affiliated with CPRPs may consider exposing students to CPRPs through a variety of mechanisms, such as assemblies, residency fairs, or other development programs. Penultimate-year students more often attributed greater value to CPRPs than final-year students. One of the chronologically driven differences between these student groups is that final-year students would have nearly completed advanced pharmacy practice expeJournal of the American Pharmacists Association
Journal of the American Pharmacists Association
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Abbreviation used: CPRPs, community pharmacy residency programs. Totals less than 1,722 responses indicate missing data. a Indicates significance at alpha level of 0.05. b Indicates significance at alpha level of 0.01.
Please indicate how valuable CPRPs are for: Developing skills in disease management Learning to provide quality patient care Developing skills in medication therapy management Learning and using advances in technology Gaining expertise in pharmacy practice management Gaining expertise in business management Learning to develop innovative pharmacy services Learning to implement innovative pharmacy services Developing teaching skills Developing research skills Developing prevention and wellness programs Developing patient education skills Experience with direct patient contact and interaction Enhancing clinical knowledge Enhancing drug information skills Learning about the drug distribution system Providing additional opportunities for employment Opportunities for medical/professional writing Opportunities for giving formal presentations Opportunities in elective rotations
Penultimate-year students (n = 626) No. (%) Not at all Somewhat Mostly Very valuable valuable valuable valuable 30 (4.79) 183 (29.23) 153 (24.44) 178 (28.43) 31 (4.95) 118 (18.85) 183 (29.23) 209 (33.39) 23 (3.67) 78 (12.46) 179 (28.59) 263 (42.01) 44 (7.03) 195 (31.15) 179 (28.59) 124 (19.81) 20 (3.19) 102 (16.29) 198 (31.63) 543 (86.74) 16 (2.56) 66 (10.54) 190 (30.35) 257 (41.05) 18 (2.88) 104 (16.61) 180 (28.75) 227 (36.26) 17 (2.72) 94 (15.02) 176 (28.12) 241 (38.50) 38 (6.07) 162 (25.88) 171 (27.32) 155 (24.76) 163 (26.04) 231 (36.90) 93 (14.86) 41 (6.55) 8 (1.28) 47 (7.51) 121 (19.33) 345 (55.11) 12 (1.92) 41 (6.55) 107 (17.09) 359 (57.35) 13 (2.08) 34 (5.43) 97 (15.50) 375 (59.90) 26 (4.15) 201 (32.11) 185 (29.55) 107 (17.09) 20 (3.19) 136 (21.73) 208 (33.23) 155 (24.76) 23 (3.67) 107 (17.09) 202 (32.27) 177 (28.27) 43 (6.87) 105 (16.77) 171 (27.32) 192 (30.67) 103 (16.45) 235 (37.54) 114 (18.21) 58 (9.27) 75 (11.98) 214 (34.19) 151 (24.12) 71 (11.34) 80 (12.78) 196 (31.31) 145 (23.16) 87 (13.90)
Table 1. Comparison of penultimate- and final-year students’ perceptions of CPRPs Final-year students (n = 1,096) No. (%) Mostly Not at all Not at all Somewhat valuable valuable valuable valuable 65 (5.93) 379 (34.58) 282 (25.73) 240 (21.89) 62 (5.66) 284 (25.91) 314 (28.65) 303 (27.64) 49 (4.47) 195 (17.79) 290 (26.46) 425 (38.77) 114 (10.40) 390 (35.58) 283 (25.82) 172 (15.69) 61 (5.57) 235 (21.44) 336 (30.66) 327 (29.83) 37 (3.38) 177 (16.15) 343 (31.30) 391 (35.67) 40 (3.65) 204 (18.61) 340 (31.02) 365 (33.30) 34 (3.10) 204 (18.61) 343 (31.30) 366 (33.39) 86 (7.85) 320 (29.20) 306 (27.92) 234 (21.35) 262 (23.91) 401 (36.59) 199 (18.16) 84 (7.66) 16 (1.46) 96 (8.76) 264 (24.09) 556 (50.72) 20 (1.82) 97 (8.85) 232 (21.17) 579 (52.82) 24 (2.19) 89 (8.12) 202 (18.43) 614 (56.02) 62 (5.66) 355 (32.39) 315 (28.74) 202 (18.43) 55 (5.02) 260 (23.72) 357 (32.57) 257 (23.44) 42 (3.83) 240 (21.90) 330 (30.11) 313 (28.55) 93 (8.49) 240 (21.90) 316 (28.83) 277 (25.27) 189 (17.24) 414 (37.77) 224 (20.44) 95 (8.66) 129 (11.77) 355 (32.39) 269 (24.54) 170 (15.51) 198 (18.07) 355 (32.39) 229 (20.89) 137 (12.50) P 0.001b 0.001b 0.019a 0.001b 0.000b 0.001b 0.087 0.009b 0.025a 0.066 0.019a 0.012a 0.014a 0.762 0.116 0.219 0.001b 0.99 0.08 0.008b
Research Notes
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Somewhat valuable
562 (32.64) 402 (23.34) 273 (15.85) 585 (33.97) 337 (19.57) 243 (14.11) 308 (17.89) 298 (17.31) 482 (27.99) 632 (36.70) 143 (8.30) 138 (8.01) 123 (7.14) 556 (32.29) 396 (23.00) 347 (20.15) 345 (20.03) 649 (37.69) 569 (33.04) 551 (32.00)
Not at all valuable
95 (5.52) 93 (5.40) 72 (4.18) 158 (9.18) 81 (4.70) 53 (3.08) 58 (3.37) 51 (2.96) 124 (7.20) 425 (24.68) 24 (1.39) 32 (1.86) 37 (2.15) 88 (5.11) 75 (4.36) 65 (3.77) 136 (7.90) 292 (16.96) 204 (11.85) 278 (16.14)
435 (25.26) 497 (28.86) 469 (27.24) 462 (26.83) 534 (31.01) 533 (30.95) 520 (30.20) 519 (30.14) 477 (27.70) 292 (16.96) 385 (22.36) 339 (19.69) 299 (17.36) 500 (29.04) 565 (32.81) 532 (30.89) 487 (28.28) 338 (19.63) 420 (24.39) 374 (21.72)
Mostly valuable
CPRPs (n = 1,722) No. (%)
Abbreviations used: CPRPs, community pharmacy residency programs; HSRPs, health-system residency programs. Totals less than 1,722 responses indicate missing data. a Indicates significance at alpha level of 0.01.
Please indicate how valuable CPRPs (HSRPs) are for: Developing skills in disease management Learning to provide quality patient care Developing skills in medication therapy management Learning and using advances in technology Gaining expertise in pharmacy practice management Gaining expertise in business management Learning to develop innovative pharmacy services Learning to implement innovative pharmacy services Developing teaching skills Developing research skills Developing prevention and wellness programs Developing patient education skills Experience with direct patient contact and interaction Enhancing clinical knowledge Enhancing drug information skills Learning about the drug distribution system Providing additional opportunities for employment Opportunities for medical/professional writing Opportunities for giving formal presentations Opportunities in elective rotations
Table 2. Comparison of students’ perceptions of CPRPs and HSRPs
418 (24.27) 512 (29.73) 688 (39.95) 296 (17.19) 550 (31.94) 648 (37.63) 592 (34.38) 607 (35.25) 389 (22.59) 125 (7.26) 901 (52.32) 938 (54.47) 989 (57.43) 308 (17.89) 412 (23.93) 490 (28.46) 469 (27.24) 153 (8.89) 241 (14.00) 224 (13.01)
Very valuable
31 (1.80) 43 (2.50) 136 (7.90) 59 (3.43) 111 (6.45) 356 (20.67) 115 (6.68) 106 (6.16) 42 (2.44) 47 (2.73) 238 (13.82) 84 (4.88) 110 (6.39) 26 (1.51) 27 (1.57) 99 (5.75) 37 (2.15) 31 (1.80) 25 (1.45) 48 (2.79)
Not at all valuable
205 (11.90) 209 (12.14) 498 (28.92) 328 (19.05) 445 (25.84) 683 (39.66) 493 (38.63) 477 (27.70) 251 (14.58) 189 (10.98) 692 (40.19) 469 (27.24) 463 (26.89) 79 (4.59) 100 (5.81) 434 (25.20) 205 (11.90) 195 (11.32) 126 (7.32) 174 (10.10)
Somewhat valuable
455 (26.42) 511 (29.67) 485 (28.16) 613 (35.60) 524 (30.43) 297 (17.25) 576 (33.45) 586 (34.03) 572 (33.22) 504 (29.27) 367 (21.31) 527 (30.60) 487 (28.28) 223 (12.95) 412 (23.93) 535 (31.07) 462 (26.83) 468 (27.18) 394 (22.88) 400 (23.23)
Mostly valuable
HSRPs (n = 1,722) No. (%)
779 (45.24) 706 (41.00) 343 (19.92) 468 (27.18) 387 (22.47) 124 (7.20) 271 (15.74) 286 (16.61) 592 (34.38) 719 (41.75) 146 (8.48) 359 (20.85) 382 (22.18) 1,103 (64.05) 905 (52.56) 360 (20.91) 720 (41.81) 730 (42.39) 881 (51.16) 805 (46.75)
Very valuable
χ2 153.3 353.9 71.3 454.6 178.7 91.5 172.6 186.5 255.8 161.9 57.2 215.4 192.6 129.1 308.2 260 348.2 176.6 212.4 354.8
P <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a
Research Notes
Journal of the American Pharmacists Association
Research Notes
riences (APPEs) at the time of this survey. If and how APPEs influenced students’ survey responses warrant further investigation. For now, the findings of this study may assist CPRP coordinators, pharmacy educators, preceptors, and pharmacists in addressing, educating about, or reinforcing the value skill sets or educating students about CPRP skill sets, particularly in the transition to the final year of pharmacy school.
Limitations This study used a self-administered survey, which lends itself to nonresponse bias. Readers should be cautioned regarding the large sample size in this study, in that statistically significant differences may not necessarily be important from a practical standpoint. In addition, receiving data from 55 of the 119 schools of pharmacy may limit generalizability of the results.
Conclusion The results of this study suggest students’ perceived value of CPRPs may be related to their year of pharmacy school, the pharmacy practice skill in question, and whether they attended a pharmacy school affiliated with a CPRP. The findings of this study may provide insight into residency match discrepancies and assist CPRP co-
ordinators in addressing skill sets or educating students about skill sets for which students perceive little value is garnered from CPRPs. These findings also have value for pharmacy educators interested in reinforcing the value of CPRPs and for stakeholders interested in expanding the current number of CPRPs. References 1. Stolpe SF, Adams AJ, Bradley-Baker LR, et al. Historical development and emerging trends of community pharmacy residencies. Am J Pharm Educ. 2011;75(8):160. 2. American Society of Health-System Pharmacists. Residency capacity survey results. www.ashp.org/DocLibrary/Accreditation/ Residency-Capacity-Survey-Results.aspx. Accessed July 18, 2012. 3. Unterwagner WL, Zeolla MM, Burns AL. Training experiences of current and former community pharmacy residents, 1986-2000. J Am Pharm Assoc. 2003;43(2):201–6. 4. Schommer JC, Bonnarens JK, Brown LM, Goode JR. Value of community pharmacy residency programs: college of pharmacy and practice site perspectives. J Am Pharm Assoc. 2010;50(3):e72–88. 5. Bonnarens JK. Community pharmacy residency training. J Pharm Soc Wisc. 2004;7(6):60–2. 6. American Society of Health-System Pharmacists. PGY1 Community Residency Directory. www.natmatch.com/cgibin/direct_filedisp.pl. Accessed April 12, 2012.
call for submissions
JAPhA seeks publishable landscape or nature photographs Do you have one or more photographs from a recent trip that you would like to share with your colleagues in pharmacy? The JAPhA editors are seeking color photographs for the front cover of the journal and for inclusion at the ends of Science & Practice articles. The photographs should be artistic, high-quality shots of nature, landscape, or city scenes containing no identifiable people. If you have photographs that might fit this bill, e-mail the images to the Managing Editor at [email protected]. If your submission is chosen for inclusion, the editors will contact you for a high-quality image and the necessary permissions to use your work in the Journal.
13-045 Call for Photographs RIGHT.indd 1
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Student pharmacists’ perceptions of community pharmacy residency programs Manasi V. Datar, Erin R. Holmes, Alex J. Adams, and Samuel F. Stolpe
Abstract Objectives: To compare penultimate-year (next-to-last) and final-year student pharmacists’ perceptions of the educational value of community pharmacy residency programs (CPRPs) and to compare student pharmacists’ perceptions of the educational value of CPRPs and health-system residency programs (HSRPs). Methods: A self-administered online survey was sent to administrators at 119 Accreditation Council for Pharmacy Education–accredited schools of pharmacy for ultimate distribution to penultimate- and final-year student pharmacists. The survey included demographic measures and a 20-item residency program “perceived value of skill development” scale developed for this study. Results: 1,722 completed surveys were received and analyzed. Penultimate-year students attributed greater value to CPRPs more frequently than final-year students. Students more often attributed higher value to CPRPs for skills related to business management, practice management, and medication therapy management, while they attributed higher value to HSRPs for skills related to teaching, research, and clinical knowledge. Conclusion: The results of this study suggest students’ perceived value of CPRPs may be related to their year of pharmacy school and the pharmacy practice skill in question. Keywords: Residencies, community pharmacy residency programs, student pharmacists. J Am Pharm Assoc. 2013;53:193–197. doi: 10.1331/JAPhA.2013.12107
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or decades, community pharmacy residency programs (CPRPs) have honed pharmacy graduates’ clinical and practice management skills and have served as a means of integrating and sustaining innovative patient care services in community pharmacies.1 Different from postgraduate year 1 (PGY1) health-system residency programs (HSRPs), which focus on training pharmacists to provide and integrate pharmacy services into the hospital and health-system settings, PGY1 CPRPs focus on training pharmacists to provide a variety of patient care services in the community setting.1 Fewer CPRP positions are available (125) relative to HSRPs (>2,000), especially considering that there are more than 60,000 community pharmacies in the country compared with approximately 5,800 registered hospitals.1 As stakeholders consider expanding the number of available CPRPs, evaluating student pharmacists’ perceptions of CPRPs may facilitate and inform their efforts. A review of the literature showed that the perceptions of CPRPs of residency preceptor directors,2 current and former residents,3 schools of pharmacy,4 and community practice sites with and without residency programs4 have been assessed. However, student pharmacists’ perceptions of CPRPs have not been addressed. The findings of this study may provide insight for stakeholders considering expansion of the current number of CPRPs, as well as assist current CPRP coordinators in addressing or educating students about skill sets for which students perceive little value is garnered from CPRPs. Study findings also may guide pharmacy educators, pharmacists, residency program directors, and preReceived May 21, 2012, and in revised form November 16, 2012. Accepted for publication December 21, 2012. Manasi V. Datar, MS, is a graduate student; and Erin R. Holmes, PharmD, PhD, is Assistant Professor, School of Pharmacy, University of Mississippi, University, MS. Alex J. Adams, PharmD, is Director of Foundation Programs, National Association of Chain Drug Stores Foundation, Arlington, VA. Samuel F. Stolpe, PharmD, was Executive Resident, National Association of Chain Drug Stores Foundation, Arlington, VA, at the time this study was conducted; he is currently Adjunct Professor, College of Pharmacy, Howard University, Washington, DC; and Associate Director, Quality Initiatives, Pharmacy Quality Alliance, Springfield, VA. Correspondence: Erin R. Holmes, PharmD, PhD, 233 Faser Hall, School of Pharmacy, University of Mississippi, University, MS 38677. Fax: 662-915-5102. E-mail: erholmes@ olemiss.edu Funding: Research grant from the National Association of Chain Drug Stores Foundation. Acknowledgments: To Lynette Bradley-Baker, Director of Professional Alliance Development, American Association of Colleges of Pharmacy, for support and assistance in disseminating the survey. Previous presentation: APhA–APPM Presentation Merit Award recipient, APhA Annual Meeting & Exposition, March 9–12, 2012, New Orleans, LA.
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Research Notes
ceptors in reinforcing the value of CPRPs or clarifying student perceptions or misconceptions.
Objectives The objectives of this study were to (1) compare penultimate-year (next-to-last) and final-year student pharmacists’ perceptions of the educational value of CPRPs and (2) compare students’ perceptions of the educational value of CPRPs and HSRPs.
Methods Investigators developed a self-administered Web-based survey that included demographic measures and a 20-item residency program “perceived value of skill development” scale, through which respondents were asked to rate the value of each item (Table 1). Items were developed using relevant residency program literature3–5 and investigator input. The survey was reviewed for comprehensiveness and clarity by a convenience sample of student pharmacists before receiving institutional review board exemption. Penultimate- and final-year student pharmacists in the 119 Accreditation Council for Pharmacy Education–accredited schools of pharmacy at the time of data collection (April 2011) were recruited for participation. To initiate data collection, a preliminary e-mail was distributed by the American Association of Colleges of Pharmacy to its Council of Faculties, Experiential Education Section, and Student Services Personnel Special Interest Group e-mail distribution lists. The e-mail outlined the objective of the study and informed recipients that a subsequent e-mail would contain a survey for distribution to penultimate- and final-year student pharmacists. Five days later, the email containing the survey link and cover letter was sent to the same recipients. The following week, a reminder e-mail was sent, in which recipients were asked to forward the e-mail to students who had not completed the survey. Mann-Whitney U tests were used to assess differences in perceptions of CPRPs between penultimateand final-year students, while chi-square tests were used to compare differences in CPRP and HSRP perceptions among all respondents.
Results A total of 1,722 completed surveys were received from student pharmacists in 55 pharmacy schools (46% school response rate), 25 of which are affiliated with a CPRP program (based on the American Society of Health-System Pharmacists PGY1 Community Residency Directory).6 The mean (±SD) age of respondents was 26 ± 4.3 years. Most respondents were women (71%) and final-year students (64%). Of students surveyed, 88% and 57% reported some type of experience in chain and independent pharmacy settings, respectively. Table 1 provides a comparison of penultimate- and final-year students’ perceptions of the value of CPRPs 194 JAPhA | 5 3 :2 | M AR/AP R 2013
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on 20 skill development items. Penultimate-year students more often attributed greater value to CPRPs than final-year students. Some of these attributions of greater value were statistically significant, whereas others were not significant. The only CPRP skill development item rated to be more valuable by final-year students was the “development of research skills” item. Table 2 provides a comparison of all respondents’ perceptions of CPRPs and HSRPs. Depending on individual skill development items, students more frequently attributed higher value to either CPRPs or HSRPs. For example, students attributed more value to CPRPs for developing skills in medication therapy management, practice management, business management, innovative pharmacy services, prevention and wellness programs, patient education, patient contact and interaction, and drug distribution. More value was attributed to HSRPs for developing skills in disease management, quality patient care, using advances in technology, teaching, research, clinical knowledge, drug information, medical/professional writing, giving formal presentations, and opportunities in elective rotations and employment. Although the results are not provided in tabular form, students from CPRP-affiliated schools more often attributed higher—though not always statistically significantly higher—value ratings to CPRPs compared with students who were not from CPRP-affiliated schools. Similarly, students with experience in the independent pharmacy setting consistently attributed higher—though not always statistically significantly higher—value ratings to CPRPs compared with students with experience in other settings.
Discussion Depending on individual skill development items, students more frequently attributed higher value to either CPRPs or HSRPs. Given the differing foci of CPRPs and HSRPs, some of these findings may not be surprising. Findings that raise concern (such as lower values attributed to research skill development in CPRPs compared with HSRPs) may beckon CPRP stakeholders to engage in efforts to clarify student perceptions. For example, students from CPRP-affiliated schools often attributed higher ratings to CPRP skill development items than students from non–CPRP-affiliated schools. This may suggest that exposure to CPRPs influences student perceptions of CPRPs. Schools of pharmacy that are not affiliated with CPRPs may consider exposing students to CPRPs through a variety of mechanisms, such as assemblies, residency fairs, or other development programs. Penultimate-year students more often attributed greater value to CPRPs than final-year students. One of the chronologically driven differences between these student groups is that final-year students would have nearly completed advanced pharmacy practice expeJournal of the American Pharmacists Association
Journal of the American Pharmacists Association
j apha.org
Abbreviation used: CPRPs, community pharmacy residency programs. Totals less than 1,722 responses indicate missing data. a Indicates significance at alpha level of 0.05. b Indicates significance at alpha level of 0.01.
Please indicate how valuable CPRPs are for: Developing skills in disease management Learning to provide quality patient care Developing skills in medication therapy management Learning and using advances in technology Gaining expertise in pharmacy practice management Gaining expertise in business management Learning to develop innovative pharmacy services Learning to implement innovative pharmacy services Developing teaching skills Developing research skills Developing prevention and wellness programs Developing patient education skills Experience with direct patient contact and interaction Enhancing clinical knowledge Enhancing drug information skills Learning about the drug distribution system Providing additional opportunities for employment Opportunities for medical/professional writing Opportunities for giving formal presentations Opportunities in elective rotations
Penultimate-year students (n = 626) No. (%) Not at all Somewhat Mostly Very valuable valuable valuable valuable 30 (4.79) 183 (29.23) 153 (24.44) 178 (28.43) 31 (4.95) 118 (18.85) 183 (29.23) 209 (33.39) 23 (3.67) 78 (12.46) 179 (28.59) 263 (42.01) 44 (7.03) 195 (31.15) 179 (28.59) 124 (19.81) 20 (3.19) 102 (16.29) 198 (31.63) 543 (86.74) 16 (2.56) 66 (10.54) 190 (30.35) 257 (41.05) 18 (2.88) 104 (16.61) 180 (28.75) 227 (36.26) 17 (2.72) 94 (15.02) 176 (28.12) 241 (38.50) 38 (6.07) 162 (25.88) 171 (27.32) 155 (24.76) 163 (26.04) 231 (36.90) 93 (14.86) 41 (6.55) 8 (1.28) 47 (7.51) 121 (19.33) 345 (55.11) 12 (1.92) 41 (6.55) 107 (17.09) 359 (57.35) 13 (2.08) 34 (5.43) 97 (15.50) 375 (59.90) 26 (4.15) 201 (32.11) 185 (29.55) 107 (17.09) 20 (3.19) 136 (21.73) 208 (33.23) 155 (24.76) 23 (3.67) 107 (17.09) 202 (32.27) 177 (28.27) 43 (6.87) 105 (16.77) 171 (27.32) 192 (30.67) 103 (16.45) 235 (37.54) 114 (18.21) 58 (9.27) 75 (11.98) 214 (34.19) 151 (24.12) 71 (11.34) 80 (12.78) 196 (31.31) 145 (23.16) 87 (13.90)
Table 1. Comparison of penultimate- and final-year students’ perceptions of CPRPs Final-year students (n = 1,096) No. (%) Mostly Not at all Not at all Somewhat valuable valuable valuable valuable 65 (5.93) 379 (34.58) 282 (25.73) 240 (21.89) 62 (5.66) 284 (25.91) 314 (28.65) 303 (27.64) 49 (4.47) 195 (17.79) 290 (26.46) 425 (38.77) 114 (10.40) 390 (35.58) 283 (25.82) 172 (15.69) 61 (5.57) 235 (21.44) 336 (30.66) 327 (29.83) 37 (3.38) 177 (16.15) 343 (31.30) 391 (35.67) 40 (3.65) 204 (18.61) 340 (31.02) 365 (33.30) 34 (3.10) 204 (18.61) 343 (31.30) 366 (33.39) 86 (7.85) 320 (29.20) 306 (27.92) 234 (21.35) 262 (23.91) 401 (36.59) 199 (18.16) 84 (7.66) 16 (1.46) 96 (8.76) 264 (24.09) 556 (50.72) 20 (1.82) 97 (8.85) 232 (21.17) 579 (52.82) 24 (2.19) 89 (8.12) 202 (18.43) 614 (56.02) 62 (5.66) 355 (32.39) 315 (28.74) 202 (18.43) 55 (5.02) 260 (23.72) 357 (32.57) 257 (23.44) 42 (3.83) 240 (21.90) 330 (30.11) 313 (28.55) 93 (8.49) 240 (21.90) 316 (28.83) 277 (25.27) 189 (17.24) 414 (37.77) 224 (20.44) 95 (8.66) 129 (11.77) 355 (32.39) 269 (24.54) 170 (15.51) 198 (18.07) 355 (32.39) 229 (20.89) 137 (12.50) P 0.001b 0.001b 0.019a 0.001b 0.000b 0.001b 0.087 0.009b 0.025a 0.066 0.019a 0.012a 0.014a 0.762 0.116 0.219 0.001b 0.99 0.08 0.008b
Research Notes
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Somewhat valuable
562 (32.64) 402 (23.34) 273 (15.85) 585 (33.97) 337 (19.57) 243 (14.11) 308 (17.89) 298 (17.31) 482 (27.99) 632 (36.70) 143 (8.30) 138 (8.01) 123 (7.14) 556 (32.29) 396 (23.00) 347 (20.15) 345 (20.03) 649 (37.69) 569 (33.04) 551 (32.00)
Not at all valuable
95 (5.52) 93 (5.40) 72 (4.18) 158 (9.18) 81 (4.70) 53 (3.08) 58 (3.37) 51 (2.96) 124 (7.20) 425 (24.68) 24 (1.39) 32 (1.86) 37 (2.15) 88 (5.11) 75 (4.36) 65 (3.77) 136 (7.90) 292 (16.96) 204 (11.85) 278 (16.14)
435 (25.26) 497 (28.86) 469 (27.24) 462 (26.83) 534 (31.01) 533 (30.95) 520 (30.20) 519 (30.14) 477 (27.70) 292 (16.96) 385 (22.36) 339 (19.69) 299 (17.36) 500 (29.04) 565 (32.81) 532 (30.89) 487 (28.28) 338 (19.63) 420 (24.39) 374 (21.72)
Mostly valuable
CPRPs (n = 1,722) No. (%)
Abbreviations used: CPRPs, community pharmacy residency programs; HSRPs, health-system residency programs. Totals less than 1,722 responses indicate missing data. a Indicates significance at alpha level of 0.01.
Please indicate how valuable CPRPs (HSRPs) are for: Developing skills in disease management Learning to provide quality patient care Developing skills in medication therapy management Learning and using advances in technology Gaining expertise in pharmacy practice management Gaining expertise in business management Learning to develop innovative pharmacy services Learning to implement innovative pharmacy services Developing teaching skills Developing research skills Developing prevention and wellness programs Developing patient education skills Experience with direct patient contact and interaction Enhancing clinical knowledge Enhancing drug information skills Learning about the drug distribution system Providing additional opportunities for employment Opportunities for medical/professional writing Opportunities for giving formal presentations Opportunities in elective rotations
Table 2. Comparison of students’ perceptions of CPRPs and HSRPs
418 (24.27) 512 (29.73) 688 (39.95) 296 (17.19) 550 (31.94) 648 (37.63) 592 (34.38) 607 (35.25) 389 (22.59) 125 (7.26) 901 (52.32) 938 (54.47) 989 (57.43) 308 (17.89) 412 (23.93) 490 (28.46) 469 (27.24) 153 (8.89) 241 (14.00) 224 (13.01)
Very valuable
31 (1.80) 43 (2.50) 136 (7.90) 59 (3.43) 111 (6.45) 356 (20.67) 115 (6.68) 106 (6.16) 42 (2.44) 47 (2.73) 238 (13.82) 84 (4.88) 110 (6.39) 26 (1.51) 27 (1.57) 99 (5.75) 37 (2.15) 31 (1.80) 25 (1.45) 48 (2.79)
Not at all valuable
205 (11.90) 209 (12.14) 498 (28.92) 328 (19.05) 445 (25.84) 683 (39.66) 493 (38.63) 477 (27.70) 251 (14.58) 189 (10.98) 692 (40.19) 469 (27.24) 463 (26.89) 79 (4.59) 100 (5.81) 434 (25.20) 205 (11.90) 195 (11.32) 126 (7.32) 174 (10.10)
Somewhat valuable
455 (26.42) 511 (29.67) 485 (28.16) 613 (35.60) 524 (30.43) 297 (17.25) 576 (33.45) 586 (34.03) 572 (33.22) 504 (29.27) 367 (21.31) 527 (30.60) 487 (28.28) 223 (12.95) 412 (23.93) 535 (31.07) 462 (26.83) 468 (27.18) 394 (22.88) 400 (23.23)
Mostly valuable
HSRPs (n = 1,722) No. (%)
779 (45.24) 706 (41.00) 343 (19.92) 468 (27.18) 387 (22.47) 124 (7.20) 271 (15.74) 286 (16.61) 592 (34.38) 719 (41.75) 146 (8.48) 359 (20.85) 382 (22.18) 1,103 (64.05) 905 (52.56) 360 (20.91) 720 (41.81) 730 (42.39) 881 (51.16) 805 (46.75)
Very valuable
χ2 153.3 353.9 71.3 454.6 178.7 91.5 172.6 186.5 255.8 161.9 57.2 215.4 192.6 129.1 308.2 260 348.2 176.6 212.4 354.8
P <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a <0.0001a
Research Notes
Journal of the American Pharmacists Association
Research Notes
riences (APPEs) at the time of this survey. If and how APPEs influenced students’ survey responses warrant further investigation. For now, the findings of this study may assist CPRP coordinators, pharmacy educators, preceptors, and pharmacists in addressing, educating about, or reinforcing the value skill sets or educating students about CPRP skill sets, particularly in the transition to the final year of pharmacy school.
Limitations This study used a self-administered survey, which lends itself to nonresponse bias. Readers should be cautioned regarding the large sample size in this study, in that statistically significant differences may not necessarily be important from a practical standpoint. In addition, receiving data from 55 of the 119 schools of pharmacy may limit generalizability of the results.
Conclusion The results of this study suggest students’ perceived value of CPRPs may be related to their year of pharmacy school, the pharmacy practice skill in question, and whether they attended a pharmacy school affiliated with a CPRP. The findings of this study may provide insight into residency match discrepancies and assist CPRP co-
ordinators in addressing skill sets or educating students about skill sets for which students perceive little value is garnered from CPRPs. These findings also have value for pharmacy educators interested in reinforcing the value of CPRPs and for stakeholders interested in expanding the current number of CPRPs. References 1. Stolpe SF, Adams AJ, Bradley-Baker LR, et al. Historical development and emerging trends of community pharmacy residencies. Am J Pharm Educ. 2011;75(8):160. 2. American Society of Health-System Pharmacists. Residency capacity survey results. www.ashp.org/DocLibrary/Accreditation/ Residency-Capacity-Survey-Results.aspx. Accessed July 18, 2012. 3. Unterwagner WL, Zeolla MM, Burns AL. Training experiences of current and former community pharmacy residents, 1986-2000. J Am Pharm Assoc. 2003;43(2):201–6. 4. Schommer JC, Bonnarens JK, Brown LM, Goode JR. Value of community pharmacy residency programs: college of pharmacy and practice site perspectives. J Am Pharm Assoc. 2010;50(3):e72–88. 5. Bonnarens JK. Community pharmacy residency training. J Pharm Soc Wisc. 2004;7(6):60–2. 6. American Society of Health-System Pharmacists. PGY1 Community Residency Directory. www.natmatch.com/cgibin/direct_filedisp.pl. Accessed April 12, 2012.
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