September 25, 2014

Consumerism and Entitlement: What is Education Worth?

by Gina Stassinos, Pharm.D., Clinical Toxicology Fellow, Maryland Poison Center and University of Maryland School of Pharmacy

Recently, I took advantage of Maryland’s tax free week and bought myself a few clothes. I wasn’t entirely sure of a few purchases.  So I asked about the return policy. Indeed, I later discovered that some things didn’t fit me well.  Economic exchanges can be a risk, especially large economic exchanges. What if that product being purchased was an education? A professor at a graduation ceremony once told the class that, unlike other things that can be lost, an education can’t be taken away from you. An education may be the single best investment anyone can make.  But I’ve heard some graduates say they would not make the same decision to pursue pharmacy as a career path or enroll in a specific program or school if they could do it over. Indeed, this question was included on the Pharmacy Alumni Survey distributed by the American Association of Colleges of Pharmacy and the Accreditation Council for Pharmacy Education.

It is difficult to believe that the value of an education could be in disputed. Like the dress sitting in my closet, some people haven’t gotten much use out of their degree.  Some degrees are tied to a specific set of skills that have perceived value in the marketplace. But if the necessary skill set changes or demand shifts, the anticipated return on investment will be diminished or lost. There are also people who enroll in a specific school only to find the culture isn’t a good fit for them.  Lastly, educational value can be viewed from a quality standpoint. Teachers and schools today are ranked and evaluated based on numerous parameters.

These “value” propositions often espouse an ideology that view students as consumers — consumers entitled to a quality produce at a reasonable (competitive) price.  Students (the consumers) are not accountable for the quality of the product.  Rather, an education is something to be purchased and it is a means to employment. Academic entitlement is a term used to describe the tendency of students to expect academic success without taking personal responsibility for achieving the success. Entitled behaviors include being overly critical of instructors, contesting grades, demanding accommodations, and arriving late to class.1  A number of causes have been identified.  The millennial generation has been described as coddled narcissists.  There has been a rise in the number of market-driven degree programs and for-profit educational institutions.  Moreover, consumerism — societal trends to acquire ever increasing amounts of goods and services as well as to protect consumers against useless, inferior, or dangerous products — has become pervasive.2 Several negative consequences of academic entitlement and student consumerism have been described. The rigorousness of instruction and school-wide morale are reduced when professors must cater to student desires and are pressured to make the “numbers look good” by inflating grades.  When the student is a consumer, teachers and schools are more apt to tolerate unprofessional behaviors.  In the end, more graduates may be unemployable because they lack the knowledge, skills, and attitudes needed.

Are students today really entitled narcissists? Academic entitlement is certainly not new.  It has been described as early as 1986.3  A study conducted at Roseman University of Health Sciences attempted to develop an objective and measurable way to identify individuals who are “academically entitled.”  They found that only 10% of their graduating students (14 out of 141) were “academically entitled” based on the criteria they developed.2  In the end, the authors concluded that there is a lack of empirical data about whether academic entitlement is a growing problem.

Let’s look at student consumerism using a different variable – the cost of education. A study comparing national data regarding pharmacy and other health care professions found that pharmacy students’ total debt increased 23% over the last 5 years compared to 4.7% for dental and 8.5% for medical students. It also found that the return on investment expressed as a ratio of average salary to indebtedness was now below 1.0 and the number of pharmacy positions in the United States is no longer increasing.4 The authors concluded that institutions were shifting are greater cost burden to students. It could be that students are painfully aware of their degree of indebtedness and as cost increases so do their expectations.

What is the solution to student consumerism and risky educational investments? Many have proposed to decrease tuition, increase government regulation, or decrease the number of graduates.  In reality, controlling the ebb and flow of an economy isn’t easy.  Centrally controlled economies (think the old Soviet Union and Eastern Block countries!) don’t have a particularly good track record.  Most agree that an undue cost burden should not be placed on students as this fuels consumerism. Some experts believe that academic entitlement in health professional education can be combatted by rightfully acknowledging that the patient is the consumer (not the student).5

Instructors should be prepared to face entitled students by increasing their awareness of the issues and cautiously considering student demands, and designing assessments that reinforce student accountability.1  
All consumers, whether they are buying a dress or paying for tuition, should accept that there is risk in their decisions. It is common practice to assign value to intangible assets, like a college degree, more can be done to measure the quality appropriately.6  More objective data is needed to differentiate reasonable student requests from entitled ones. Student requests may be reasonable when they are based on four fundamental rights: 1) opportunities to learn, 2) to learn from faculty members dedicated to the best teaching practices, 3) to learn within a curriculum designed to prepare them for the profession, and 4) to have access to resources necessary to succeed.7 Clothing stores may go out of business and clothes will get used and thrown away, but education lasts a lifetime.  There will always be patients needing high quality providers. The focus should not be on whether the purchase should occur or if it fits just right, but on how we can enhance its value and take pride in our profession.

  1. Cain J, Romanelli F, Smith KM. Academic Entitlement in Pharmacy Education. Am J Pharm Educ 2012; 76: Article 189.
  2. Jeffres M, Barclay SM, Stolte SK. Academic Entitlement and Academic Performance in Graduating Pharmacy Students. Am J Pharm Educ 2014; 78: Article 116.
  3. Dubovsky SL. Coping with entitlement in medical education. N Engl J Med. 1986;315:1672–1674
  4. Cain J, Campbell T, Cogndon HB, et al. Pharmacy Student Debt and Return on Investment of a Pharmacy Education. Am J Pharm Educ 2014; 78: Article 5.
  5. Holdford DA. Is a Pharmacy Student the Consumer or the Product? Am J Pharm Educ 2014; 78: Article 3. 
  6. Cain J, Noel Z, Smith KM, Romanelli F. Four Rights of the Pharmacy Educational Consumer. Am J Pharm Educ 2014; 78: Article 115.
  7. Fazlagic A. Measuring the intellectual capital of a university. Paper presented at: Conference on trends in the management of human resources in higher education; 2005 Aug 25-26; Paris, France.

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