Team-based Learning (TBL) in the Health Professions

by Mallory Pullman, PGY1 Pharmacy Practice Resident, The University of Mississippi Medical Center 

Today, to meet the current healthcare needs of society, health professions students must be able to learn vast amounts of information and have a deep understanding of difficult concepts. In addition to having a comprehensive knowledge base, health professions students must be able to apply this knowledge to varying clinical scenarios.  Further, they must be able to work both independently and in collaboration with others. It is therefore necessary that teaching approaches in health professions education be tailored to these needs, preparing students for their careers. 

One method of learning that is starting to gain traction within health professions education is team-based learning (TBL). TBL is an instructional method that emphasizes self-preparation outside of class followed by the application of the knowledge learned in class. In TBL, courses are typically separated into modules or units and students are assigned to small groups. Before class, students are given materials to review, which they must learn independently. Assigning materials to review prior to class ensures students are responsible for their own understanding and gives students the opportunity to learn the material in a way that is most effective for them.

Then, at the start of each class, students are given an assessment to analyze how well they have learned the material. The assessment is termed an individual Readiness Assurance Test (IRAT).  Students first complete the test as an individual and, then, as a team – an assessment called the group Readiness Assurance Test (GRAT). Both the individual and group scores contribute to students’ grades. After the students complete the team test, they have the opportunity to discuss the material with the instructor and appeal answers they got incorrect. The discussion and appeal process enhances students’ understanding by requiring students to defend their answers. Students also learn by listening to the rationales provided by other teams, providing students with diverse perspectives. To conclude the assessment portion of each class, the instructor may present a brief lecture and lead a discussion on concepts students appear to be struggling with most. To further reinforce students’ learning, the remainder of each class is focused on completing application exercises.¹ 

Before deciding to implement TBL, it is crucial to examine how effective the learning method is, especially in health professions education. Constructivist learning theory, whereby the student “constructs” his/her own knowledge, provides the theoretical basis for TBL. TBL places the responsibility of learning on students by requiring them to be prepared for assessments at the start of each class and be ready to use their new knowledge to solve relevant problems.²  Several studies have shown TBL improves learning. One study assessed the impact of TBL on academic performance during comprehensive course examinations for second-year medical students.³ In a 2-year analysis of 178 second-year medical students, analyzing scores on 28 comprehensive course examinations, the investigators found that grades increased by a mean of 5.9% after TBL implementation, with lower-achieving students reaping a greater benefit.³ The authors concluded that the application exercises, allowing teams to use their aggregated knowledge to solve challenges, and the interaction with peers and faculty, likely contributed to the positive impact on students’ learning.

Similarly, a study conducted by Zgheib and colleagues examined the effect of TBL on learning in a second-year medical pharmacology course.⁴ The researchers evaluated individual and group answers to all IRAT and GRATs, concluding that TBL approaches were more effective than traditional learning methods. While TBL appeared to improve student understanding of difficult concepts, the authors felt the method was not more effective for learning simpler concepts.

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Another advantage of implementing TBL, especially in health professions education, is the opportunity to acclimate students to working in teams. In the health professions, it is common for physicians, pharmacists, nurses, and other medical professions to work closely together to solve complex medical problems. Using TBL methods in the classroom, where students practice listening to one another and sharing knowledge to solve challenges can prepare students for collaborating with health profession colleagues throughout their careers. Overall, TBL not only improves academic performance and students’ understanding of difficult concepts, it gives students an opportunity to practice the team-work skills they will need throughout their careers.

The potential advantages of the TBL method provide enough justification for health profession educators and programs to implement this learning technique. Health professions educators can implement TBL techniques by simply requiring students to self-prepare outside of class and reserving class time for group interaction.  To hold student accountable for pre-class work, it is important to use reinforcement examinations. This pre-class work is critical for the discussions and application exercises to be successful.

However, there are a few logistical issues that educators should consider before implementing TBL in their courses. First, educators must consider how they will form student teams. In order to develop group cohesion, TBL groups should remain the same throughout the duration of the course. Ideally, teams should be strategically formed based on three principles: 1) teams should be assigned by the instructor - not student-selected; 2) teams should be as diverse as possible; and 3) the selection process should be transparent.⁵ Implementing these principles allows the development of diverse groups that bring different strengths and experiences to the discussion and application exercises. In addition to discussing how team assignments were made, educators must orient students to the TBL method by explaining pre-class preparation, application exercises, and the readiness tests. Ensuring that students have a complete understanding of TBL and its benefits is essential for students and co-instructors.  Getting everyone’s commitment is critical when implementing a novel teaching approach. Using the principles of instructional design, considering the design, development, and implementation of each instructional unit, are fundamental to the success of TBL. 

References:

1. What is TBL?. Team Based Learning Collaborative. Published 2019. Accessed October 23, 2019.
2. Brame C. Team-based learning. Vanderbilt University. Published 2019. Accessed October 23, 2019.
3. Koles, P. et al. The Impact of Team-Based Learning on Medical Students’ Academic Performance. Academic Medicine 2010;85(11): 1739-45.
4. Zgheib N. et al. Using team-based learning to teach pharmacology to second-year medical students improves student performance. Medical Teacher 2010;32(2):130-5. 
5. Getting Started with TBL. Team Based Learning Collaborative. Published 2019. Accessed October 24, 2019.

Generational Differences and Its Impact on Teaching and Learning

by Hannah Daniel, PharmD, PGY-1 Pharmacy Practice Resident, University of Mississippi Medical Center

People from different generations routinely interact in higher education today and generational differences impact the learning environment. Members of Generations Y, also known as Millennials, and Z make-up the majority of the health professional students with most faculty members being members of earlier generations, primarily Generation X and Baby Boomers. The learning environment is significantly different for each generation. Millennials are accustomed to instant gratification, technologically advanced learning, and interactive activities aimed at providing lots of stimulation to stay engaged. Generation Z is accustomed to even higher levels of digital technology and connectedness, which will potentially lead to greater expectations for customized instruction for each student.¹ With so much focus on technology and the need for constant stimulus, faculty members are challenged to teach in ways that are quite different from the ways they were taught. Marc Prensky in his essay about the differences between digital natives and digital immigrants makes an intriguing point: “Today’s students are no longer the people our education system was designed to teach.²” Current literature suggests we should be adapting to the learner; however, it is unclear if learning outcomes are improved.  This raises an important question:

“Should teachers make adjustments in their teaching methods to accommodate students from a different generation?”

To understand some of the generational differences between students and faculty, one can compare leadership style preferences between generations. In 2018, the American Journal of Pharmaceutical Education (APJE) published an article about leadership styles reflecting generational differences in the academy. The four leadership styles they described included:

• Classic entrepreneur: Competitive and opportunistic
• Modern missionary: Looks for significance and meaning to promote impact
• Problem solver: Focuses on concrete results; values top-down experiences and a “take-charge” approach
• Solution finder: Modest and humble

Baby Boomers, those primarily exposed to male and military leaders, tend to lean towards a problem solver style. On the other hand, Millennials have a tendency to lean towards a modern missionary or solution finder style.³ The difference in styles also reflects learning styles. Baby Boomers thrive on concrete information and structure while Millennials strive for more hands-on and less structured approaches.

The majority of current faculty were taught in a traditional and passive manner.  They were encouraged to read the material and to take notes in class. Although these methods of learning are effective, today’s students struggle to learn in this environment due to a strong desire for hands-on and more interactive methods. Some programs have transitioned away from teacher-centered approaches to more learner-centered methods, such as problem-based learning, to adapt to a new generation of learners. A major reason to adapt teaching methods is premised on the idea that “successful students are those that are engaged during the learning process,” which means using strategies that motivate your students. One study conducted at Creighton University in Nebraska compared pre-test scores vs. post-test scores and average time spent on a case between an interactive computer-based case and a standard paper-based approach. While students assigned to the computer-based case group scored slightly higher on their pre-test and post-test and spent less time on the case, none of these results were significant.¹

However, not all students in the same generation share the same learning preferences. Some students learn best in traditional ways while others learn best when interactive methods are employed. Thus, it can be argued that adapting teaching styles to match students’ preferences is not infeasibility or wise. Moreover, exposing students to different learning methods will challenge them, leading to better educational outcomes, and teaching them to be more adaptable. In a study conducted at Texas Tech University Health Sciences Center School of Pharmacy, students on rotation and preceptors completed the validated Pharmacist’s Inventory of Learning Styles (PILS) questionnaire to identify their dominant learning styles. The investigators found that, although this information helped guide the preceptors to challenge students, it did not impact student or preceptor performance — even when the preceptor adapted his/her teaching methods to better align with the student’s preferred learning style.⁴ Even though this study did not specifically address classroom-based instruction, it provides some insights regarding the use of individualized instruction using the student’s preferred learning style as well as their non-preferred styles.

It seems clear there must be a compromise between students and educators. Educators should not be expected to change their entire way of teaching.  Similarly, students should not be expected to change their entire way of learning. Educators can incorporate active learning strategies into their traditional lectures to increase motivation and engagement. By adding versatility to their teaching repertoire, educators will be able to reach a wider range of students.¹ Examples of active learning that can be incorporated into a lecture include the following:

• Problem-solving exercises
• Think-pair-share
• Short demonstrations followed by a class discussion

It is also useful, after lecturing for 20-30 minutes, to pause for five to ten minutes, allowing students to work together in pairs or groups to recall, clarify, and elaborate on the material before moving forward. Another way to engage students is to ask five to ten questions related to the most pertinent material from the previous class session to stimulate recall before the start of class.⁵

There are generational differences between students and educators, leading to different learning preferences. Although impractical for educators to tailor their teaching methods to each student’s learning style, it is important for all, students and educators alike, to acknowledge the changing dynamics between generations and be open to all styles of learning. Again, “successful students are those that are engaged during the learning process,” but responsibility for engagement does not fall solely on the educator. Educators should not make major adjustments to what they do but rather find common ground. Students should be open to different ways of learning to challenge themselves and increase their adaptability.

References:

1. Pick A, Begley K, Augustine S. Changes in teaching strategies to accommodate a new generation of learner: A case study. Pharm Educ. 2017;17(1):95–99.

2. Prensky M. Digital natives, digital immigrants. MCB University Press, 2001. Accessed 31 October 2019.
3. Boyle CJ, Gonyeau M, Flowers SK, et al. Adapting Leadership Styles to Reflect Generational Differences in the Academy. Am J of Pharm Educ. 2018;82(6): Article 6886. doi.org/10/5688/ajpe6886.
4. Robles J, Cox C, Seifert C. The impact of preceptor and student learning styles on experiential performance measures. Am J Pharm Educ. 2012;76(7): Article 128. doi:10/5688/ajpe767128.
5. Promoting active learning. Standford: Teaching Commons. Accessed 4 November 2019.

Smartphones and Applications: Teaching Student Pharmacists to Appropriately Use Them

by Dylan B. Ware, PharmD, PGY1 Pharmacy Resident, Baptist Memorial Hospital-North Mississippi

I once heard a classmate say: “I don’t have to know this off the top of my head.” “Just Google it” and “Hey Siri” are other common phrases that I hear quite often from pharmacy students. Honestly, I have been guilty of expressing statements similar to these when I was a student. However, as a pharmacist now, I approach this form of thinking quite differently.

When I was enrolled in pharmacy school, I had the opportunity to hear many professors speak about their educational experiences when they were a student. These conversations helped me understand the differences in the learning methods and examination processes between my professors’ experiences compared to mine. Each of these conversations always seemed to have one commonality; they did not have access to online resources and smartphones like pharmacy students have today. The Internet and smartphones have become a huge part of American culture over the past ten years. The Pew Research Center reports that about 96% of people in the United States own some kind of cellphone and the vast majority of those people own a smartphone.¹

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Healthcare professionals and students use smartphones that are capable of downloading applications to assist with daily functions. Healthcare professionals can use applications for information management, time management, reference and information gathering, and clinical decision making.² Information management incorporates an easy way to write notes, take photographs, and organize information on smartphones.² Smartphones allow healthcare professionals to manage their time by scheduling appointments and meetings.² Most medical textbooks, medical literature sources, and drug reference guides have smartphone applications for health care professionals to download and use.² Clinical decision-making tools such as treatment guidelines, diagnosis aids, medical calculators, and laboratory test interpretations can all be found through applications available on smartphones.²

Pharmacy students should be taught to utilize tertiary resources such as Micromedex^®, Clinical Pharmacology, and Lexicomp^®. Each of these sources has a personalized mobile application that can be readily accessible in the palm of a hand.  But how should we teach student pharmacists to appropriately use these applications? I have found it effective to first explain some purposes of these applications which include: finding dosing recommendations, looking up drug interactions, adjusting medications for renal and hepatic dysfunction, and understanding how to explain adverse effects and counseling points to patients. Once the purpose of these applications is understood, teaching students how to use and apply the information is a vital skill.

The University of Mississippi School of Pharmacy has partnered with my residency site, Baptist Memorial Hospital-North Mississippi, to host second-year student pharmacists as they complete their Introductory Pharmacy Practice Experiences (IPPEs). Some of the educational activities that the student pharmacists complete include: gathering a medication history and performing a medication reconciliation, reviewing medical records for laboratory monitoring data, and participating in discharge counseling. As a preceptor for these student pharmacists, I have taught them how to use Micromedex^®, Clinical Pharmacology, and Lexicomp^® to complete these activities.

1.   Medication history with reconciliation

a.  Using these applications to look up medications that are unfamiliar to the student pharmacists and understanding their indications for use

2.   Chart review with laboratory monitoring

a.  Reviewing a patient’s lab values and using these applications to look up important monitoring parameters of each medication to ensure the medication is safe and effective for each patient

3.   Discharge counseling

a.  Looking up every medication the patient is expected to take after hospital discharge and using the counseling section of these applications to ensure all information is discussed before discharge

However, there will be certain situations in clinical practice where instant drug recall is needed. Examples include: treating cardiac arrest, stabilizing critical care patients, and creating repertoire with other health care professionals when pharmacy specific questions are needed immediately. In these situations, we should teach student pharmacists that using these smartphone applications is not feasible and being able to respond immediately is critical.

When else should students be taught they cannot use smartphone applications? That would be for examinations that prepare students for licensure: the NAPLEX^® and MPJE^®. The NAPLEX^® first-time pass rate was 94.9% in 2014 and dropped to 89.5% in 2017.^3,4 In a recent commentary published in AJPE, the authors discuss possible explanations for the decreasing pass rates, including diminished exam preparation, declining academic ability, and the increasing difficulty of the NAPLEX^®.³ Additionally, the authors speculate that smartphones may be affecting students' ability to apply and recall information.³  In a recent study, the investigators found that  "when people expect to have future access to information, they have lower rates of recall of the information itself and enhanced recall instead for where to access it."⁵ It's true that smartphones are capable of replacing some cognitive functions.⁶ But student pharmacists should be taught early in their pharmacy school curriculum that smartphones are not allowed on the NAPLEX^® and MPJE^®. Therefore, immediate recall of information learned during pharmacy is required to successfully pass the board examinations.

Learning or memorizing all the information about every single drug available is impossible. Smartphone applications obviously have a role. Therefore, student pharmacists should be taught about how to effectively use tertiary resources such as Micromedex^®, Clinical Pharmacology, and Lexicomp^®. However, they should understand the difference between when it is appropriate and not appropriate to use smartphone applications. All student pharmacists should have a strong fund of knowledge that is not dependent on checking a smartphone and should be lifelong learners.

References:

1. Pew Research Center Internet and Technology. Mobile Fact Sheet. 2019 June 12.
2. Ventola CL. Mobile Devices and Apps for Health Care Professionals: Uses and Benefits. PT. 2014 May;39(5):356-364.
3. Fjortoft N, Getting J, Verdone M. Smartphones, Memory, and Pharmacy Education. American Journal of Pharmaceutical Education. 2018;82(3) Article 7054.
4. National Association of Boards of Pharmacy. NAPLEX Pass Rates August 2019.
5. Sparrow B, Liu J, Wegner DM. Google effects on memory: cognitive consequence of having information at ourfingertips. Science. 2011;33396043):776-778
6. Wilmer HH, Sherman LE, Chein JM. Smartphones and Cognition: A Review of ResearchExploring the Links between Mobile Technology Habits and Cognitive Functioning. Front Psychol. 2017;8:605.

Why Self-Assessment and Life-Long Learning Go Hand-in-Hand

By Brie Holmes, PharmD, PGY1 Pharmacy Practice Resident, Magnolia Regional Health Center

 

Healthcare is advancing and expanding at an astounding rate. Now, more than ever, healthcare professionals must take the initiative to learn about new technology, diagnoses, and treatment options to provide the best care to patients.¹ Healthcare practice is rooted in trusting patient/provider relationships, and healthcare professions are expected to continually expand their knowledge. It is simply not adequate to rely on one’s initial education and training or the required continuing education hours to stay well informed about the latest developments.² Instead, healthcare professionals must take responsibility and be self-directed learners to remain competent throughout their career.

Self-assessment methods and the utility of those methods has been well studied. Research has shown that those who regularly engage in a self-assessment process have increased academic achievement and workplace performance.¹ Andrade defines self-assessment as “…a process of formative assessment during which students reflect on and evaluate the quality of their work and learning, judge the degree to which they reflect explicitly stated goals or criteria, identify strengths or weaknesses in their work and revise accordingly.”³ There are other definitions of self-assessment, but all sources agree that it is a process with the goal of continuous improvement involving an intrinsic evaluation of one’s knowledge and performance, recognizing one’s own deficits, and implementing a plan to correct identified deficits. Because there is a clear expectation for healthcare professionals to stay up-to-date on new research, there is also an expectation that healthcare professionals skillfully use self-assessment techniques to accomplish this. Despite what’s known about effective self-assessment methods and their benefits, there are numerous studies showing the general inability of students and healthcare providers alike to accurately assess their knowledge and skills and, therefore, effectively address deficits. In fact, only 45% of the studies included in a systematic review of the physician literature showed a positive relationship between self- and external assessments.³ Not only is this a disservice to oneself as a professional, but it is also a disservice to our patients who have trusted us to provide the best care possible.

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Multiple studies have suggested students and some providers are not able to correctly assess their learning needs.  One possible explanation is that students have grown accustomed to dependent learning. Historically, evaluation of knowledge has largely been done using exams. This external form of evaluation often creates dependent learners who have very little intrinsic consideration or responsibility. Dependent learning can quickly dissolve motivation to gain knowledge outside of what will be on an exam and instead encourages memorization, resulting in a reliance on external motivation and validation.³ This process does not adequately equip students with the necessary skills required for work after graduation as they are not prepared to take the initiative to identify their learning needs or to address perceived deficits. After graduation, there will no longer be someone who will identify the student’s learning needs or direct them to appropriate learning activities.¹ Thus, educators can and should incorporate self-assessments early in the curriculum to teach students this important skill so that they can apply it in the real world.⁵

Developing good self-assessment skills can also improve the learner’s willingness to accept feedback as well as develop their self-confidence.³ It is well-accepted that self-assessment is a learned skill.  It not something that most people “just naturally” know how to do. Because of this, the Accreditation Council on Pharmacy Education has stated that self-assessment should be integrated into the pharmacy curriculum early and continued throughout the curriculum.³ Additionally, the American Medical Association considers self-assessments to be a vital professional skill and has suggested guided self-assessments be incorporated at the earliest possible stage in medical training.⁴ The key to guiding self-assessments is ensuring the student receives quality external feedback. Some examples of activities educators could incorporate that would provide an opportunity for self-assessment coupled with external feedback is an Objective Structured Clinical Examination (OSCE), particularly if they are videotaped and reviewed by the student.  Problem-based learning cases and independent learning projects can also be used, whereby students compare their self-assessment of their performance to external evaluations using rubrics.^1,3

If educators want their students to be competent and successful healthcare professionals who embrace the notion of continuous professional development, they must instill the importance and benefits of self-assessments and stimulate increased motivation to engage in the process.³ As research continues to show the clear benefits of self-assessment, accrediting bodies require health professional programs to include self-assessments.  Self-assessment techniques should be introduced early in curriculums alongside external assessments.  This will help students learn the vital skill of identifying deficits and critically evaluating their work.  In this way, students will be better prepared for post-graduation work and lifelong learning. Furthermore, self-assessments should prompt students to consider their personal and professional goals while equipping them with the tools necessary to achieve those goals. Without effective self-assessment strategies, healthcare professionals will not be adequately prepared for lifelong learning in a field that is constantly expanding and changing.

References

1.    Guglielmino LM. The case of promoting self-directed learning in formal educational institutions. South African Education Journal. 2013;10(2):1-18.

2.    Asadoorian J, Batty, H. An evidence-based model of effective self-assessment for directing professional learning. Journal of Dental Education. 2005;69(12):1315-1322.

3.    Motycka CA, Rose RL, Ried LD, Brazeau G. Self-assessment in pharmacy and health science education and professional practice. Am J Pharm Educ 2010;74(5) Article 85.

4.    Duffy FD, Holmboe ES. Self-assessment in lifelong learning and improving performance in practice. JAMA 2006;296(9):1137-1139. doi: 10.1001/jama.296.9.1137

5.    Adachi C, Tai JH-M, Dawson P. Academics’ perceptions of the benefits and challenges of self and peer assessment in higher education. Assessment & Evaluation in Higher Education. 2017;43(2):294-306. doi:10.1080/02602938.2017.1339775.

The Importance of Financial Management Courses for Professional and Graduate Students

by Heidi Ott, PharmD, PGY1 Pharmacy Practice Resident, G.V. (Sonny) Montgomery VA Medical Center, Jackson, MS

It is no surprise that the cost of attending college is expensive. Pursuing professional or graduate degree, such as a PharmD or PhD, is even more costly. The average annual tuition for graduate programs ranges between $30,000-$40,000.¹ These programs typically 4 years, so those annual tuition fees really add up. How are students supposed to afford this? Well, they become very familiar with Sallie Mae, Direct Plus, and numerous other loan programs. Nearly 85% of pharmacy students borrow money to pay for their degree and their average loan debt is $166,528.²



Students must take ownership and accept responsibility for their financial futures. While some things may be out of their control, students have choices that can affect their education-related debt. It can be tempting to use student loans to support a lifestyle that unnecessarily escalates debt burden. Thus, it is important for students to learn how to manage their finances appropriately; otherwise, they could spend a lifetime carrying around student loans.¹

A cross-sectional study assessing graduating pharmacy students’ attitude toward debt revealed that fear of debt was correlated with higher perceived levels of stress and higher student loan amounts.³ Conversely, increased contemplation and knowledge about loans was associated with lower amounts borrowed. The authors concluded that educational programming concerning loans, debt and personal financial management might help reduce student anxiety as well as the amount borrowed.

Financial/debt management courses should be included in the curriculum for all graduate and professional degree programs because the prevalence and amount of debt among these students is so high. These courses should be structured in such a way that students are required to actively design their own financial plans. There are many books available to help with money management and some of these books (i.e. Personal Finance for Dummies) are used in personal finance courses. While these books are great resources, they are not a substitute for a well-designed course led by an experienced instructor.

A report in American Journal of Pharmaceutical Education entitled An Elective Course in Personal Finance for Health Care Professionals provides insight into how to design and implement a financial/debt management course.⁴ The course was offered as a 1.5 credit course to second-year students in an accelerated, 3-year Doctor of Pharmacy (PharmD) program. The course met for 1.5 hours per week for 10 weeks. Educational outcomes of the course were to provide to students the knowledge and skills to:

• Develop a plan to achieve financial goals
• Create and evaluate a personal budget
• Plan insurance strategies for property, health, disability, and life risks
• Analyze credit and loan vehicles
• Understand basic investment concepts regarding stocks, bonds, and mutual funds
• Compare and contrast options involved in deciding whether to rent or purchase a home
• Prepare income taxes
• Facilitate a discussion with financial professionals using appropriate terminology

The course coordinator chose to focus on active learning techniques instead of using examinations to test the mastery of the learning objectives. Student grades were based on participation during lectures and completion of a series of assignments. Students who turned in consistent and thoughtful assignments received full credit; while, an assignment not thoughtfully prepared was given back to the student to redo. The assignments that seemed to have the greatest impact on the students included the personal budgets, credit card comparison assignment, debt reduction worksheet, personal property inventory, and the tax return exercise. Students took the JumpStart Financial Literacy Survey prior to the course and at the end of the course. The students’ mean score prior to receiving any instructions was 60% and improved significantly with the mean post-assessment score reaching nearly 90%.⁴

Students today often prefer to learn using technology and social media platforms. One potential way to provide instruction on financial/debt management would be to use the online program called Your Financial Pharmacist.⁵ This course provides a systematic approach to creating your own financial freedom strategy. A strength of this program is that it offers a private online group for students to interact with one another and get personal help. However, one challenging element is that all the modules/materials are only available online. While some students prefer online instruction, other students will likely require face-to-face guidance. This course offers resources, such as a zero-based budgeting template, the Public Service Loan Forgiveness (PSLF) checklist, and a student loan milestone checklist. In addition to these resources, Your Financial Pharmacist offers benefits exclusively to student members of the American Pharmacists Association (APhA) including member-only webinars, podcast episodes, financial advice articles, and financial consultations with the Your Financial Pharmacist team.⁶

A longitudinal analysis of East Tennessee State University Class of 2014 pharmacy graduates examined the association between completion of a personal finance elective course in pharmacy school and post-graduation personal finance behaviors. Eighteen months following graduation, this analysis revealed that students who took the personal finance elective were significantly more likely to develop monthly budgets and report positive career satisfaction when compared to students who did not.⁷ It is clear that these courses are well-received and students likely used the information from the course to build a more successful financial future.

Ultimately, access to financial/debt management courses may give students in graduate and professional degree programs greater self-assurance about their financial future. This can result in greater independence, job satisfaction, and, ultimately, better patient care. It is important to make updates/revisions to the instructional design of these courses to keep students engaged. Some revisions that should be considered are adding technology into the course using podcasts, blogs, and online private groups to help students communicate with financial advisors and peers.

References 

1. Cain J, Campbell T, Congdon HB, et al. Complex Issues Affecting Student Pharmacist Debt. American Journal of Pharmaceutical Education. 2014; 78 (7): Article 131. Accessed 29 September 2019.
2. American Association of Colleges of Pharmacy Graduating Student Survey: 2018 National Summary Report. Office of Institutional Research and Effectiveness. Accessed 30 September 2019.
3. Chisholm-Burns MA, Christina SA, Jaeger MC, Williams J. Association between Pharmacy Students’ Attitudes Toward Debt, Stress, and Student Loans. American Journal of Pharmaceutical Education. 2017; 81 (7): Article 5918.
4. Chui MA. An Elective Course in Personal Finance for Health Care Professionals. American Journal of Pharmaceutical Education. 2009; 73 (1): Article 6.
5. Your Financial Pharmacist: Student Resources 2019. Accessed 01 October 2019.
6. American Pharmacists Association: Financial Education 2019. Accessed 01 October 2019.
7. Hagemeier NE, Branham T, Ansari N. Personal Finance Beliefs and Behaviors: A Longitudinal Analysis of Pharmacy Graduates. American Journal of Pharmaceutical Education. 2016; 80 (5): Article S2.