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
- 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.
- American Association of Colleges of Pharmacy Graduating Student Survey: 2018 National Summary Report. Office of Institutional Research and Effectiveness. Accessed 30 September 2019.
- 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.
- Chui MA. An Elective Course in Personal Finance for Health Care Professionals. American Journal of Pharmaceutical Education. 2009; 73 (1): Article 6.
- Your Financial Pharmacist: Student Resources 2019. Accessed 01 October 2019.
- American Pharmacists Association: Financial Education 2019. Accessed 01 October 2019.
- 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.
by Alicia Rogers, Pharm.D., PGY-1 Pharmacy Resident, Baptist Memorial Hospital-North Mississippi, Oxford, Mississippi
In recent years, there has been lots of discussion about whether to require students to attend class for lectures and then later allow students access to recordings of the lectures. Until recently, I didn’t quite understand why this was such a hot topic or what all the fuss was about. My thoughts were simple. If students wanted to skip class and watch lectures at a later time, let them. However, as I’ve come to understand, there is bigger picture. It’s not simply about convenience or preferences, it’s about student learning. Does allowing students to have remote and later access to recorded lectures affect students’ long- term memory and performance? I decided to take a deeper look.
Recently, investigators at the University of North Carolina Eshelman School of Pharmacy published a study entitled “Exploring the Consequences on Memory of Students Who Know They Have Access to Recorded Lectures.”2 I found the results very interesting and contrary to my assumptions. The study included to two parallel groups: students with access to a recording of a lecture after the lecture was delivered and students who did not. The goal of this study was to test immediate recall performance and to gauge performance during delayed recall. Students with access to recorded lectures had the option to repeatedly view the material. Students without access would need to find other means to review the material. This study found that there was increased performance in delayed recall with the group with assess to lectures. However, access to recorded lectures was not beneficial from any other standpoint and there was a suggestion that knowledge of assess to recorded lectures could have negative effects on memory and encoding long-term.2 In their discussion, the authors explore two educational theories which may explain this finding: The Efficient Encoding Hypothesis and The Desirable Difficulty Hypothesis. When students have access to recorded lectures, taking fewer notes reduces the quality of brainpower to learn because no real work is required to support the commitment to long-term memory. There was also evidence to support The Efficient Encoding Hypothesis whereby students with no access took fewer notes, but in turn, paid more attention to the initial lecture for greater understanding.2 These results were completely different than what I thought would be true.
One major problem I have with this study is the conditions under which it was conducted. It was a simulation. Thus, the study lacked "real life" variables and consequences. This might play a major role in students' behaviors and subsequent performance. Performance and memory are dependent on several intrinsic factors, including motivation.
The authors should be applauded for considering some important instructional design principles to help students learn effectively in their study. Microlearning, spaced learning, and retrieval were all used. Microlearning is providing instruction in short snippets such 5-15 minute videos.3 Spaced learning is the act of repeating information to learners over time instead of relaying all of the information in a single session. Spaced learning substantially improves long-term encoding and may boost learning by as much as 200%.3 Lastly, retrieval involves improving retention and performance by asking questions. All three learning strategies were used in both groups. Research suggests that these strategies help learners refresh their knowledge and strengthen their memory of the content.
These instructional design strategies are routed in several theories in education psychological including behaviorism, cognitive learning theory, and constructivism. Behavioral psychology advocates repetition and reinforcement in learning material to create a “behavior” in the learner. Cognitive psychology focuses on engaging the learner’s senses to create a learning process, while constructivism emphasizes the learner’s own experience and personal interpretation.1 There are intrinsic factors that play a role in learning including motivation and how individuals encode information. It would be expected that students that re-watch recorded lectures would have increased retention. Although re-watching recorded lectures is not the only means to increase retention, it does provide an opportunity for repetition.
As a former pharmacy student, access to recorded lectures allowed me to reinforce the information that was initially covered during a face-to-face lecture. There are times when students can be distracted during a lecture — after 1 or 2 hours, who wouldn’t get distracted! Having access to recorded lectures allows student access to materials they may have missed during the live session. Some students use recordings in order to fill in gaps in their notes and to help with a better understanding of the course material. When re-watching lectures, students can slow down the speed and this can be helpful to some students who need a bit more time to fully understand what the teacher is saying (e.g. students whose primarily language is not English).
We are in the technology age. Millennials are accustomed to online learning and having information available at their fingertips 24/7. Many people enjoy the convenience of technology and take advantage of learning on-the-go. As a student, I enjoyed being able to re-watch lectures in the comfort of my own home so that I could focus on understanding the information without interruptions. I believe students can get more out of lectures when they do not have a constant stream of distractions. Distractions are a common problem in the classroom. Thus, not having access to recorded lectures after class would be detrimental from some, if not most, students.
So, while this study is intriguing, I do not think denying access to recorded lectures is the best strategy to enhance recall and long-term memory. Indeed, there was no difference in performance when students re-studied using a recorded lecture when compared to when students retrieved information through questioning.4 While the overall group performance was similar, there are likely individual differences and some students would undoubtedly perform better using one reinforcement strategy versus another.
In my opinion, this study was flawed. The study was not conducted under “real life” conditions and the subject matter (astronomy) was unrelated to anything that a pharmacy student would ordinarily study. Moreover, students are expected to learn and retain information from multiple courses and subjects simultaneously. In a pharmacy curriculum, knowledge builds on itself. Students often use previously learned material to help bring together their understanding and “just-in-time” access to recorded lectures can be very helpful. So, while access to recorded lectures might not be helpful in simulated learning environments like this study, it doesn’t appear to be harmful. So, if it’s not broken, why fix it?
References
1. Little B. Principles of instructional design. Retrieved from https://www.mindtools.com/blog/corporate/principles-instructional-design/ Accessed on October 6, 2019.
2. Patel B, Yook G, Mislan S, and Persky A. Exploring the consequences of memory of students who know they have access to recorded lectures. American Journal of Pharmaceutical Education 2019; 83(5): Article 6958. Retrieved from https://www.ajpe.org/doi/full/10.5688/ajpe6958
3. ShifteLearning. Use these 5 instructional design strategies to create an effective e-learning course. Retrieved from https://www.shiftelearning.com/blog/instructional-design-strategies-effective-elearning Accessed on October 6, 2019.
4. Palmer S, Chu Y, and Persky A. Comparison of re-watching recording and retrieval practice as post-class learning strategies. American Journal of Pharmaceutical Education 2019; Publication Ahead of Print. Retrieved from https://www.ajpe.org/doi/pdf/10.5688/ajpe7217
