Editor's Note: Aligning the Practice Community and Academia

JUNE 01, 2008
James C. McAllister III, MS, FASHP

Mr. McAllister is a health-systems consultant based in Chapel Hill, North Carolina.

For years, I have heard practitioners from virtually all practice settings complain about schools of pharmacy failing to prepare professional students for practice following graduation. Although I understand their concerns and recognize that some students are not prepared to step into the shoes of an experienced pharmacist their first day on the job, I also know that a recent graduate's drug knowledge is vastly superior to the curriculum provided to me many years ago. Schools of pharmacy have a daunting task in terms of meeting the expectations of diverse employers regarding a new graduate's capabilities. A host of factors, such as growing class sizes, shrinking budgets, dwindling research funding, competitive salaries for faculty, and faculty retention, contribute to the conundrum.

Changes in academia itself may have an even more profound impact on new graduate preparedness. The proliferation of distance learning and Web-based course work, which does not require class attendance, minimizes the socialization and professionalization that historically occurred during students' college experience.

I understand that new teaching techniques are necessary to reduce costs and expand enrollment using satellite campuses to meet market demands, but what may be lost in terms of camaraderie, a sense of belonging, lifelong friendships, and professionalization must be maintained. I am confident that our leading colleges of pharmacy understand the risks of what some schools of pharmacy refer to as an "educational renaissance," but I am not confident that strategies are in place to shore up what may be at risk. Preceptors must play an important part in these strategies.

Practitioners in all practice settings have played an increasingly important role in professional education as schools have migrated to the entry-level doctor of pharmacy degree curriculum. Regrettably, preceptors and their employers do not consistently approach their clerkship responsibilities with an appreciation for the importance of the role they serve in preparing future practitioners. We must realize that the time consumed in offering a rich practice experience is an investment in the profession's future. All too often relationships between schools and preceptors (or the preceptor's employer) are strained with inconsistent alignment of expectations, including getting paid for providing the clerkship itself. Without question, each school needs a forum and a consistent process for discussing and permanently resolving issues.

Aligning practice and academia is a complex problem, with challenges for academia, employers, practitioners, and students. Not only do we need to overcome historical problems, but we urgently need to address the consequences of dramatic changes in teaching methods. It seems unrealistic to expect that our professional associations can collectively lead an initiative with such diverse challenges. Perhaps the American Association of Colleges of Pharmacy (with support from professional associations) should appoint a commission or other working group with representation from all interested parties, including students, nonpharmacist executives from hospitals and community pharmacy, academia, and a diverse corps of practitioners to study the current state of affairs and make appropriate recommendations. To ensure that the group remains on target, minutes of meetings and preliminary recommendations should be published frequently as the process evolves so that ample opportunity is given for a successful outcome.

Until then, practitioners from all settings should embrace their colleges of pharmacy and begin at a local level to address some of the challenges. I would suggest that practitioners should (1) participate in the process of interviewing applicants for admission, (2) become a part of early orientation for the students, (3) volunteer to serve as lecturers or discussion leaders in class, and (4) lead a process to substantially enhance the experiential portion of the curriculum.

I have confidence that we can use our creativity and professional commitment to resolve this conundrum, as it is in our collective best interest. What do you think?

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