The escalating coronavirus disease 2019 (COVID-19) pandemic rapidly pushed traditional face-to-face instruction within schools of pharmacy into a fully remote learning environment in which Doctor of Pharmacy (PharmD) students found themselves learning new technology while engaging in their rigorous academic programs.

Final year PharmD students faced challenges and concerns about completing their education and on-time graduation in the unanticipated wake of COVID-19, which increased their own risk of exposure.  Along with these curricular changes, students faced new personal challenges such as caregiving or parenting while attending to their studies, being unable to engage in patient-care activities if immunocompromised, loss of income due to sudden unemployment, and mental health effects from additional stress, fears, and concerns. 

Thirteen research-intensive institutions across the United States administered questionnaires to PharmD students to solicit data about the impact of COVID-19 on their educational experiences and to them personally. Open-ended responses from students offered detailed context and nuance related to their own self-efficacy and outlook on the transitions. 

Students also described the benefits and challenges of fully remote learning and the level of support they received from their own social networks, schools, and clinical practice sites. These responses offered insight into the psychosocial and emotional impact of the COVID-19 pandemic on direct and indirect aspects of their learning experience.

Reviewing student responses through the lens of Schlossberg’s Four S’s offers a framework for understanding how students coped with this transition (Goodman, 2006). The Schlossberg framework suggests key questions that pharmacy school faculty, administrators, and preceptors should consider as they reorient their students, faculty, and staff to a new learning and working environment this fall.

Situation
COVID-19 was the catalyst for an immediate, grand scale, disruptive experiment across higher education in which nearly every student experienced fully remote learning. Although COVID-19 led to a large-scale transition in delivery, it also set in motion a number of transitions that individuals faced, such as leaving campus to go home, taking classes remotely, and not seeing classmates on a daily basis. 

Self
PharmD students were forced to evaluate their own self-confidence and self-efficacy in facing new and sudden challenges to their hierarchy of needs, affecting their ability to cope with the acute transition. Students felt anxious, scared, concerned, and worried about COVID-19, the move to remote learning, and their future in the profession​. 

Support
The transformed learning and working environment highlighted student support needed for success in a highly rigorous academic culture. When asked about the benefits of transition to remote learning, time and money were identified as key elements. Further analysis showed time with family, time to study, and saving time and money by eliminating commuting or childcare obligations were all perceived benefits. Identified challenges were maintaining focus and motivation, ineffective communication, distractions at home, food insecurity, and technology issues. 

Strategies
The strategies used to cope with transition are different based on individual situations, sense of self, and support networks. For this reason, it is difficult to find one-size-fits-all coping mechanisms. This can be difficult for schools working under rigid accreditation standards.      

Schools should consider these questions as they make plans for the fall:
 
  • How will we demonstrate compassion for students when unanticipated situations arise?
  • How will we recognize unforeseen transition issues impacting students? 
  • How will we create an environment that helps students cope with the anxiety of this transition?
  • How will your school be intentional about giving students space to adjust and decompress as they re-enter the rigor of their academic life?
  • How will we develop flexible support systems that address individualized student challenges?   
  • How will we reimagine partnerships with preceptors and practice sites to support students during this transition?
  • How will we redesign academic programs to optimize benefits and address challenges of remote learning to create more flexible forms of curricular delivery? 
  • How will we reorient faculty and staff to be leaders during this transition?
  • How will we involve students in the planning process? 
  • How must we reassure students about the future of pharmacy practice at this time?
  • Does this mass experiment suggest that schools can be more flexible and innovative while continuing to deliver an excellent education?

Pharmacy students have concerns as they wait to learn what their educational experience will be like in the fall. Strategies implemented by schools can be as transformative as the impact of COVID-19. 

PharmD programs should proactively revise their teaching and training in a way that allows for greater flexibility and integrates the best aspects of remote learning and ultimately provides the support necessary during transitions. Permanent changes in content delivery, assessment, and student support are warranted as the COVID-19 pandemic continues to evolve in the United States next year.

A student-centered, transformative, and blended learning approach to the “new normal” must be holistic, meeting the needs of all pharmacy students while considering circumstances that affect their ability to cope, such as family and financial obligations, physical health, and psychological emotional well-being.

About the Authors
Michael J. Fulford, PhD, is Director of Assessment and Interim Lead for Faculty Affairs in the University of Georgia College of Pharmacy.

Lisa Lebovitz, JD, is Assistant Dean for Academic Affairs and Assessment in the University of Maryland School of Pharmacy.

Mary Elizabeth Ray, PharmD,  is Associate Dean of Academic Affairs in the University of Iowa College of Pharmacy.

Jason K. Wallace, PhD, is an Educational Research Professional in the University of Georgia College of Pharmacy and Adjunct Professor of Higher Education at the University of Southern Mississippi.

Brianna Henson, MPA, is Director of Curriculum Development in the University of Kentucky College of Pharmacy.

Kelly M. Smith, PharmD, is Dean of the University of Georgia College of Pharmacy.