Graduating During the Pandemic
Pharmacy students, particularly the graduating class of 2020, have been uniquely affected by the coronavirus disease 2019 (COVID-19) pandemic. Students raised concerns about the potential impact on their professional career due to the unforeseen schedule changes.

In March 2020, universities were faced with the decision of transitioning to remote learning to protect students and their families from COVID-19. Approximately 69,000 US schools closed, affecting 36 million students, and New York quickly became the epicenter of the pandemic in the United States. Across the globe, 56 countries closed schools, impacting more than 516 million students worldwide.1 Finding the safest solution for experiential pharmacy students to finish their advanced pharmacy practice experiences (APPEs) was the main priority, which led to online didactic classes and virtual/remote APPEs being created to keep students on track with their education.

Universities had to adapt quickly and accommodate a large number of students. On March 10, 2020, St. John’s University announced that all P4 students would be released from APPEs and experiential education (EE) remained suspended for 4 weeks. During that time, students were surveyed on preferences and comfort level with face-to-face or remote learning. Meanwhile, university administration was concerned about securing enough personal protective equipment (PPE) for students and faculty due to the shortage. The delay in APPEs affected the graduation date for many of my classmates who needed to complete EE beyond mid-May. Even after graduation, there were questions about when we would receive authorization to complete our board licensing exams.
 
Students graduating during the pandemic were also affected by the unprecedented job market. Interviews were held online, jobs that offered the option to work from home became completely remote positions, and other jobs in clinical settings mandated employees work face-to-face with proper PPE. More opportunities arose in the midst of the pandemic as the need for front-line health care professionals increased, which led to some universities implementing early graduation to allow for earlier entrance into the workforce.

Perspective of Tina Kanmaz, PharmD, Assistant Dean, Experiential Pharmacy Education
 
How did you manage expectations for students who had to transition to remote APPEs?

Kanmaz: Transparency in communication between the Office of Experiential Pharmacy Education (OEPE) and the class of 2020 was essential. We had to get comfortable quickly communicating that these were unprecedented times. Although there was tremendous uncertainty ahead, we were committed to getting through this time together. Our ultimate priority was safety first, for students and their families.

St. John’s and the overwhelming majority of our experiential sites were in the epicenter of the pandemic when the university closed. Many of our students live in multigenerational homes and use public transportation to the areas most impacted by COVID-19. Once student safety was ensured, the OEPE communicated frequently with students through email and remote town hall meetings. Two P4 students served as class liaisons, which included gathering questions, tracking minutes, creating a frequently asked questions document, and posting updates on the class Facebook page.

There was a period of 4 weeks that students were in limbo after suspension of APPEs while the pharmacy practice faculty rapidly developed remote APPEs from scratch. We felt it was crucial to maintain a high level of communication with students, even if it meant saying we did not have a definitive plan, but were working tirelessly to create quality remote experiences and resume EE.

How did you connect with other schools to discuss implementing remote APPEs?

Kanmaz: The Accreditation Council for Pharmacy Education (ACPE) provided guidance to colleges and schools of pharmacy on proceeding with EE while still effectively meeting the accreditation standards. Further, ACPE guidance allowed for remote delivery of APPEs, since many practice sites were closed to face-to-face EE in Spring 2020.

As an active member of the American Association of Colleges of Pharmacy (AACP), specifically AACP’s Experiential Education Section (EES), I connected with colleagues nationally who were dealing with the impact of COVID-19. The EES has a list-serve, through which many experiential administrators communicated their college’s or school of pharmacy’s experiential contingency plans. Additionally, the EES leadership conducted multiple virtual meetings to discuss interpretations of ACPE’s guidance to meet the ACPE Standards during the pandemic.

What do you think the impact will be on students?

Kanmaz: The university mandated that all courses move to remote delivery during period 10. The overwhelming majority of students had already completed 7 or 8 of their 9 APPEs at that point. Approximately 40% graduated 1 month late but the rest of the class graduated on time.

The students who graduated late did not experience much delay getting licensed, since social distancing guidelines led to delays in administering licensing examinations. I think the pandemic had a more significant impact socially on these students who missed out on an in-person doctoral hooding ceremony and the traditional end of the program PharmD formal, as well as celebratory events with family and friends. These milestone events have been put on hold indefinitely until it is safe to resume large gatherings.

Are you keeping the same plan for future classes of students?

Kanmaz: The pandemic has had a much more significant impact on the Class of 2021 who started APPEs in May 2020, only 2 months into the pandemic. Most students completed their first 2 or 3 APPEs remotely. Health systems did not start to reopen to EE in the New York City area until August or September, and some hospitals still have not reopened. As we move into late December with COVID-19 cases on the rise, sites are starting to close again.

Faculty and preceptors are providing telehealth services to meet the ambulatory care learning objectives and remote electronic health record access for inpatient and health system experiences. Face-to-face interactions with patients and health care providers are lacking for some of these experiences, which is a limitation of the educational experience. While many students are choosing face-to-face experiences, others are opting for remote learning experiences to protect at risk family members. The availability of institutional sites in our area have been significantly reduced, and keeping this class on track has been a challenge.

Conclusion
During these unprecedented times, it has been an insightful learning experience to adapt to rapid change while also preparing for a bright future in pharmacy. Many pharmacy classes have faced unknowns this past year; however, we have learned to be agile and resilient as we provide optimal patient care in these times.

In a short amount of time, the university provided a tremendous amount of support for not only my class, but to subsequent graduating classes. As a new graduate, I am beyond grateful for the effort and dedication that my mentor, Dr. Kanmaz, and St. John’s University contributed to the class of 2020.

REFERENCES
  1. Walravens S. Coronavirus Forces Millions Of Students Online, But Not All May Benefit. Forbes. https://www.forbes.com/sites/geekgirlrising/2020/03/16/online-learning-isnt-enough-schools-should-prepare-for-summer-school-says-education-expert/?sh=300f35067e45. Published March 17, 2020.