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Members from Cohort 13 of the Academic Leadership Fellows Program (ALFP) 2016-2017 were challenged to present a debate on the topic: "In Turbulent Times, Pharmacy Education Leaders Must Take Aggressive Action to Prevent Further Declines in Enrollment" at the American Association of Colleges of Pharmacy INfluence 2017 meeting in Rio Grande, Puerto Rico. This paper is the result of thoughtful insights emerging from this debate. We present a discussion of the question of whether pharmacy education leaders must take aggressive action or strategic approaches to prevent further declines in enrollment. There are many thoughts regarding current declines in enrollment. Some educators contend that a more aggressive approach is needed while others argue that, while aggressive actions might lead to short-term gains, a more viable approach involves strategic actions targeting the underlying causes for decreasing enrollment. This paper explores themes of enrollment challenges, current and future workforce needs, and financial issues for both pharmacy programs and students. In summation, both aggressive actions and a strategic, sustainable approach are urgently needed to address declining enrollment.

This commentary is an observation of longitudinal trends in national data on the pharmacist workforce and pharmacy education. Data indicate seismic shifts in supply and demand, from critical shortage to imminent oversupply. The change in the profession to employing more patient-care focused jobs has been observed as slow and minimal, although academia has focused on the clinical training and rapidly increased enrollments. Pharmacy is on the brink of transforming the profession, but several important changes are still required to alter the current trajectories of supply and demand. Pharmacy schools, associations, and employers must devote all energies to immediate and significant actions that tip the balance in favor of pharmacists of the future.

Computerization is transforming health care. All clinicians are users of health information technology (HIT). Understanding fundamental principles of informatics, the field focused on information needs and uses, is essential if HIT is going to support improved patient outcomes. Informatics education for clinicians is a national priority. Additionally, some informatics experts are needed to bring about innovations in HIT. A common approach to pharmacy informatics education has been slow to develop. Meanwhile, accreditation standards for informatics in pharmacy education continue to evolve. A gap remains in the implementation of informatics education for all pharmacy students and it is unclear what expert informatics training should cover. In this article, we propose the first of two complementary approaches to informatics education in pharmacy: to incorporate fundamental informatics education into pharmacy curricula for all students. The second approach, to train those students interested in becoming informatics experts to design, develop, implement, and evaluate HIT, will be presented in a subsequent issue of the Journal .

Objective. To develop and test a conceptual model that hypothesized student intention to undertake a higher degree in pharmacy practice research (PPR) would be increased by self-efficacy, outcome expectancy, and the social influence of faculty members. Methods. Cross-sectional surveys were completed by 387 final-year pharmacy undergraduates enrolled in 2012 and 2013. Structural equation modeling was used to explore relationships between variables and intention. Results. Fit indices were good. The model explained 55% of the variation in intention. As hypothesized, faculty social influence increased self-efficacy and indirectly increased outcome expectancy and intention. Conclusion. To increase pharmacy students' orientation towards a career in PPR, faculty members could use their social influence by highlighting PPR in their teaching.

Objective. To project the net cumulative income break-even point between practicing pharmacists and those who enter the workforce directly after high school graduation or after obtaining a bachelor's degree. Methods. Markov modeling and break-even analysis were conducted. Estimated costs of education were used in calculating net early career earnings of high school graduates, bachelor's degree holders, pharmacists without residency training, and pharmacists with residency training. Results. Models indicate that over the first 10 years of a pharmacist's career, they accumulate net earnings of $716 345 to $1 064 840, depending on cost of obtaining the PharmD degree and career path followed. In the break-even analysis, all pharmacy career tracks surpassed net cumulative earnings of high school graduates by age 33 and bachelor's degree holders by age 34. Conclusion. Regardless of the chosen pharmacy career track and the typical cost of obtaining a PharmD degree, the model under study assumptions demonstrates that pharmacy education has a positive financial return on investment, with a projected break-even point of less than 10 years upon career entry.

Objective: To describe the development of a capstone course using qualitative results of focus groups and to determine the impact of the course using a pre- and postcourse surveys., Design: A course titled Advanced Patient Care was developed using themes emerged from 3 stakeholder focus groups and implemented with case-based sessions, interactive exercises, and Objective Structured Clinical Examinations (OSCEs). Pre- and postcourse surveys were conducted to assess the students' confidence and knowledge in managing 8 commonly-encountered conditions., Assessment: During the 2-year course implementation, a total of 169 students participated in the pre- and postcourse surveys (87.6% response rate). The mean total confidence score increased significantly from 54.3 (±9.2) to 69.0 (±8.6, p < 0.001), and the total mean knowledge score increased significantly from 6.3 to 6.9 (p < 0.001)., Conclusion: The capstone course, fueled by focus group findings and implemented using interactive sessions and simulations, positively impacted students' confidence and knowledge for clinical practice experiences and professional practice.

Objective: To describe the evolution of learning styles of pharmacy residents as they transition from residency to practice., Methods: Cross-sectional survey and interview-based study. A complete provincial cohort of former pharmacy residents (N=28), who had their learning styles characterized with the Pharmacists' Inventory of Learning Styles (PILS) at the beginning of their residency and, 1 year post-residency, were invited to repeat the PILS. Interviews were administered to consenting participants to gain additional insight., Results: Twenty-seven of the former residents (96%) completed the PILS survey and 16 (59%) completed the post-PILS interview. Thirteen (48%) changed their dominant learning style and 20 (74%) changed their secondary learning style. Six (22%) participants did not change either learning style. The overall proportion of dominant assimilators (59%) and convergers (26%) remained similar to baseline (52% and 26%, respectively), meaning participants had adopted and abandoned different learning style in similar numbers. Change in learning style was associated with being a preceptor (p<0.05), as 58% of the 12 former residents who became preceptors stated in the interview they had adjusted their teaching practices based on knowledge of their learning styles gained during their residency., Conclusion: Changing learning style is common for former residents after 1 year in postresidency practice. There is no overall direction to the change; former residents transition into and out of various learning styles with similar frequency and retain preferences for passive/abstract learning approaches over active/concrete ones. The early-career lability in learning style the study demonstrated may reveal an opportunity to guide pharmacists toward more active learning preferences through residency curricula, preceptorship, and mentorship.

Canadian faculties (schools) of pharmacy are actively engaged in the advancement and restructuring of their programs in response to the shift in pharmacy to pharmacists having/assuming an advanced practitioner role. Unfortunately, there is a paucity of evidence outlining optimal strategies for accomplishing this task. This review explores several educational changes proposed in the literature to aid in the advancement of pharmacy education such as program admission requirements, critical-thinking assessment and teaching methods, improvement of course content delivery, value of interprofessional education, advancement of practical experiential education, and mentorship strategies. Collectively, implementation of these improvements to pharmacy education will be crucial in determining the direction the profession will take.

The demand for public health services is being outpaced by a shrinking public health workforce. This creates a unique opportunity for pharmacists to become more engaged in public health activities, particularly in rural underserved areas. To meet the need for additional public health professionals, we designed a master of public health (MPH) program in a rural state under the leadership of a department of pharmacy practice. In addition to a core set of courses, the MPH program has public health specialty tracks (disease state management, emergency management, health promotion practice, infectious disease management, food safety, gerontology, and medical management and administration) that could be completed as a certificate program or used towards an MPH degree. The program allows students to complete the graduate degree with a minimum of prerequisite coursework. The MPH degree provides an opportunity for pharmacists and other health care professionals to gain an understanding of the interprofessional approach to solving public health problems and will enhance their role in public health and within their health care team.

Objectives: To determine the primary reasons why pharmacy faculty intend to remain or leave their current institution and why they left their most recent academic institution, and the relative contribution of various organizational and individual characteristics toward explaining variance in turnover intentions., Methods: A survey instrument was e-mailed to pharmacy faculty members asking respondents to indicate up to 5 reasons for their intentions and up to 5 reasons why they left a previous institution. The survey also elicited perceptions on quality of work life in addition to demographic and institutional data, upon which turnover intentions were regressed using a forward-conditional procedure. Organizational commitment as a moderator of turnover intentions was regressed over the remaining variables not acting directly on employer intentions., Results: Just over 1 in 5 respondents indicated intentions to leave their current academic institution. Excessive workload, seeking a new challenge, poor salary, and poor relationships with college or school administrators were frequently cited as reasons for leaving. Turnover intentions are influenced directly by department chair support and organizational commitment, which moderates various support and satisfaction variables., Conclusions: Pharmacy faculty members' decision to remain or leave an institution is dependent upon developing a sense of commitment toward the institution. Commitment is facilitated by support from the institution and department chair, in addition to a sense of satisfaction with the teaching environment.

Objective: To offer a physics course that is relevant to pharmacy students, yet still contains many of the fundamental principles of physics., Design: The course was modified over a period of several years to include activities and examples that were related to other courses in the curriculum., Assessment: Course evaluations were given to assess student attitudes about the importance of physics in the pharmacy curriculum., Conclusion: Students' attitudes have changed over time to appreciate the role that physics plays in their studies. Students gained confidence in their ability to learn in other courses.

Homeopathy has been the cause of much debate in the scientific literature with respect to the plausibility and efficacy of homeopathic preparations and practice. Nonetheless, many consumers, pharmacists, physicians, and other health care providers continue to use or practice homeopathic medicine and advocate its safety and efficacy. As drug experts, pharmacists are expected to be able to counsel their patients on how to safely and effectively use medications, which technically includes homeopathic products. Yet many pharmacists feel that the homeopathic system of medicine is based on unscientific theories that lack supporting evidence. Since consumers continue to use homeopathic products, it is necessary for pharmacists to have a basic knowledge of homeopathy and to be able to counsel patients about its general use, the current state of the evidence and its use in conjunction with other medications.

This study was initiated to examine the attitudes of some of the future health care providers, family practice residents, toward various ambulatory pharmacy services. Pharmacy students were then asked to predict what the resident attitudes would be and the results were compared. This project addressed the following questions: (i) What are the expectations of family practice residents of what today's pharmacists should be doing? and (ii) How accurately can pharmacy students judge what the responses of the residents will be? The survey results indicated that the family practice residents' perceptions of certain pharmacist behaviors rated significantly higher than how the pharmacy students thought they would respond. Such behaviors included: (i) maintain and review patient profiles; (ii) counsel patients; (iii) take medication/allergy histories; (iv) provide therapeutic information to physicians; and (v) stock a wide variety of generic drugs. Most of these behaviors reflect direct involvement of the pharmacist in disseminating information to the patient and/or physician. Other expanded roles of the pharmacist such as triage, refill determination, reimbursement for consultation services, and chronic care management were given low priority.