Effect of the nontraditional pharmD degree on practice patterns based on a survey of graduates from Six programs

American Journal of Pharmaceutical Education, Fall 1999 by Fjortoft, Nancy, Weigand, Lisa, Lee, Mary

This study describes the effect of the nontraditional PharmD (NTPD) degree on individual practice patterns using a national sample. A survey was mailed to all graduates of NTPD programs at six of the seven schools of pharmacy that had NTPD graduates at the time of the study. All programs were accredited by the American Council on Pharmaceutical Education. Surveys were returned from 399 pharmacists (response rate 65.7 percent). Chi-Square analyses indicated statistically significant differences in distribution of practice setting and job title between the last position as BS-trained pharmacist and the first position as a PharmD-trained pharmacist. Respondents were spending a statistically significant higher percentage of their time selecting the most appropriate drugs and drug formulation, developing treatment plans to manage adverse reactions or drug interactions, and assisting physicians with prescribing decisions in their first position as a PharmD-trained pharmacist than their last position as a BS-trained pharmacist. Data results indicated that respondents demonstrated statistically significant higher levels of job satisfaction in their first position as a PharmD-trained pharmacist than their last position as a BS-trained pharmacist. Individual pharmacists benefit from NTPD programs through changes in practice patterns and higher levels of job satisfaction.

INTRODUCTION

Colleges of Pharmacy across the country have or are in the process of developing nontraditional PharmD (NTPD) Programs. These programs enable baccalaureate-trained (BS) pharmacists to return to school on a part-time basis and obtain the PharmD degree. Many programs use distance learning techniques, prior learning assessments, and other educational innovations that provide students with flexibility and convenience while maintaining academic integrity and vigor. Currently there are NTPD programs in 30 of the 50 states, with approximately 50 schools and colleges of pharmacy offering NTPD programs.

Clearly many individual pharmacists perceive the need to increase their knowledge base and skill level and are opting to enroll in NTPD programs. Previous studies of practice patterns of BS versus traditional PharmD graduates have generally demonstrated that PharmD pharmacists spend a greater percentage of time performing clinical activities than BS trained pharmacists(1). In addition, PharmD pharmacists are more likely to assume positions in an institutional setting(1-4), and have demonstrated higher levels of job satisfaction(1). It is not clear if NTPD graduates can expect the same outcomes. Since the number of NTPD programs are increasing, and concomitantly, the number of NTPD graduates will increase, the ramifications of this type of program and its graduates on individual practice patterns and institutional management needs to be elucidated.

Previous studies on the impact of nontraditional PharmD programs on practice have been school-specific, small samples, and purposely broad in their analysis of tasks. These studies have indicated that pharmacists who complete NTPD programs spend significantly more time on clinical activities than when they were BS-trained pharmacists(5,6). Fjortoft and Engle also reported significant changes in practice setting, promotions, and increased levels of job satisfaction among NTPD Program graduates at the University of Illinois at Chicago(6). This study utilizes a national sample of NTPD graduates and assesses changes in specific practice behaviors and attitudes.

Objectives. The objectives of the project include: (i) assessing the impact on the NTPD degree on individual practice patterns relative to changes in practice setting and job title; (ii) assessing the difference, if any, in job satisfaction between last job as a BS pharmacist, and first job as a PharmD pharmacist; and (iii) assessing the difference, if any, in practice activities between last job as a BS pharmacist and first job as a PharmD pharmacist.

METHODS

This retrospective nonrandomized survey study targeted a population of all graduates of NTPD programs accredited by the American Council on Pharmaceutical Education. Seven schools were identified as having graduates at the time of the study in June 1997(7). Letters were sent to the nontraditional PharmD administrator/faculty at the seven schools asking for their voluntary cooperation on the project. Six of the seven programs agreed to participate by providing direct mailing services to their NTPD graduates, or names and addresses of their NTPD graduates, The schools represented both private and public institutions, and were from a broad geographic area. The six schools had a total of 607 NTPD graduates.

A survey instrument was developed to assess demographic variables and the parameters stated in the objectives. Respondents were asked to specify their primary and secondary reasons for obtaining a PharmD degree; these responses were provided as short answers. The survey items used to assess job satisfaction were taken from the University of Michigan's Quality of Employment Survey(8) and have been used by others to assess pharmacists' job satisfaction(1,6,9). These items used a Likert scale and the responses ranged from I=very true to 4=not at all true. Intrinsic job satisfaction included items such as "I can see the results of my work" and "I have an opportunity to develop my own special abilities." Extrinsic job satisfaction included items that assess satisfaction with external conditions of the job such as salary, hours, travel to and from work, physical surroundings, etc. The survey items used to assess practice behaviors were derived from the American Association of Colleges of Pharmacy Background Paper 11(10). Respondents were asked to provide the percentage of time they spent performing specific tasks. The tasks included: (i) counseling patients; (ii) determining proper dose, dosing schedule for patients; (iii) selecting the most appropriate drugs and drug formulations for patients; (iv) monitoring the efficacy and safety of the drug regimen; (v) monitoring to prevent adverse drug reactions; (vi) developing treatment plans to manage adverse reactions or drug interactions; (vii) monitoring drug regimens to ensure patient compliance; and (viii) assisting physicians with prescribing decisions. The survey instrument was pilot tested on seven pharmacy faculty, some of whom were graduates of NTPD programs. Changes were made in the instrument as warranted. These individuals were then excluded from the study.