The Pharmacy Manpower Project, Inc., projects that by 2020, there will be a deficit of nearly 157,000 pharmacists in the U.S., according to its report Professionally Determined Need for Pharmacy Services in 2020. The effects of low enrollment in pharmacy schools are already being felt across the country, particularly in rural areas.
[Above: Pharmacy students at Creighton University in Omaha, Neb.]
According to U.S. Census Bureau data from 2010, people living in rural areas account for 19.3 percent of the total U.S. population, yet the National Institutes of Health’s National Library of Medicine has found that only 12 percent of the nation’s pharmacists practice in these regions.
To improve these figures, and the quality of care for patients in rural areas, some colleges and universities have focused on expanding distance learning programs to provide increased access to pharmacy education for students in even the most remote areas.
While several schools and colleges of pharmacy offer online classes, Creighton University in Omaha, Neb., offers what was the first accredited, full-time online pharmacy program in the country; the second is offered at Lake Erie College of Osteopathic Medicine in Florida, which modeled its program after Creightons.
In 2001, the university launched the Doctor of Pharmacy Distance Program — with grants from the National Community Pharmacists Association — to lead more students toward careers in pharmacy.
“We really reached out to those students who had a lifelong dream of being part of the pharmacy team, but couldn’t relate,” says Zara Risoldi Cochrane, director of the program and associate professor in Creighton’s Department of Pharmacy Practice. “We found a good foothold for rural communities and were able to reach students in more remote areas. The benefits were that we were able to address healthcare needs in these areas as well.”
Filling a Need
For many people living in rural areas, higher education is not necessarily the next step after high school. According to the U.S. Department of Agriculture, only 18 percent of people living in rural areas have at least a four-year degree, and only 6 percent have an advanced degree.
Creighton is hoping to change this situation and attract more individuals to the pharmacy field by providing an easily accessible, and affordable, education. Students from across the country who are enrolled in the university’s distance program experience their entire education from the comfort of home, except for a few trips to Creighton’s campus.
Courses are available to students through video-capture technology, which works to keep them engaged by providing activities, such as multiple choice questions and quizzes, all while the professor is teaching. Students are able to flag troublesome or confusing lectures and post questions in real time, giving professors insight into how well their students comprehend aspects of the curriculum.
“It allows us that two-way feedback, which is important to what we do,” Risoldi Cochrane says. “We can’t be successful unless we understand where students are succeeding.”
In addition, all exams are administered through an online proctoring service that students connect to through their personal computers. Using webcam monitors, the system is able to detect whether they are cheating on tests by using their notes or textbooks. Online proctors also conduct basic troubleshooting procedures and are prepared to assist students if the system experiences technical difficulties.
Creighton has developed effective ways to ensure that students are receiving not only a quality education, but also academic support as they work to complete the program.
“We hire mentors, similar to teaching assistants, who live and work across the country, and they [provide] additional support for online students,” Risoldi Cochrane says. “They communicate through Skype so students don’t have to worry about time differences, and there is always someone available to respond to their needs.”
This system allows participants to engage with one another across long distances, sharing experiences and learning to work together.
Students also get the opportunity to meet face to face. Each summer, those enrolled in the online program meet on Creighton’s campus for two weeks to participate in hands-on patient care training and an evaluation. Risoldi Cochrane says that it is important for them to interact with one another to further build communications skills — an integral aspect of the pharmacy profession.
Students in Creighton’s doctor of pharmacy program are required to enroll in clinicals during their fourth year. To accommodate distance learners, the university created a team of faculty and staff to set up, monitor, and manage clinical rotations in each student’s hometown.
“Students are getting real-life experience in the communities where they are living,” Risoldi Cochrane says. “Our team communicates with [their clinical] site and ensures there is an educational plan for the student, and we train the [pharmacists running the clinicals] to give feedback and provide management.”
Through its distance learning program, Creighton aims to help fill the pharmacist gap in underserved regions.
“Many of our distance students are located in areas where there is a deficit in pharmacists,” Risoldi Cochrane says.
“We’re attempting to meet that need.”
Creighton’s Pharmacy Assessment Committee has conducted extensive research on students’ success after graduation, including where they find employment. Results have shown that graduates from rural areas tend to stay in those regions, revealing the important role the distance program is playing in increasing service in areas in need.
“There are several counties that are so rural, so remote, that there are no healthcare providers,” Risoldi Cochrane says. “[The program] gives students the opportunity to practice pharmacy … as they cater to the needs of their own communities.”
Alternative Distance Learning Models
While Creighton may currently have the only full-time online pharmacy program, many universities are doing more to expand their online presence to reach more potential pharmacy students.
The University of Kansas (KU) pharmacy program is the only one in the state and is offered through the university’s main campus in Lawrence; however, the use of live-transmission lectures allows the university to expand its reach to students on the Wichita campus, KU’s newest extension.
“We wanted to reach across the state better,” says Kenneth Audus, dean of the School of Pharmacy.
Audus says the university decided streaming lectures would be the best way to provide education to students in Wichita from KU’s main campus. In addition to the system allowing students to listen to lectures in real time, it also allows for interaction between professors and distance pharmacy majors.
Students are paired together during lectures and use a desktop microphone to communicate with professors during the transmission; as they log in, their pictures appear on the professor’s screen, helping ensure attendance. This format also enables students to be active in discussion and ask questions as they arise.
Students are required to purchase an iPad, which allows professors to take attendance in seconds and provides students access to notes and lectures any time using Blackboard, an online educational management system.
Audus says the school’s efforts to attract more students across the state to pharmacy education have contributed to the university’s placing more pharmacists in rural areas throughout Kansas.
“Kansas has 105 counties, and seven of them didn’t have a pharmacist or a pharmacy,” he says. “Now, we’ve brought that down to two.”
While some students express the desire to stay in urban areas, faculty in KU’s School of Pharmacy encourage them to consider jobs in rural communities by emphasizing the demand in those areas. During winter breaks, the school takes students to small-town pharmacies across the state to show them where they are needed.
The University of Cincinnati (UC) in Ohio is also working to expand the reach of pharmacy education. In January 2016, UC’s College of Pharmacy will be adding to its offerings an online certificate and master’s degree program in pharmacy management. These programs are geared toward people who already hold a pharmacy degree but would like to become a leader in the industry.
“For a pharmacist who wants to receive additional training in management, their options would be an MBA program or a master’s in health administration,” says Neil MacKinnon, a professor and dean of the UC College of Pharmacy. “There’s nothing pharmacy-related, but now, with these programs, they can learn how to inspire and manage people in the field.”
The online master’s degree program in pharmacy leadership will be the first of its kind in the nation, and since it will allow students to earn their degree from anywhere, those already practicing in rural areas won’t be forced to leave their communities.
MacKinnon explains that many advanced pharmacy programs are intense, full-time commitments, meaning that students would have to quit their jobs in order to complete them. However, with UC’s new online programs, this isn’t necessarily the case.
In addition, UC’s current pharmacy programs provide recorded lectures, like those at Creighton and KU, so students can listen to them at a time that works for their schedules.
According to MacKinnon, who was previously the director of the Arizona Center for Rural Health, each state works to analyze where healthcare practitioners are needed and recognizes the demand for more in rural areas. He believes online programs have the potential to bridge this gap.
“[Online] programs have the ability to reach pharmacists,” MacKinnon says. “We’ve developed these to be [completed] anywhere in the world, and that provides the opportunity for more education for pharmacists who would otherwise have to give up their current lives.”
Although online programs like these may not be able to eliminate the projected pharmacist deficit, pharmacy schools are showing that using technology to increase educational access and opportunities can have a positive impact on the future of pharmacy education and practice — especially in rural communities.●
Madeline Szrom is a contributing writer for INSIGHT Into Diversity.