Feasibility and Benefit of Using a Community-Sponsored, Team-Based Management Project in a Pharmacy Leadership Course

Abstract

Objective. Assess the impact of community-sponsored, team-based management projects in a leadership and management course on PharmD students’ teamwork skills and project sponsor satisfaction. 

Design. Third-year pharmacy students were divided into eight to ten groups to complete a project proposed by local pharmacists as a “lab” to practice teamwork skills. Projects intended to meet a real need of the submitting organization or the pharmacy profession.

Methods. A validated Team Performance Survey (TPS) assessed teamwork effectiveness. Project sponsors completed surveys to evaluate the quality of the students’ work, the likelihood of project implementation, the benefit of participation, and willingness to sponsor future projects.

Findings. One hundred percent of students and sponsors completed the assessments. TPS average scores across 2017, 2018, and 2019 show that 17 out of 18 activities ranked over 90% by students as being used “every time” or “almost every time,” indicating that students performed well in this team setting. Free-text responses indicated that students found value in participating in management projects. Common themes of project advantages include networking with sponsors, teamwork, building community in the classroom, the autonomy of creating deliverables, and applicable and impactful projects. All sponsors were willing to participate again, and the majority listed interacting with students and increasing their connection to the College as benefits. Ninety-five percent of sponsors said they were “extremely” or “somewhat likely” to implement the student project.

Summary. Community sponsored, team-based management projects in a leadership and management course serve as a model for developing students’ teamwork skills within pharmacy curricula.

Keywords: leadership, teamwork, curriculum, management, project

Introduction and Leadership Framework

The American Society of Health-System Pharmacists (ASHP) 2005 landmark publication highlighted the need for more intentional leadership development in Doctor of Pharmacy (PharmD) programs. The publication stressed that many key pharmacy leadership positions could go unfilled, including a need for over 4,000 new directors in the following decade, unless the pharmacy profession addresses the lack of leadership training.1  White et al. identified that 75% of pharmacy directors do not anticipate remaining in their current positions and only 17% of employers have the ability to fill vacant leadership positions within two months. Employers face difficulty hiring for leadership positions due to 1) a lack of practitionerswith leadership experience, 2) a lack of interestamong current practitioners, and 3) the belief that leadership positions are stringent and stressful. ASHP’s 2012 leadership assessment identified that “a higher percentage of employers (from 3% in 2004 to 17% in 2011) could fill vacant leadership positions within two months, and 37% of employers reported that filling a leadership position was more difficult than it was three years ago (from 57% in 2004).”2 While the need for pharmacist leadership training has been recognized and improved over the past decade, preparing individuals to tackle complex leadership issues remains a challenge.

Student pharmacists may enter the workforce with insufficient leadership skills to effectively serve in a formal leadership position, to function effectively within clinical teams, and to advance the pharmacy profession.3 Elective courses and optional extra-curricular activities increase students’ exposure to leadership, but these limited opportunities may lead to an overall lack of leadership training within the profession. 3 During a complete revision of the PharmD curriculum, The University of Utah College of Pharmacy) identified a need for intentional leadership development through curricular mapping. To address this need, The University of Utah College of Pharmacy developed a longitudinal leadership curriculum based on the framework of Relational Leadership (RL) created by Primary Care Progress (PCP), a non-profit, grassroots leadership development organization dedicated to advocating for improved health care. RL, currently utilized in a multi-site interprofessional, cross-generational leadership program called the Relational Leadership Institute and with interprofessional PCP student teams across the country, consists of four domains: manage self, foster teamwork, coach and develop, and accelerate change.4 This new leadership curriculum, sought to identify innovative and authentic ways to give students experience related to these four domains of leadership.

Several institutions have successfully developed educational projects that focus on leading change5, medication reviews to prevent adverse events such as falls6, or disease state education.7 However, these projects tend to be facilitated by faculty or students rather than current practitioners. The Leadership and Management course at the University of Utah College of Pharmacy (UUCOP) piloted an experiential component of community practitioner-sponsored, team-based management projects to provide context and a “learning lab” for enhanced self-awareness and effective teams. Team-based management projects move away from simulation, business planning, or mock exercises that could have minimal applicability to students. 8-10 Given that engaging with pharmacists allows students to see how leadership can shape real-world practice and has shown to be effective,11 the team-based management projects connected students with current practitioners to collaborate on management or practice-based projects.

Based on a review of the literature, the community sponsored, team-based management projects at the University of Utah College of Pharmacy present a novel, “win-win” educational experience in leadership development for both pharmacy students and pharmacist-sponsors in a leadership and management course. This paper describes a professional curriculum course focused on developing teamwork skills through tackling real-life management problems, with the goal to equip students with the necessary skills to become successful team members. This paper will be the first of its kind to assess the feasibility and benefit of community-sponsored, team-based management projects in a leadership and management course on providing PharmD students’ and the project sponsor experience over three years.

Educational Context and Methods

The UUCOP is a public college of pharmacy within a large academic medical center with an enrollment of approximately 60 students per class. PHARM 7340 Leadership and Management for Pharmacists is a required, two-credit didactic-experiential course taught in the fall semester of the third professional year within the four-year didactic curriculum. A significant portion of the UUCOP longitudinal leadership curriculum resides in the Leadership and Management for Pharmacists course. Students who enter the course have a basic understanding of RL from lectures and activities in other courses with introductory learning specifically related to self-awareness, but limited learning related to effective teams.  The course meets once weekly for two hours over 14 weeks and includes didactic lectures with active learning strategies, reflection, breakout sessions, application exercises, activities in a separate recitation course, and a small-group project. Students complete two didactic modules to build a basic understanding of key leadership concepts, then participate in community practitioner-sponsored, team-based management projects.

Experiential: Practitioner-Sponsored Projects

Involving community sponsors from various settings exposes students to a variety of leadership styles and practices.12 Before each semester began, local pharmacists serving in leadership or clinical roles in retail, ambulatory care, hospital, and managed care settings were contacted and invited to submit management or practice-related projects that could be completed in approximately nine weeks. Sponsors submitted a project form (Appendix 1) to guide the creation of the project, ensure the project would meet course objectives and provide deliverables for the students to complete by the end of the semester. The project form was reviewed and approved by the faculty course director with feedback given and adjustments made as needed to meet project and course objectives. This process also allowed the course director to vet potential sponsors. Projects were designed with the intent that the sponsor could easily implement the project following course conclusion. Sponsors were given extensive latitude to submit projects across a wide array of topic areas. Elements of the projects included but were not limited to, practice management, practice/service development, patient safety, continuous quality improvement, operations, literature evaluation, and production of publishable work. Four to six students were assigned to each project based on their project preference through a ranking survey. Project sponsors and students participated in a vision session during class to establish a relationship as a team, discuss the goals of the project, and create a plan on how to produce the desired results. Students completed their projects longitudinally over the course of the semester. Through this activity, students had the opportunity to learn teamwork by engaging in brainstorming session; collecting and analyzing data; and preparing deliverables and presentations. Students were encouraged to use the RL concepts of manage self, foster teamwork, coach and develop, and accelerate change throughout the duration of the project. At the conclusion of the semester, teams presented their project and deliverables via a formal presentation to project sponsors and the class. Presentations were assessed by the course master, project sponsors, and teaching assistant(s) via rubrics, grading on organization, content, visuals, speaking and presentation skills, conclusion, participation, and responses to live questions.

Two key areas were identified for the assessment of the team-based management projects: team effectiveness in completing the project and sponsor experience. Team effectiveness assesses students’ function in teams as a result of didactic instructions and how well students utilize effective leadership and teaming strategies to accomplish a specific outcome.  In other words, this assessment documented how well students were actually able to accomplish work in a team—which we believe is a reflection of students’ understanding and application of the desired leadership and teaming skills.   

Assessing for sponsor experience ensured the team produced a quality product that met the expectations of the sponsor. Additionally, areas for improvement and future opportunities for collaboration were identified. It was also important to assess the likelihood of projects being implemented to ensure the real-world applicability of the project and the potential for students to continue their efforts with sponsors after course completion.

To assess these key areas, students completed an anonymous, validated Team Performance Survey (TPS) and sponsors completed a project sponsor experience survey via Qualtrics12 upon completion of the semester. Student and sponsor surveys were collected for the Fall 2017, 2018, and 2019 semesters.

Team Effectiveness

The student survey included a previously validated instrument, the Team Performance Survey (TPS).13 The TPS aims to assess how effectively students work together in a team and, potentially, if they were able to implement course concepts that led to improved behavior throughout the duration of the project. In the TPS, students indicated how often on a five-point scale their team members engaged in each of eighteen activities that characterize an effective team (as shaped by effective leadership). Table 1 lists all TPS elements. At the end of the TPS survey, students provided feedback on project experiences to improve student experience in subsequent years.

Sponsor Experience

The project sponsor survey was developed by the course director and collected the sponsors’ assessment of the quality of their students’ work, the likelihood that they would implement the results of the projects, likelihood of sponsoring a future project, and sponsorship benefit on a five-point scale. Free text responses allowed the sponsors to describe features necessary for the creation of successful projects and make suggestions for the future. Feedback was requested to improve sponsor experience in subsequent years in hopes of ensuring a sufficient number of sponsors willing to participate.

For both the team effectiveness and sponsor experience surveys collected in 2017, 2018, and 2019, the scaled data was summarized by the percentage of responses for each choice and the text responses were examined and inductively coded to identify common themes.

Findings and Discussion

Team Effectiveness

Since implementation in Pharmacy Leadership and Management in 2017, 153 students have participated in team-based management projects. One-hundred percent of students completed the TPS. Results indicate that student teams were able to work together to create a final project and develop mutual respect with one another (Table 1). Average scores of the TPS (2017, 2018, and 2019) report that all indicators of team effectiveness had high percentage of responses in the “almost every time” or “every time” response categories. The activity with the lowest average ranking, “often members helped a fellow team member to be understood by paraphrasing what he or she was saying” was ranked above 85%. Overall, the TPS responses indicate students within the Leadership and Management course can form and use relevant leadership and teaming skills to operate within highly effective teams. Free text response regarding the best parts of the community-sponsored, team-based projects identified that students found value in networking with sponsors and other pharmacists through their projects; working in and providing informal leadership on teams; learning about a new area of pharmacy and/or management skill; building community in the classroom; the autonomy of creating deliverables; interesting and relevant projects topics; and working on practical, applicable, and impactful projects (Table 2). Points for improvement included starting projects earlier in the semester, having more time in class to work on projects as a team, having more explicit guidance on project deliverables, and encouraging more frequent contact with project sponsors during the semester (Table 3). From 2017 to 2019, the areas for improvement stayed relatively consistent, but time allotted to work on projects in class and introducing projects earlier in the semester improved.

We interpret the results of the TPS to conclude that students were able to use leadership and teaming skills introduced in the course to work together to accomplish the final project and function as an efficient team, with all categories of this survey being rated over 85%.

Sponsor experience

Between 2017, 2018, and 2019, there was a total of 28 projects with 16 pharmacists who served as sponsors. Four pharmacists sponsored two projects in the same year, five pharmacists served as project sponsors in two out of the three years, and two pharmacists served as project sponsors each of the three years. All 28 project sponsors completed the sponsor survey. One-hundred percent of project sponsors reported that students were able to create deliverables that met expectations with no or minor revisions needed. Sixty-four percent of the project sponsors reported that they would be extremely likely to implement the student projects into their practice (30% of project sponsors reported “likely” and 6% reported “neutral” or “somewhat unlikely”). Benefits of participation to the sponsors included the opportunity to interact with students, engage with the College of Pharmacy, and network with future colleagues while accomplishing something meaningful that would benefit the project sponsor’s work organization (Figure 1). All project sponsors stated they would be willing to sponsor future projects. Free text responses identified that providing students with feedback, setting clear expectations, and communication were essential elements for creating a successful project (Table 4). Communication about expectations and deadlines between students and mentors was a challenge that many project sponsors faced (Table 5). Points for improvement included setting expectations early with students, creating deadlines, and frequent check-ins.

One key factor considered in the design of the course and the management project was the project sponsor’s experience and whether the projects would actually be implemented. Although one project sponsor indicated that “it would be unlikely for them to implement the project into their practice,” the majority indicated that project implementation was likely. Additionally, all of the sponsors answered that they would be willing to help with a future project, signaling an overall high level of satisfaction with the experience. Five pharmacists sponsored projects in two consecutive years and two pharmacists sponsored projects in three consecutive years indicating that community partners built a strong relationship with UUCOP and found value in working with the student teams. The relationships built with UUCOP and students may motivate project sponsors to continue to develop high-quality, innovative and authentic projects.

Implications

The team-based management project continues to be a core element of the Leadership and Management for Pharmacists course. Since their inception, the projects have evolved to explore advanced pharmaceutical practices and produce more innovative and impactful deliverables. The diversity of projects to meet the interests of students has been a strong focus of improvement.  Given the growing demands on student time, more in-class opportunities have been given for project work and, therefore, greater use of leadership and teaming skills. Frequent contact between sponsors and students has been emphasized.

The assessment of team-based leadership projects in the Leadership and Management course identified several “wins” that did not occur in the UUCOP curriculum previously and have not been identified by previous literature. The course creates new and authentic connections between education and practice by engaging students on relevant projects that benefit all involved. Through the projects, students are able to connect with mentors and potential employers while gaining experience using their leadership and teaming skills and becoming more comfortable in their understanding of leadership roles needed to move pharmacy forward. Project sponsors gained closer connections with students who may become their employees and the ability to implement projects that benefit their organizations. By utilizing their community connections and focusing on addressing sponsor needs, other institutions could adopt this model of using team-based projects to provide real-world opportunities for students to learn firsthand how important leadership and teaming skills can be.

A potential barrier for adopting this model of community-sponsored, team-based projects is the inability to find sponsors to offer and facilitate projects that can be completed within a semester, are relevant to advancing current pharmacy practice, have a real-life application, and are intended to be implemented at respective practices sites. Beyond implementation in a leadership or management course, a similar model could be applied to interprofessional education or therapeutics courses where the projects are clinical in nature. This process could also be utilized for medication safety, quality improvement, pharmacy & therapeutics committees, or in other administrative functions occurring in health systems. In all cases, institutions would be free to adapt the parameters of these value-added learning experiences to local conditions, resources, and interests.

The community-sponsored, team-based management projects provided students the opportunity to develop their individual and team leadership skills while creating a beneficial project for the community sponsors and participating organizations. Evaluations from both students and sponsors suggest that community-sponsored, team-based management projects will serve as an effective tool in preparing students to lead change upon entry into the profession and positively impact pharmacy organizations.

Disclosures

Conflicts of Interests: The authors have no pertinent conflicts of interest with respect to the research, authorship, and/or publication of this article. Authors do not have any competing or conflicts-of-interest.

Financial Disclosure: There are no financial conflicts of interest to disclose.

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Appendix 1: Sponsor Project Forms



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Feasibility and Benefit of Using a Community-Sponsored, Team-Based Management Project in a Pharmacy Leadership Course by Kyle M. Turner, PharmD, BCACP, Gursimran Kaur, PharmD Candidate, Shannon M. Tuttle, PharmD, Anthony G. Minjarez, PharmD & Craig Henchey, PhD