Abstract
Objective. To develop, refine, and integrate introductory-level strengths instruction within a doctor of pharmacy (PharmD) curriculum.
Design. Over 8 years, student pharmacists completed the StrengthsFinder assessment tool and identified their top 5 Signature Themes (talents). They then participated in either Web-based learning modules or live workshops designed to facilitate professional development.
Assessment. Students preferred the live instruction over Web-based learning modules. Post-instruction evaluations demonstrated that students discussed their Signature Themes with peers, preceptors, and family members. Pharmacists working with students in strengths-related activities reported that the students applied the information in the practice setting. Both pharmacists and students recommended that this material be required for all students.
Conclusions. Identifying a role in pharmacy that aligns with one's personal talents is critical for the success of pharmacy graduates. Strengths instruction is an important component of professional and career development, and can aid in identifying roles.
INTRODUCTION
For pharmacy to meet its goal of being the profession responsible for ensuring optimal medication use in our society, pharmacists must give the best of their abilities to the profession. Multiple pharmacy leadership conferences have articulated the importance of identifying an individual's strengths and leveraging them in organizations.1-4 In addition, authors have promoted the increased awareness and use of strengths in the profession5-10 and highlighted the impact this can have on employee satisfaction, retention, and improved departmental efficiency.4
The intersection of a person's talents, knowledge, and skills is their unique strengths.11 For instance, a child may be born with a natural ability for ice skating; however, to become a strong skater, they need to combine their natural ability with knowledge of the various jumps and spins, and skills, such as foot placement and speed control. In pharmacy, a pharmacist with a talent for analyzing may be an asset to a pharmacy and therapeutics committee, particularly if she has developed knowledge of the pharmacy and therapeutics process and skill in literature review.
The Clifton StrengthsFinder (Gallup, Inc., www.streghtsfinder.com) is a tool that can be used as a first step in identifying strengths; it identifies a person's talents. However, the identification of the “sweet spot,” where a particular individual's knowledge, skills, and talents intersect, is a challenge. When the challenge is met, employee engagement increases significantly. Employees who are in positions that allow them to do what they do best every day are 50% more likely to work in business units with lower employee turnover, 38% more likely to work in more productive business units, and 44% more likely to work in business units with higher customer satisfaction scores.12 Extrapolating this to pharmacy, when pharmacists are given professional responsibilities that rely on their strengths, they are more likely to engage in those professional responsibilities with enthusiasm and with a higher degree of self-motivation.13 In turn, this enthusiasm and motivation can create professional satisfaction that will be exemplified in a pharmacist's service to others, commitment to professional development, and desire to advance the profession.
In addition to benefiting the profession, employers, and the engagement and satisfaction of individual pharmacists, strengths can play an important role in career advancement and trajectory. The Gallup Organization has studied human behavior and management for 75 years, including employee performance, engagement, and strengths. They have articulated 3 findings from their studies of excellence and top achievers. Top achievers: (1) fully recognize their talents and develop them into strengths, (2) apply their strengths in roles that best suit them, and (3) invent ways to apply their strengths to their achievement of tasks.14 Both pharmacists and employers benefit when employees are well matched to their roles and responsibilities. Recognizing and developing students pharmacists' strengths can facilitate the identification of roles within the profession that best suit them, allowing them to perform at their highest potential as pharmacists.
Strengths Instruction
Chip Anderson, cofounder of the StrengthsQuest program, challenges educators with 16 propositions for promoting achievement. Within these, he states:The future achievement and the quality of life students will experience, will in large measure be determined by the extent to which they discover their greatest talents, and they develop and apply their strengths. Therefore, it is of utmost importance that we as educators and that our educational institutions (from the most elementary to the most advanced graduate and professional programs) consider that our most critically important job is helping students discover talents and develop and apply strengths through the many courses, programs, services and other opportunities that we offer.15
The StrengthsQuest program was designed to help educators and advisors incorporate strengths-based experiences in programming for high school and college students. Hodges and Harter, in describing the theory and research underlying the program, report outcomes such as increased confidence and academic success.16 Austin reports increased positive academic behaviors after a 6-week strengths development intervention for freshman high school students.17
While academic performance can always be supported further, student pharmacists already have considerable academic experience and have demonstrated academic success prior to admission. With professional students, programming with a focus on career and professional development is desirable. The importance of a focus on strengths education in pharmacy has been articulated10; however, no articles have described the educational processes by which student pharmacists can identify, grow, and foster their unique strengths for the benefit of their future career.
The Accreditation Council for Pharmacy Education's Standards and Guidelines do not directly address expectations for student pharmacists learning about personal strengths. However, recognizing that awareness of personal talents and abilities in a professional context is a foundation from which engagement in life-long learning will emanate, this work is connected to the expectations of Standard 12 of the Guidelines. This Standard highlights a program's need to prepare pharmacists who will be self-directed lifelong learners.18 Self-directed lifelong learners must have a keen understanding of their personal abilities, as well as a sense of their professional direction, in order to design and implement personalized learning plans.
The Center for the Advancement of Pharmaceutical Education (CAPE) highlights the importance of student pharmacists having personal awareness of their strengths and the ability to apply them within their career. Specifically, the CAPE Educational Outcomes state that pharmacists must maintain professional competency by committing themselves to being independent, self-initiated life-long learners who can: (1) assess personal knowledge and abilities independently; and (2) recognize self-limitations and seek appropriate assistance/clarification.19 An understanding of one's personal strengths provides a foundation for this approach to life-long learning.
The University of Minnesota College of Pharmacy engaged in an 8-year journey in defining strengths instruction. The process of design, implementation, evaluation, reflection, and refinement has resulted in the development of 3 distinct levels of strengths instruction, which have been applied with student pharmacists, pharmacy practice residents, and practicing pharmacists.20 An educational process has been developed with the intent of:
enhancing awareness of strengths
encouraging reflection on the past and future use of Signature Themes of Talent
fostering strength-based career-decision making and career renewal
increasing the application of strengths in teams and organizations
supporting the use of strengths in leadership
The purpose of this article is to describe a school's journey in refining and evolving strengths instruction within a PharmD curriculum. Particular attention will be given to the lessons learned when delivering introductory level strengths instruction. In addition, student and faculty response to making strengths instruction a mandatory component of the curriculum will be examined.
DESIGN
Evolving Strengths Instruction
Strengths instruction began as an optional seminar in 2002, offered as part of a core third-year pharmaceutical care laboratory course focused on patient care delivery and sterile and nonsterile compounding. In 2007, instruction was incorporated into an elective course, Leading Change in Pharmacy I, offered each fall. This course serves about 30 second- and third-year students each offering, divided between the Twin Cities and Duluth campuses. The initial move of strengths instruction to an elective course was received well and pharmacists participating in a shared mentorship experience within the course affirmed the importance of the topic to pharmacy. In 2007, during an end of class course evaluation activity, students recommended that strengths be moved earlier in the curriculum and made available to all students. This recommendation also was made by elective course participants in 2008. In the fall 2009, 2 initiatives were undertaken that moved strengths instruction from elective to mandatory. First- and second-year students were required to take the Clifton StrengthsFinder as part of the Early Pharmacy Practice Experience Foundations course. Workshops were added to this requirement in fall 2010. Also in 2009, third-year students were required to complete the Clifton StrengthsFinder and to participate in an online or live 2-hour educational workshop. A series of strengths-related reflections were then incorporated into their advanced pharmacy practice experience (APPE) portfolio requirements. The content and structure of these courses and workshops was designed to meet the learning objectives outlined in Table 1. In each delivery method, combinations of lecture, small-group discussion, and individual reflection were incorporated to enhance student learning. Figure 1 depicts the timeline for evolution of strengths instruction for students.
Learning Objectives for Introductory Learning Objectives for Strengths Instruction
Timeline for doctor of pharmacy (PharmD) curriculum strengths instructional delivery at the University of Minnesota.
Introductory-Level Learning Objectives and Pedagogy
During the evolution of strengths instruction, a sequence of learning objectives and activities were developed. This sequence was divided into introductory, intermediate, and advanced levels to guide strengths instruction for pharmacy.20 Table 1 summarizes the introductory-level learning objectives and related Bloom's taxonomy levels. The introductory level of strengths instruction focuses on the development of knowledge of the strengths philosophy and terminology, recognition of talents used in recent pharmacy experience, and identification of opportunities for the learner to use his/her talents in future pharmacy-related roles and responsibilities. Determining baseline knowledge of the learner's strengths was vital in achieving our ultimate goals of fostering strength-based career-decision making and career renewal, increasing the application of strengths in teams and organizations, and supporting the use of strengths in leadership.
Multiple types of learners, ranging from student pharmacists to residents to practicing pharmacists, participated in this instruction. Regardless of the ultimate level of learning achieved, all began with the introductory level objectives. The educational environment used is flexible and dependent on a combination of the location and preferences of the learner. Live and online workshops were conducted for both student and pharmacist learners. With each delivery format, the learner begins by reading StrengthsFinder 2.0 and completing the Clifton StrengthsFinder. Students also completed an introductory assignment, which required them to reflect on the concepts from each of their Signature Themes and identify the concepts from that Theme's description that most resonates with them. Students then were asked to describe how they had applied the talents within each Signature Theme to a recent pharmacy-related situation.
The 2-hour live workshop was designed to explicitly address the objectives through a combination of mini-lectures, and large- and small-group discussions. An online version of the workshop was available to participants 24/7 over a 2-week period through the University's online learning management system. This time period coincided with the time period of the repeated offerings of the live workshop. The online workshop used prerecorded lectures, online exercises, discussion boards, and an online quiz to achieve the same introductory objectives in an asynchronous manner. Live sessions allowed for more immediate feedback and tailoring based on the questions and concerns that participants raised. Because of the synchronous format, live sessions also allowed participants to conveniently learn from one another. For these reasons, live sessions were recommended. However, online sessions were made available to all students in the APPE portfolio initiatives due to scheduling constraints.
Descriptive statistics from workshop and course evaluations, as well as qualitative responses and stakeholder perspectives were used throughout the evolution of this approach to inform instructional design and improvement.
EVALUATION AND ASSESSMENT
Evaluation of Initial Instruction
The first 5 years of strengths instruction consisted of 1 discussion session conducted in a small seminar group as part of a much larger course. Being 1 discussion, it was not assessed explicitly on the course evaluation. In 2007, strengths instruction was formally incorporated as a unit within the Leading Change in Pharmacy I elective. Table 2 summarizes student evaluations of strengths instruction from 2007 (63% response rate) and 2008 (76% response rate).
Student Ratings of Strengths Instruction in a Leading Change in Pharmacy Coursea
In 2008, an online module was used for the delivery of some aspects of the strengths instruction. With its media enhanced stories of strengths, use of brief presentations, and self-paced nature, the instructors felt that it might appeal to alternate learning styles. In general, students felt the content was repetitive and that face-to-face instruction was preferable and sufficient for achievement of the objectives. Subsequent to this feedback, topics in the course were reorganized and classroom-based instruction was used exclusively in 2009.
Evaluation of Recent Elective
As we worked to identify a location within the curriculum for strengths instruction for an entire class of students, the learning objectives for introductory strengths instruction were refined. Once this enhanced progression of objectives was available, the end-of-course evaluations became more specific on the acquisition of strengths-related skills. Table 3 provides student self-ratings from the fall 2009 offering of the elective course, which reflect students' perceptions of enhanced abilities to understand and apply strengths.
Strengths-Related Self-Ratings of Pharmacy Students Enrolled in a Leading Change in Pharmacy Course (N=25)a
In addition to improving quantitative evaluation of strengths instruction, new qualitative items were added in 2009. Respondents reported the following issues related to the introductory-level strengths objectives when responding to the question “With the strengths content, I struggled most with…”
describing strengths to others
identifying examples when strengths were applied
understanding the differences between strengths and Signature Themes
adopting a mentality that an emphasis should be placed on strengths development over fixing weaknesss
accepting that there are no bad strengths
understanding that some Signature Themes may relate to strengths that one has not used yet in one's careers
establishing a clear plan for strengths application over one's career
These qualitative comments have been especially helpful in continuing to refine the mini-lectures, discussion questions, and exercises in the workshops.
Comparisons Across Forms of Delivery
As part of their APPE portfolio requirements, the class of 2010, was asked “After completing the strengths instruction, I have shared one or more of my Signature Themes with: (select all that apply).” This same question was asked of the class of 2011, after completing the Leading Change in Pharmacy course. Fifty-four percent of the class of 2010 and 73% of students in the Leading Change in Pharmacy course responded. The results in Table 4 provide an opportunity to compare responses given when the content was mandatory versus optional. No incentives for responses were offered to either group of learners.
Student Sharing of Signature Themes Post-learning Experience
Responses students received from those with whom they have shared their Signature Themes also has been examined. The fall 2009 strengths survey instrument included an open-ended prompt: “When I shared my Signature Themes the results/reactions/responses have included:” Eight of the 20 students described the feedback they had received as “positive,” “interested,” “good reaction,” while 8 others were told that the strengths described the student well and “that sounds like you.” Only 1 student reported receiving a negative response (her spouse said he was “cynical” about personality tests). In addition, of the 20 respondents to this question, 5 indicated that those providing feedback had expressed an interest in taking the assessment themselves. Student self-ratings regarding perceived level of achievement of strengths-related learning objectives are provided in Table 5.
Student Self-Ratings of Strengths Learning Objectives Post Learning Experience
Peer Evaluation of Instruction
Through the development of learning activities in the Leading Change in Pharmacy course sequence, relationships have been developed with 35 local pharmacists who are regarded as leaders in the profession. These pharmacists are referred to as Leadership Networking Partners and represent a variety of practice settings and positions. These individuals have become colleagues in developing the Leading Change in Pharmacy courses and experiences for student pharmacists. In particular, the partners ensure that our content and objectives are well aligned to practice needs. These leaders are required to complete the StrengthsFinder assessment and an orientation with the course instructors. After completion, they are matched with students in the Leading Change in Pharmacy elective courses so that students can see the application of class concepts “in the real world.”
The partners have supported strengths instruction. All partners commit to sharing their strengths with their students, discussing their student's strengths, and sharing examples of strengths in the workplace. Although the partners are experienced pharmacists and well versed in strengths, they continue to find that sessions with students aid in their own learning. They also have indicated that the strengths discussions are valuable to the students. In addition to course evaluations, we asked partners to complete an electronic survey instrument regarding their peer's learning, interactions with the student, and perceptions of student learning. Table 6 shows the results of these peer evaluations for 71% of the 2009 partners.
2009 Leadership Networking Partner Responses Related to Strengths Learninga
DISCUSSION
All colleges and schools of pharmacy engage in activities that focus on the professionalization of student pharmacists and seek to prepare them for rewarding careers in the profession. As an institution contemplates how it will engage its students in professional development, it should not only focus on preparing students to be excellent pharmacists, but also helping students understand the specific roles they are best equipped to play in the profession. Use of the StrengthsFinder assessment, as well as learning activities that help define students' talents and strengths in the context of pharmacy, is a powerful framework for guiding a learner's self-discovery for a rewarding career path. As a result, this work has applicability to all colleges and schools of pharmacy.
In fall 2009, student ratings did not receive as high a proportion of “strongly agree” responses for the following areas: strengths objectives; instruction related to myths; and strengths as an intersection of knowledge, skills, and Signature Themes. This may reflect concepts that may challenge students when first encountering this material. In particular, terminology can be used imprecisely, which can lead to confusion. Although talents, Signature Themes, and strengths are explicitly defined in the instruction, in discussions among new learners, terminology tends to be used interchangeably. Many students struggle to remember that the StrengthsFinder assessment only identifies talents. More work must be done to identify an individual's unique strengths. Extensive support materials, such as Go, Put Your Strengths to Work,21 have been developed to support this level of learning. The distinction between talents/Signature Themes and strengths is an important one that introductory learners should understand because it provides the motivation for continuing on to an intermediate level, where strengths can be developed and honed.
Live and online formats generated sharing at approximately the same rates (Table 4); however, the Leading Change in Pharmacy elective course appears to have resulted in higher sharing rates. These results must be interpreted with caution. A number of variables could have affected these rates, including timing of survey administration relative to instruction, and differences in instruction. The Leading Change in Pharmacy students receive a more intense program, complete more in-depth assignments, and have one-on-one strengths mentoring meetings with an instructor, commensurate with the introductory and intermediate level objectives addressed in this instruction.20 The process of student pharmacists sharing and discussing Signature Themes and specific strengths is an important outcome of strengths instruction. Forthright discussions with prospective employers will be needed to negotiate job responsibilities that are in alignment with their strengths. More immediately, student pharmacists sharing their strengths with preceptors could assist in identifying opportunities to develop the students' strengths during experiential education.
In addition, some differences in agreement with the learning objectives were seen among some student groups (Table 5). The Leading Change in Pharmacy elective extends over multiple class periods, occurs earlier in the curriculum, and uses a different textbook than is used in the portfolio course. Additionally, strengths instruction in the Leading Change in Pharmacy course is addressed with a broader perspective, speaking to both personal development as well as application to effective leadership, whereas the portfolio course focuses only on personal development. There also may be positive effects because of the more advanced concepts that are introduced (eg, strengths in teams and strengths in organizations). In addition, this group of students elects to participate in strengths instruction. As various levels of strengths instruction are defined and implemented within pharmacy curricula, close attention to achievement of learning objectives will be needed.
The StrengthsFinder tool probably will become more frequently used by organizations that employ pharmacists. It may be introduced to pharmacist managers as a mechanism to support their role in staff development and productivity, or to all staff members as part of an institutional initiative. This increased application of the strengths philosophy by organizations will create an opportunity for a longitudinal personal development strategy that extends from a professional program well into a professional career. Student pharmacists' exposure to these principles will allow pharmacy graduates to integrate more seamlessly into organizations that have already adopted this philosophy. As a result, introductory strengths instruction is not only applicable and transferable to other colleges and schools of pharmacy, their efforts in this area are transferable to the professional environment in which many graduates will practice.
Our experience in teaching students about their strengths started with an elective course. More recently, strengths instruction has become required of all students. In this transition, we have observed that the frequency of encountering students who resist the notion that strengths-related concepts are relevant to a career in pharmacy increases. When teaching strengths to all students, instructors must be deliberate in their discussion of how the strengths concepts will benefit the learner now and in the future. In addition, the involvement of P4 students on advanced pharmacy practice experiences, pharmacy practice residents, and practice faculty members is important. As co-facilitators in workshops, they can share stories related to their personal strengths and recent practice experiences.
Some learners receive their results and clearly see how the Signature Themes descriptions reflect who they are, but struggle with how they can use their Signature Themes in a practice environment. To address this challenge, trained pharmacists have been used to provide feedback on strengths activities as part of the college's APPE portfolio process. For students participating in strengths learning within elective coursework, one-on-one discussions with learners to more fully explore talents and strengths have been used. These discussions often involve advice on career options that may best align with a student's Signature Themes.
All colleges and schools of pharmacy are committed to the professional development of their graduates. However, they may need to formally consider how they will invest resources with respect to these initiatives. Also, colleges and schools must consider whether they have adopted these philosophies into the operations of their staff and program. For institutional commitment to be fully achieved, colleges and schools need to engage in this material at the administrative level and to consider its implications regarding institutional operations, PharmD program design, and delivery and resource allocation. If longitudinal curricular integration is desired, colleges and schools may need to formally engage faculty members in professional development on the topic of strengths. They also may need to consider the methods for preparing volunteer faculty members in IPPE and APPE programs to supplement classroom instruction and optimally support students in discovering what their talents and strengths mean in the professional world.
Most programs already have one or more individuals responsible for student development and an innate desire to see students succeed is common among committed educators. However, passion for student development alone is not enough to guarantee an instructor's success in facilitating strengths-focused learning. An instructor working in this area must have the opportunity to read, apply, and interpret literature and the experiences of others who have previously engaged in this work. The following activities are recommended to best prepare faculty and staff members to lead integration of this content into a professional program:
Read multiple books published by Gallup and Marcus Buckingham, including First Break all the Rules; Now, Discover Your Strengths; Go Put Your Strengths to Work; and Strengths-Based Leadership.
Consider participating or reviewing additional learning resources such as a Gallup workshop, the video series Trombone Player Wanted, or the video component of the book The Truth About You.
Speak with faculty members from other programs that have experience teaching this material. This recommendation is not focused only on pharmacy faculty members, as many universities use the StrengthsFinder in undergraduate education or in administrative support within their institution. Pharmacy instructors are encouraged to determine whether programs already exist on their campus and whether the presence of these programs could support their efforts.
Reach out to key pharmacy personnel in the college or school's region to determine whether the StrengthsFinder has been used within their organizations. Other organizations may have lessons that could be useful for adoption in the professional program, suggestions for bridging instruction into experiential education, or access to resources that may be helpful in strengths instruction.
SUMMARY
The identification and development of individual pharmacists' strengths is important for the advancement of the profession and can begin in pharmacy school. One school's journey in refining and evolving introductory level strengths instruction has been outlined, including student and peer response, and challenges and recommendations for institutions considering similar initiatives.
ACKNOWLEDGEMENTS
Student educational initiatives reported in this article were supported in part by a development fund made available by a gift from Walmart, Inc. This fund provides support for certain course activities as well as acquisition of some of the learning materials used for instruction.
Footnotes
↵* Affiliation at time of study. Dr. Traynor's current affiliation is with Concordia University of Wisconsin, Milwaukee, WI.
- Received October 4, 2010.
- Accepted December 13, 2010.
- © 2011 American Association of Colleges of Pharmacy
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