Research ArticleRESEARCH

Well-being Content Inclusion in Pharmacy Education Across the United States and Canada

Elizabeth Buckley, Simi Gunaseelan, Benjamin D. Aronson, Heidi N. Anksorus, Victoria Belousova, Tram B. Cat, Kristine M. Cline, Stacey D. Curtis, Christina E. DeRemer, David Fuentes, McKenzie S. Grinalds, Seena L. Haines, Hannah E. Johnson, Karen Kopacek, Jessica M. Louie, Nkem P. Nonyel, Natasha Petry, Shawn Riser Taylor, Suzanne C. Harris, Cheryl A Sadowski and Anandi V. Law
American Journal of Pharmaceutical Education April 2023, 87 (3) ajpe8918; DOI: https://doi.org/10.5688/ajpe8918

Abstract

Objective. To describe the landscape of well-being content inclusion across schools and colleges of pharmacy in the United States and Canada through identification of content implementation, incorporation, and assessment.

Methods. A cross-sectional survey was distributed to all accredited schools and colleges of pharmacy in the United States (n=143) and Canada (n=10). Survey questions included curricular and cocurricular timing, frequency, assessment strategies, and support for well-being initiatives, using a framework of eight dimensions (pillars) of wellness to categorize content.

Results. Descriptive data analyses were applied to 99 completed surveys (65%), 89 (62%) in the United States and 10 (100%) in Canada. Well-being content was most prevalent within the cocurricular realm and incorporated into didactic and elective more than experiential curricula. The most content came from intellectual, emotional, and physical pillars, and the least content came from financial, spiritual, and environmental pillars. Less than 50% of schools and colleges of pharmacy include well-being within their strategic plans or core values. Funding is primarily at the level of the university (59%) or the school or college of pharmacy (59%). Almost half of respondents reported inclusion of some assessment, with a need for more training, expertise, and standardization.

Conclusion. Survey results revealed a wide range of implementation and assessment of well-being programs across the United States and Canada. These results provide a reference point for the state of well-being programs that can serve as a call to action and research across the Academy.

Keywords

INTRODUCTION

Well-being is defined as an optimal and dynamic state allowing people to achieve their full potential, while wellness is the quality or state of being in good health.1,2 Health care professionals face significant well-being challenges, and these difficulties begin among health care professional trainees.3-6 Facets of well-being, specifically emotional health, lend to greater self-efficacy in accomplishing academic goals.7-10 Existing literature outlines approaches such as stress reduction education used by schools and colleges of pharmacy to improve well-being within their curricula and health care settings.11,12

In 2019, several pharmacy organizations convened to develop strategic actionable recommendations to improve well-being within the profession as outlined in the Enhancing Well-Being and Resiliency Among the Pharmacist Workforce: A National Consensus Conference.13 Eleven out of 50 recommendations specifically related to academia. As a result, in 2020, the American Association of Colleges of Pharmacy (AACP) Well-Being and Resiliency Community (WBRC) was formed to promote well-being education, initiatives, and assessment within pharmacy academia.

Despite dedicated conversations on a national level for a systems approach to well-being, there is a paucity of literature regarding the current state of well-being efforts within schools and colleges of pharmacy.14 The objective of this study was to describe well-being content, implementation, and assessment across all schools and colleges of pharmacy in the United States and Canada.

METHODS

The WBRC convened a workgroup with participants from the United States and Canada to develop a survey intended to gather data regarding current well-being efforts. The workgroup divided into subgroups for each of 10 potential survey sections, and formulated questions. The well-being and wellness framework used in the survey was adapted from the Substance Abuse and Mental Health Services Administration’s eight pillars of wellness as the most inclusive way to categorize well-being content.15 Pillar definitions and examples were included as an appendix to provide clarity to survey participants based on expert opinion, experience, and extant literature.

The survey was delivered with the following companion documents: the appendix of well-being pillar definitions and examples and a Word document of the survey to allow respondents the opportunity to identify and gather the necessary information before survey completion.

Given the large scope of the project, the survey was divided into three subsurveys: curriculum overview, experiential education, and faculty development. The surveys and companion documents were tested for face and content validity by examining readability, ease, navigation, and clarity by seven WBRC members prior to dissemination.

Only the curriculum overview subsurvey is described in this manuscript. This survey contained the following six sections: demographics (12 items); faculty/staff involvement and resources (four items, regarding personnel, dedicated faculty/staff, and advanced credentials); program resources (four items, regarding institutional support for self-care well-being programs, funding sources, inclusion in strategic plan/core values); curricular and cocurricular content (19 items, regarding overall program inclusion [two items], specific topic inclusion by pillar [eight items], place, timing, and delivery methods for each pillar [eight items], and certificate training [one item]); assessment strategies (two items, including tool, frequency, and type); and well-being support and potential barriers (one table, 15 items, answered on a five-point Likert scale of “strongly disagree” to “strongly agree” including the option to answer “unable to rate”).

The three subsurveys were distributed via email to well-being representatives, identified from AACP resources and self-identification from the AACP WBRC, at 143 US and 10 Canadian pharmacy schools and colleges (153 total) with a link to the survey in Qualtrics (Qualtrics International Inc). The survey was deemed exempt by the Concordia University Wisconsin Institutional Review Board and the Research Ethics Board at the University of Alberta. Data collection began in December 2020, with monthly reminders to nonresponders through April 2021.

All statistical analyses were conducted using SPSS Statistics version 27 (IBM Corp). Data from Canadian institutions, (all four-year programs), were analyzed with data for the US four-year programs. Descriptive analyses were used to summarize data for categorical and continuous variables. Student t test or chi-square test was used to analyze continuous and categorical data, respectively. A Fisher exact test was used to compare US and Canadian data with categorical variables. For all tests of significance, a two-tailed alpha value was set at .05.

RESULTS

A total of 99 completed surveys were analyzed out of 153 invited programs (response rate 65%) after removing five duplicates. Of these, 89 (62%) were from the United States and 10 (100%) from Canada. There were no significant differences between US and Canadian schools and colleges of pharmacy. Most participating US institutions (96%) and all Canadian schools and colleges of pharmacy were accredited. Most schools and colleges of pharmacy (58%) were older than 25 years and on a single campus (77%). Over half of participating institutions were public (58% US and 100% Canadian institutions), 42% private, and 1% public or private historically black colleges and universities. Most of the responding schools had four-year programs (80%) and a Doctor of Pharmacy (PharmD) class size between 51-150 students. Prior to the COVID-19 pandemic, 90% of programs offered all in-person curricular delivery. During the COVID-19 pandemic, most (80%) programs moved to a hybrid remote and in-person delivery, with 60% delivering remote teaching synchronously. Well-being activities were included in less than half of the strategic plans and core values of universities (30%) and schools and colleges of pharmacy (41%) and in less than a quarter of department goals (24%). Institution descriptors are available in Table 1.

View this table:
Table 1.

Demographics, Personnel Engagement, and Funding Sources of Responding Schools

Nearly all respondents indicated their schools had some form of cocurricular initiatives related to well-being. When asked to indicate all possible initiatives, 95% of respondents reported student-driven initiatives, 81% included staff-directed initiatives, and 66% reported using on-demand/asynchronous workshops. About 42% of respondents indicated that cocurricular initiatives occurred at least two to four times/year.

Although the inclusion of well-being activities within the pharmacy curricula varied, the majority (90%) reported well-being content offered through the university at-large. Within schools and colleges of pharmacy, content was most frequently integrated within electives (>50%) for three- and four-year programs. Common didactic areas for well-being content included required courses, standalone courses, longitudinal course series, and integration across multiple courses. Focused experiential training (from the curricular overview survey) was the area with the least inclusion. See Figure 1 for a breakdown by three-year, four-year, and six-year program data. Three-year programs reported more well-being content in electives and longitudinal course series than within required didactics. Six-year programs reported the least curricular incorporation, with zero inclusion within integrated courses, longitudinal course series, focused experiential training, or interprofessional educational activities. Within four-year programs, the largest cohort, students’ first professional year (P1) included well-being content in didactic courses and focused interprofessional educational activities (∼35%). The P2 and P3 years offered the most elective well-being content (∼48%).

Figure 1.
Figure 1.

Curricular Inclusion of Well-being Content by Program.

Most schools and colleges of pharmacy indicated they did not offer any well-being certificate training programs. When offered, the most common program was Mental Health First Aid training (31%), followed by Question-Persuade-Refer (QPR) Gatekeeper Training for Suicide Prevention (21%), The Jed Foundation training (8%), and state/provincial boards of pharmacy training programs (7%).16,17 Most were delivered via cocurricular experiences (33%) and elective courses (20%). Four-year programs had a higher number of certificate trainings offered, mostly (42%) in P3.

Based on the total number of specific topics offered, averages across curricula for all pillars are represented from highest to lowest in Table 2. The didactic and elective curricula included the same top pillars with slight variations in rank: intellectual, emotional, physical, occupational, and social. The least represented in any area of the curricula were financial, spiritual, and environmental (<20%). The top well-being topics within each pillar covered by >60% respondents included self-awareness (75%), self-care (68%), critical reflection (67%), diversity and inclusion of minority students (63%), and stress management (63%). See Appendix 1 for specific percentages across each topic. Canadian schools had a significantly lower financial inclusion, with no need to cover student loan payback planning. Experiential well-being content was limited overall, with intellectual (17%) being the most covered pillar (Figure 2). In the four-year programs (n=79), well-being content was included in 7% of introductory pharmacy practice experiences (IPPEs) and 18% of advanced pharmacy practice experiences (APPEs). In three-year programs (n=10), three schools reported APPE inclusion and two within IPPEs. No six-year programs (n=10) reported well-being in experiential training.

View this table:
Table 2.

Specific Well-being Topic Frequency of Inclusion by Pillar

Figure 2.
Figure 2.

Curricular Inclusion of Pillars: What is Covered and Where.

Approximately 50% of surveyed programs reported using tools to assess well-being. Of those, 17% completed these assessments once overall, 37% annually, 34% several times throughout the program, and 12% twice annually. Eighty one percent of programs completed assessments in the didactic years versus 19% in the experiential year. Among these schools and colleges of pharmacy, the most assessed topics were perceived stress (n=57) and overall well-being (n=50). Schools and colleges of pharmacy reported using the following validated assessments: Maslach Burnout Inventory, My Well-Being Index, DISC assessment, StrengthsFinder, Perceived Stress Scale (PSS), Duckworth Grit Scale, and AACP Graduating Student Survey. Other respondents reported using internally developed tools to assess a variety of well-being topics (eg, overall well-being, perceived stress, coping strategies, mindfulness, and intellectual wellness).

Regarding resources, 37% of respondents reported having a dedicated person or committee/working group to oversee all student well-being initiatives. (Table 1) The dedicated person varied between administrators, faculty, and staff. Committees and groups included faculty (92%), staff (82%), and students (77%), and they met monthly (49%) or as needed (36%). Over half (58%) reported personnel participating in well-being initiatives out of goodwill, volunteering, or self-directed efforts. Although 78% of schools and colleges of pharmacy reported having personnel with credentials related to well-being (eg, wellness certified, Mental Health First Aid, lifestyle medicine), approximately one-third of respondents indicated that their dedicated well-being person did not have specific well-being credentials. Credentials held by committee members included mental/behavioral health (48%), yoga instructor (21%), and board certification in psychiatric pharmacy (BCPP) (38%).

Most (74%) institutions provided support or counseling programs separate from health coverage policies or employee assistance programs. Nearly all programs (93%) offered institution-level counseling programs for students, where a large majority (>80%) offered well-being education and exercise programs (access to gyms, vouchers for decreased gym membership fees), and over half (56%) offered time-out options (eg, quiet spaces, walking trails). For faculty and staff, the top three well-being programs offered at the institution level were education programs about wellness/maintaining well-being (77%), exercise programs (74%), and counseling programs (63%). Other notable offerings included time-out options (50%), health programs such as annual physician evaluations (47%), and hydration programs (40%).

University (59%) and schools and colleges of pharmacy (59%) resources were the most common primary funding sources for well-being activities, along with student fees (28%). Numbers were similar between public and private institutions. Grant funding from internal (3%) and external (5%) sources was reported as available yet not used and could be viable opportunities for future consideration.

Based on a five-point Likert scale, 71% of respondents strongly agreed or agreed that their institution has an overall culture of well-being, including role models to help others learn (69%) and/or a dedicated champion to lead initiatives (52%) (Table 3). In addition, 47% reported widespread interest among faculty, with 56% having access to training in general and 54% reporting access to experts for training. Although 73% strongly agreed or agreed that they have leadership support, only 61% had central administration support from the university at-large, and less than half (45%) reported faculty/staff involvement being recognized as service to the college.

View this table:
Table 3.

Responses to the Survey Questionnaire on Culture of Well-being Support and Barriers at US and Canadian Schools/Colleges of Pharmacya

Some barriers to well-being did arise. Over half of surveyed programs (58%) did not have adequate space or curricular time; 39% did not have trained personnel to teach these initiatives nor a defined leadership team to help direct these initiatives (32%) or collaborative student interest (32.9%). Financial support for wellness initiatives was reported by only 27% of respondents (indicating strongly agree or agree), while another 41% strongly disagreed or disagreed to having this support.

DISCUSSION

Approaches to prioritization, implementation, and assessment of well-being initiatives vary across schools and colleges of pharmacy in the United States and Canada. There is a need to address barriers to providing quality well-being initiatives consistently across didactic, experiential, and cocurriculums. In addition, well-being initiatives need to be enhanced and assessed at both the university level and the school/college of pharmacy level. The findings of our study confirm results of a study by Folz and colleagues, which reported prevalence of wellness programs at US schools and colleges of pharmacy.18 Both surveys included a similar and representative sampling of private and public institutions with consistency in class size among schools and colleges of pharmacy (50-100 students). Our study had a higher response rate overall (32% vs 65%).

Folz and colleagues used six dimensions of wellness (environmental and financial were not assessed), while our study specified eight.19 Similar to our study, Folz found high inclusions of the intellectual, emotional, physical, and social pillars, whereas the spiritual pillar was less incorporated.19 The intellectual domain topics included observable and measurable behaviors such as self-awareness, self-reflection, mindfulness, mindset, and meditation. Similarly, the emotional pillar included measurable variables such as self-care, stress management, emotional intelligence, and personality inventory. Occupational wellness was ranked higher in our results, possibly reflecting the shift of focus to workload and burnout during the COVID-19 pandemic. In addition, social activities received increased attention potentially due to health disparities emphasized by the number of growing social movements and awareness. The evolution of social change makes it timely for pharmacy education to continue to expand diversity and inclusion of minority and LGBTQ+ (lesbian, gay, bisexual, transgender, queer [or questioning], asexual [or allied], plus [others]) students and build community connections. Both occupational and social activities have been included within organizational strategies to reduce burnout.20 Both surveys found most well-being content being taught/applied in the cocurriculum, while experiential training had the least amount of well-being content. Limited well-being content offerings in experiential training highlights the need for more attention and development in programs, as the stress levels encountered by students in experiential learning environments are similarly encountered in residency training, with results showing higher depression, hostility, and dysphoria observed in residents.21-23 Both areas could serve as a starting point for programs to consider.

Assessment of well-being pillars and topics were variable across schools and colleges of pharmacy with a lack of standardization. Most reporting programs completed assessments multiple times throughout student academic progression, though only one-half reported using specific well-being assessments. Challenges exist regarding well-being assessments including time, survey fatigue, perception of lesser importance than curricular therapeutic/science topics, and cost to program of accessing and administering multiple validated tools. While there is the caveat that components of well-being need time and practice to identify measurable change, assessment is needed to determine the success of programs, and all stakeholders including faculty, staff, and students should be included. A balanced, intentional approach is best suited for assessment of well-being topics, which aligns with recommendations from the Accreditation Council for Pharmacy Education and the National Academy of Medicine.13,14

In addition, the National Academy of Medicine recommends a systems approach to professional well-being, specifically enacting change in health professional learning environments to mitigate burnout, enhance well-being, and reduce stigma.14 In order to enact meaningful change, there needs to be programmatic support from an organizational level. Data suggest that organizational priorities and programmatic changes positively impact student mental health and wellness.23-25 Our study indicated that less than half of universities, schools and colleges of pharmacy, and departments include well-being activities as part of their strategic plans and/or core values. When well-being is prioritized as an organizational commitment, opportunities to address personnel, time, and financial resource allocation become more feasible.26

To enact a systems approach to well-being, large-scale organization and programmatic-level changes appear necessary. Additionally, the limited number of dedicated personnel for well-being programs compels faculty and staff to participate out of goodwill. To prioritize well-being, schools and colleges of pharmacy could consider reevaluating workload and promotion criteria to encourage faculty to enact well-being initiatives. The large presence of university-level well-being programs could be helpful in alleviating some of the abovementioned barriers, namely related to personnel, time, and funding at the schools and colleges of pharmacy. Finally, there are gaps in optimal assessment and improvement of well-being programs. Useful practices for assessing well-being programs could be identified to support schools and colleges of pharmacy to make informed decisions regarding the quality and quantity of well-being initiatives to ensure strategic goals are met.

These study results need to be viewed considering known limitations of survey research. First, the length of this survey, including the breadth and depth, may have led to survey fatigue and a risk of inadequate reporting across all areas of the curriculum. Second, survey data were collected during the early COVID-19 pandemic, which may not reflect changes made later in response to the pandemic. Finally, there may have been over or underreporting of well-being content by respondents due to social desirability bias or limited access or knowledge of current initiatives. As a point of clarification, this manuscript reported experiential data gathered from the curricular overview survey. More data will be forthcoming from the separate experiential subsurvey.

With a better understanding of the current state of well-being programs, there are opportunities to further expand, refine, and evaluate well-being initiatives across the Academy. These results note that the majority of participating schools and colleges of pharmacy have some well-being initiatives, yet there is still much to be done in creating inclusive learning environments that positively impact the well-being of future pharmacy trainees. Additionally, differences in well-being implementation based on program length can be further delineated.

The results of this survey can serve as a baseline of well-being initiatives and motivation to enhance well-being programs across the country. These findings can help well-being advocates and leaders self-assess current initiatives, model inventories, content coverage, and types of assessments in comparison with other programs. For some, this means first-time implementation or significant overhaul. For others, the results may affirm what they are already doing. Schools and colleges of pharmacy need to prioritize well-being initiatives in their strategic plans and allocate resources (eg, funds, personnel, and time) to enhance implementation and assessment. Other considerations may include new faculty and/or staff hires and workload redistribution.

Additionally, this report serves as a call to action for the Academy. Recent inclusion of well-being initiatives within the 2021-2024 AACP strategic priorities (Strategic Priority #4: Achieving Well-being for All) is a step in the right direction.27 Continued emphasis and providing faculty and staff with training and resources are necessary to enable schools and colleges of pharmacy to achieve these priorities. There are also opportunities to learn from other health care profession academies that report successful well-being outcomes as they continue to emerge.11,12,25

Lastly, this study opens the door for future research and collaboration. There is a paucity of literature regarding the results of the various well-being assessments being done across schools and colleges of pharmacy that can stimulate quality improvement of current initiatives. We can partner together to identify well-being best practices and determine strategies to overcome barriers.

CONCLUSION

This large-scale assessment of well-being programs in schools and colleges of pharmacy provides a broad overview of well-being initiative implementation across the United States and Canada; however, barriers to implementation and assessment have been identified. Influential factors to consider that can promote well-being among our learners include infrastructure resources, frequency and depth of well-being content coverage, measures of assessment, and sustainability. This survey provides a reference for the state of well-being programs that can be monitored over time. These results also represent a call to action for increased awareness, support, and research across the Academy to generate more knowledge, resource exchange, and consistency amongst schools and colleges around this issue.

ACKNOWLEGMENTS

Many members from the AACP WBRC contributed expertise, effort and time in the development and review of the survey questions, survey dissemination, and interpretation of results.

Appendix

View this table:
Appendix 1.

Inclusion of Well-being Content by Pillars and Topica

  • Received October 18, 2021.
  • Accepted May 22, 2022.

REFERENCES

  1. 1.↵
    Inter-association Definition of Well-being. NIRSA: Leaders in Collegiate Recreation, NASPA-Student Affairs Administrators in Higher Education, American College Health Association; 2020. https://j7y8m8g8.rocketcdn.me/nirsa/wp-content/uploads/inter-assocation-well-being-definition-2011b.pdf. Accessed March 16, 2023.
  2. 2.↵
    Wellness. In: Merriam-Webster.com [Internet]. Springfield, MA: Merriam Webster Incorporated; 2021. https://www.merriam-webster.com/dictionary/wellness. Accessed March 16, 2023.
  3. 3.↵
    1. Durham ME,
    2. Bush PW,
    3. Ball AM
    . Evidence of burnout in health-system pharmacists. Am J Health Syst Pharm. 2018;75(23 Supplement 4):S93-S100. doi:10.2146/ajhp170818
    OpenUrlAbstract/FREE Full Text
  4. 4.
    1. Bridgeman PJ,
    2. Bridgeman MB,
    3. Barone J
    . Burnout syndrome among healthcare professionals. Am J Health Syst Pharm. 2018; 75(3):147-152. doi:10.2146/ajhp170460
    OpenUrlFREE Full Text
  5. 5.
    1. Ludwig AB,
    2. Burton W,
    3. Weingarten J,
    4. Milan F,
    5. Myers DC,
    6. Kligler B
    . Depression and stress amongst undergraduate medical students. BMC Med Educ. 2015;15:141. doi:10.1186/s12909-015-0425-z
    OpenUrl
  6. 6.↵
    1. Fuller M,
    2. Schadler A,
    3. Cain J
    . An investigation of prevalence and predictors of disengagement and exhaustion in pharmacy students. Am J Pharm Educ. 2020;84(10):7945. doi:10.5688/ajpe7945
    OpenUrl
  7. 7.↵
    1. Dyrbye L,
    2. Shanafelt T
    . A narrative review on burnout experienced by medical students and residents. Med Educ. 2016;50(1): 132-149. doi:10.1111/medu.12927
    OpenUrlCrossRefPubMed
  8. 8.
    1. Hoying J,
    2. Melnyk BM,
    3. Hutson E,
    4. Tan A
    . Prevalence and correlates of depression, anxiety, stress, healthy beliefs, and lifestyle behaviors in first-year graduate health sciences students. Worldviews Evid Based Nurs. 2020;17(1):49-59. doi:10.1111/wvn.12415
    OpenUrlPubMed
  9. 9.
    1. Maslach C,
    2. Jackson SE
    . The measurement of experienced burnout. J Organ Behav. 1981;2(2):99-113. doi:10.1002/job.4030020205
    OpenUrlCrossRef
  10. 10.↵
    1. Burr J,
    2. Beck Dallaghan GL
    . The relationship of emotions and burnout to medical students’ academic performance. Teach Learn Med. 2019;31(5):479-486. doi:10.1080/10401334.2019.1613237
    OpenUrl
  11. 11.↵
    1. Wasson LT,
    2. Cusmano A,
    3. Meli L,
    4. et al.
    Association between learning environment interventions and medical student well-being: a systematic review. JAMA. 2016;316(21):2237-2252. doi:10.1001/jama.2016.17573
    OpenUrlPubMed
  12. 12.↵
    1. McConville J,
    2. McAleer R,
    3. Hahne A
    . Mindfulness training for health profession students-the effect of mindfulness training on psychological well-being, learning and clinical performance of health professional students: a systematic review of randomized and non-randomized controlled trials. Explore (NY). 2017;13(1):26-45. doi:10.1016/j.explore.2016.10.002
    OpenUrl
  13. 13.↵
    American Pharmacists Association. Enhancing well-being and resilience among the pharmacist workforce: a national consensus conference. https://aphanet.pharmacist.com/sites/default/files/audience/APhA_Well_Being_Resilience_Report_%200719.pdf. Accessed March 16, 2023.
  14. 14.↵
    National Academies of Sciences, Engineering, and Medicine. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: National Academies Press (US); 2019. http://www.ncbi.nlm.nih.gov/books/NBK552618/. Accessed March 16, 2023.
  15. 15.↵
    Substance Abuse and Mental Health Services Administration. Creating a healthier life: a step-by-step guide to wellness. https://store.samhsa.gov/sites/default/files/d7/priv/sma16-4958.pdf. Accessed March 16, 2023.
  16. 16.↵
    QPR Institute. QPR Online Gatekeeper Training. https://qprinstitute.com/individual-training. Accessed March 16, 2023.
  17. 17.↵
    The Jed Foundation. Mental Health Resource Center. https://jedfoundation.org/mental-health-resource-center/. Accessed March 16, 2023.
  18. 18.↵
    1. Folz HN,
    2. Gauld AR,
    3. Ford BA,
    4. Thigpen J
    . National survey of schools of pharmacy on prevalence and description of wellness initiatives. Curr Pharm Teach Learn. 2021;13(10):1288-1292. doi:10.1016/j.cptl.2021.07.002
    OpenUrl
  19. 19.↵
    National Wellness Institute. The six dimensions of wellness. https://nationalwellness.org/resources/six-dimensions-of-wellness/. Accessed March 16, 2023.
  20. 20.↵
    1. Shanafelt TD,
    2. West CP,
    3. Sinsky C,
    4. et al.
    Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2017. Mayo Clin Proc. 2019;94(9):1681-1694. doi:10.1016/j.mayocp.2018.10.023
    OpenUrlCrossRefPubMed
  21. 21.↵
    1. Le HM,
    2. Young SD
    . Evaluation of stress experienced by pharmacy residents. Am J Health Syst Pharm. 2017;74(8):599-604. doi:10.2146/ajhp150763
    OpenUrlAbstract/FREE Full Text
  22. 22.
    1. Mayberry KM,
    2. Miller LN
    . Incidence of self-reported depression among pharmacy residents in Tennessee. Am J Pharm Educ. 2017;81(8):5960. doi:10.5688/ajpe5960
    OpenUrlAbstract/FREE Full Text
  23. 23.↵
    1. Williams E,
    2. Martin SL,
    3. Fabrikant A,
    4. Wang A,
    5. Pojasek M
    . Rates of depressive symptoms among pharmacy residents. Am J Health Syst Pharm. 2018;75(5):292-297. doi:10.2146/ajhp161008
    OpenUrlAbstract/FREE Full Text
  24. 24.
    1. Slavin SJ,
    2. Schindler DL,
    3. Chibnall JT
    . Medical student mental health 3.0: improving student wellness through curricular changes. Acad Med. 2014;89(4):573-577. doi:10.1097/ACM.0000000000000166
    OpenUrlCrossRefPubMed
  25. 25.↵
    1. Slavin S
    . Reflections on a decade leading a medical student well-being initiative. Acad Med. 2019;94(6):771-774. doi:10.1097/ACM.0000000000002540
    OpenUrl
  26. 26.↵
    1. Sinsky CA,
    2. Biddison LD,
    3. Mallick A,
    4. et al.
    Organizational evidence-based and promising practices for improving clinician well-being. NAM Perspect. Nov 2, 2020. doi:10.31478/202011a
  27. 27.↵
    American Association of Colleges of Pharmacy. Preparing pharmacists and the academy to thrive in challenging times. 2021-2024 Strategic plan priorities, goals and objectives. https://www.aacp.org/sites/default/files/2022-03/aacp-strategic-plan–2021-2024.pdf. Accessed March 16, 2023.
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Well-being Content Inclusion in Pharmacy Education Across the United States and Canada
Elizabeth Buckley, Simi Gunaseelan, Benjamin D. Aronson, Heidi N. Anksorus, Victoria Belousova, Tram B. Cat, Kristine M. Cline, Stacey D. Curtis, Christina E. DeRemer, David Fuentes, McKenzie S. Grinalds, Seena L. Haines, Hannah E. Johnson, Karen Kopacek, Jessica M. Louie, Nkem P. Nonyel, Natasha Petry, Shawn Riser Taylor, Suzanne C. Harris, Cheryl A Sadowski, Anandi V. Law
American Journal of Pharmaceutical Education Apr 2023, 87 (3) ajpe8918; DOI: 10.5688/ajpe8918
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