Abstract
Objective. To survey pharmacists, including those who make or contribute to hiring decisions, regarding certificate training programs and specifically about a primary care certificate for pharmacists.
Methods. We conducted a cross-sectional survey of pharmacist registrants of the Office of Continuing Professional Development at the University of Tennessee Health Science Center College of Pharmacy’s listserve, including both hiring and non-hiring pharmacists. The 40-question survey probed perceptions of various types of postgraduate training and the design of a primary care certificate training program for pharmacists. Data were collected between November and December 2020.
Results. A total of 230 pharmacists participated in this study (14% response rate), and most reported practicing in the community (n=126, 57%). Nearly half of the respondents reported making or contributing to hiring decisions of other pharmacists (n=94, 41%), and, of those, most reported that completion of a primary care certificate program by a candidate would increase their likelihood of hiring that candidate (n=50, 78%). Both groups (hiring and non-hiring pharmacists) most commonly reported that a primary care certificate training program should be 30 hours total and 12 weeks in length, ranked communication as the most important topic to be included, and indicated the didactic and simulation/experiential components should be similarly weighted.
Conclusions. Pharmacists, including those who make or contribute to hiring decisions, reported valuing certificate training programs. Developing a certificate training program that is at least 30 hours in length over 12 weeks may serve as an opportunity to address gaps in primary care in the United States.
INTRODUCTION
Pharmacists are essential members of the health care team and remain one of the most trusted professionals.1 In the midst of a rapidly evolving practice environment, pharmacists face mounting pressures—especially in the community pharmacy setting—to do more with less, and pharmacy workplace surveys report that workload is at its highest to date.2 Education and additional training opportunities must adapt to meet the needs of pharmacists in a dynamic environment to ensure they are able to practice at the top of their license.
Diverse skill sets are important for pharmacists as their roles and service offerings expand. For some pharmacists, these skills are obtained through a residency, fellowship, or advanced degree. However, not every individual who applies to a residency program is successful in obtaining a residency, and advanced degrees are costly and time-consuming.3 Certificate training programs have emerged as a bridge to support pharmacists in honing their skills on a specific topic.4–7 The Accreditation Council for Pharmacy Education (ACPE) accredits certificate training programs and requires a minimum of 15 contact hours with knowledge- and application-based components.8 These programs are offered through a variety of ACPE-accredited providers, such as professional pharmacy organizations, colleges of pharmacy, and medical education companies. Existing certificate programs cover a wide variety of subjects in pharmacy practice, such as mental health, research, informatics, compounding, and more.9,10
Due to the existing and projected shortage of primary care physicians and nurses in the United States, this is one area in particular where pharmacists are predicted to serve a greater future role.11 Coupling this projected shortage with expanded roles under collaborative pharmacy practice agreements, pharmacists are in an ideal position to deliver pharmaceutical care to patients in the primary care setting, including in chronic disease management.12 A certificate training program focused on advancing pharmacists’ roles in the primary care setting may be a prime opportunity to meet the needs of growing communities across America.
The optimal design of certificate training programs for pharmacists is not well known. Understanding the marketability of a primary care certificate for pharmacists, total hours, duration for completion, content to include, and combination of didactic versus simulation components for it to be valuable is necessary for evidence-based program implementation. Thus, we aimed to survey hiring and non-hiring pharmacists to understand their perceptions regarding certificate training programs generally and, more specifically, about a proposed pharmacist primary care certificate training program.
METHODS
We conducted a cross-sectional survey of licensed pharmacists between November to December 2020. The University of Tennessee Institutional Review Board approved this study.
Participants were recruited from the Office of Continuing Professional Development at the University of Tennessee Health Science Center College of Pharmacy’s listserve. The listserve maintains a large audience of pharmacists and pharmacy technicians. We sent two emails to all listserve members spaced approximately two weeks apart to invite them to participate. The email messages were short and concise (four sentences).13 Ten survey participants were randomly selected to receive a $25 gift card.
The survey consisted of four main parts and a total of 40 questions in a partially closed-ended format (survey available from corresponding author upon request).13 The survey instrument was peer-reviewed by four pharmacists, with two actively practicing in the primary care setting, in October 2020. Minor revisions to the survey instrument were implemented based on feedback received.
The first part of the survey asked about participant characteristics. The second part presented questions only to pharmacists who made or contributed to making decisions about whether to hire a pharmacist at their organization (referred to as the hiring pharmacists group [H]) and inquired about the following: postgraduate training requirements; the value of different postgraduate opportunities, including about the proposed pharmacist primary care certificate training program; what they though such a program should entail regarding necessary skills and time that should be allocated; and whether a candidate’s completion of a pharmacist primary care certificate would influence their hiring decisions. The purpose of this part of the survey was to obtain information from hiring individuals’ perspectives. The third part was geared toward all pharmacists and focused on their individual perceptions as distinct from the hiring role (referred to as the non-hiring pharmacists group [NH]). This part inquired about the following: completion of postgraduate training, the value of additional training, the potential value of a pharmacist primary care certificate, skills to be addressed in training, and the time that should be allocated for training (both in total hours and duration for completion). The fourth part directed participants to a portal to provide their information for a chance to obtain a gift card.
For this was a cross-sectional survey design project, frequency and percentage statistics were used to analyze categorical variables and descriptive statistics (mean, standard deviation) were performed to analyze continuous variables. No inferential statistics were performed in the study. All analyses were conducted using SPSS, version 28 (Armonk, NY: IBM Corp).
RESULTS
A total of 230 pharmacists participated in this study (14% response rate). Most respondents were female (n=125, 57%), White (n=192, 88%), had a mean (SD) age of 52 (12.97) years old, were located in the Southern United States (n=177, 70%), and were not of Hispanic, Latino, or Spanish origin (n=213, 99%). Most pharmacists reported practicing in the community (n=126, 57%), followed by in hospital (n=44, 20%), ambulatory care (n=19, 9%), and other settings (n=18, 8%). Most pharmacists earned a Doctor of Pharmacy (PharmD) as their terminal degree (n=127, 58%) (Table 1); most pharmacists also reported completing additional training after terminal degree completion (n=87, 67%), which were most commonly certificate programs (n=76, 54%).
Characteristics of Hiring and Non-Hiring Pharmacists Who Responded to a Survey Regarding Their Perceptions of a Primary Care Certificate Training Programa
Of 230 pharmacist respondents, a total 94 respondents reported making decisions on whether to hire other pharmacists at their organization (n=66, 31%) or contributing to those hiring decisions (n=28, 19%). Of those that reported making or contributing to hiring decisions, few reported requiring postgraduate training (n=15, 16%), and if they did require it, a residency was most commonly required. Most did not anticipate requiring additional raining in the future (n=72, 80%) and reported that if the pharmacist had completed a certificate training program, they would consider them a competitive applicant (n=57, 89%).
Most non-hiring pharmacists reported believing that completing postgraduate training in general (n=112, 87%) as well as completing a certificate training program in particular (n=113, 87%) helps pharmacists be more competitive in the job market. Residency programs were ranked as most valuable, followed by a certificate program, fellowship, or an additional degree. Hiring pharmacists were specifically asked about their perceptions of a pharmacist primary care certificate training program aimed at equipping pharmacists to take on new roles and expand service offerings in the primary care setting (Tables 2 and 3). When asked about their agreement with the statement, “If a pharmacist applicant completed this primary care certificate, I would be more likely to hire that pharmacist,” most pharmacists strongly agreed or agreed with the statement (n=50, 78%). Finally, most hiring pharmacists indicated that they would recommend that a pharmacist complete the pharmacist primary care certificate training program to be more competitive in the job marketplace (n=55, 89%).
Hiring and Non-hiring Pharmacists’ Responses to Survey Items Regarding Length and Timeline for a Pharmacist Primary Care Certificate Training Program
Hiring and Non-hiring Pharmacists’ Responses to a Survey Regarding Content That Should Be Included in a Pharmacist Primary Care Certificate Training Program
Both hiring and non-hiring pharmacists reported similar perceptions about the design of a primary care certificate training program (Table 2). Both groups ranked communication (both verbal and written) as the most important skill to be included in the certificate program (Table 3). When asked the number of hours of training to be practice ready on a skill, hiring pharmacists reported substantially fewer hours to be practice ready in all skills compared to hours reported by non-hiring pharmacists, with clinical topics ranked the highest by both groups (H=6.57 hours, NH=33.66 hours) (Table 3). Both groups reported that the experiential (eg, hands-on experience in a clinical practice setting) component would be the most critical to include, followed by didactic (eg, disease state review), simulation (eg, standardized patient encounter), and dedicated pharmacist coach/mentor components (Table 3).
Hiring pharmacists reported that a program of 30 hours in duration would be necessary to favorably influence hiring decisions; the next highest-ranking options for duration were 60 hours, 45 hours, and 15 hours (Table 2). Similarly, non-hiring pharmacists commonly reported being able to devote 30 hours to a primary care certificate program. When considering the amount of time to allocate to the experiential/simulation versus the didactic components, both groups reported it should be close to evenly split, with didactic (H=53%, NH=52%) encompassing slightly more in the program than experiential/simulation (H=47%, NH=48%). Hiring and non-hiring pharmacists most reported 12 weeks would be a reasonable timeline for completion (Table 2).
DISCUSSION
Pharmacists, including those making or contributing to hiring decisions, perceived certificate training programs as valuable. Both hiring and non-hiring pharmacists aligned on the total hours (30), duration (12 weeks), and breakdown of experiential and didactic components for the design of a proposed pharmacist primary care certificate. Developing a certificate training program may serve as an opportunity to address gaps in the existing primary care workforce in the United States.
Understanding employers’ perspectives is important for pharmacists who are considering completing a certificate training program to ensure their investment in the opportunity is valued. Our findings highlight, for the first time, that pharmacists making or contributing to hiring decisions perceive completion of a certificate training program as positively influencing their hiring decision. Notably, a disparity emerged between hiring pharmacists and non-hiring pharmacists regarding the number of training hours they perceived one would need to be practice ready for various skills; this raises a question as to whether expectations are mismatched when comparing skill development time versus the time an organization is willing to allot for a pharmacist to be practice ready. This may be an opportunity for future research to help align the expectations of hiring and non-hiring pharmacists regarding the time needed to be practice ready on key skills.
While the number of certificate programs available for pharmacists is growing, existing programs vary widely in design. Our research demonstrated that both hiring and non-hiring pharmacists agreed that the optimal design of a primary care certificate would be 30 hours over 12 weeks, and they agreed on the type of content to include and on the breakdown of simulation/experiential versus didactic components. This suggests that hiring and non-hiring pharmacists have similar expectations, but whether this design is generalizable to other types of certificate training programs offered for pharmacists remains unknown. These results serve as a starting point to design evidence-based certificate training programs.
With the rapid growth and availability of certificate programs, these types of programs may be the future of continuing education in pharmacy for several reasons. First, instead of attending a singular lecture on a very specific topic, certificate training programs explore various aspects and implications of a topic more broadly, while often still awarding continuing education credit to help pharmacists expand and maintain professional competency and skills. Traditional continuing education activities (conferences, symposia, lectures) improve participant knowledge but generally have a very limited effect on improving clinician practice and patient outcomes.14 Second, certificate training programs are much more accessible than other training, such as a residency or fellowship, in terms of both flexibility (eg, self-paced learning schedule) and opportunity. Notably, the number of pharmacist applicants for residencies far exceed positions that exist, with 6417 applicants participating in the match in 2022, of which 1451 did not match with a program.15 Third, certificate training programs are significantly more affordable than pursuing an advanced degree. Fourth, with the growing number of certificate programs comes a growing number of topics to meet the needs of a dynamic and evolving pharmacy workforce. Taking these factors together, certificate training programs represent a prime opportunity to deliver training equitably to pharmacists across the United States.
Limited data exist about the effectiveness of certificate training programs for learners who participate and the communities in which they practice. Research suggests that these types of programs may increase pharmacists’ knowledge and willingness to implement a new service in the short-term, but the long-term effects on patient care are unknown.16,17 The effect of these programs on pharmacists’ knowledge and practice as well as on the communities they practice in should be further assessed. Certificate programs could be the drivers of positive change in both workforce development and patient care, with the added advantage that they are accessible and affordable to all pharmacists in every stage of their career.
Our study has several limitations. First, due to the number of pharmacists who responded to the survey and the number of respondents who did not complete all the questions in the survey, we were unable to conduct additional inferential statistical analyses to assess whether region, age, sex, or other characteristics were associated with perceived value of the certificate training program. Second, most survey respondents were located in Tennessee, which limits the generalizability of our results. Third, most of the respondents reporting completing additional postgraduate training themselves, which may have biased their opinion about the marketability of additional training. Fourth, the survey probed hiring and non-hiring pharmacists’ perceptions of additional training rather than the results of hiring actions or offers made.
CONCLUSION
Pharmacists, including those making or contributing to hiring decisions, reported valuing certificate training programs. Both hiring and non-hiring pharmacists aligned on the recommended total hours (30), duration (12 weeks), and breakdown of experiential and didactic components for a primary care certificate training program. Developing a certificate training program may serve as an opportunity to address gaps in the current primary care workforce in the United States.
- Received February 23, 2022.
- Accepted June 27, 2022.
- © 2023 American Association of Colleges of Pharmacy
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