How Should AACP Adapt To Change? Report of the 2001/02 AACP Argus Commission

Transcription

1 How Should AACP Adapt To Change? Report of the 2001/02 AACP Argus Commission Introduction The AACP Argus Commission comprises the five immediate past presidents of the American Association of Colleges of Pharmacy (AACP). Its purpose is to scan the environment for the Association and offer its views for AACP action and policy. Also, the Commission responds to specific AACP Presidential requests for discussion and analysis. The AACP President asked the Argus Commission to review and discuss the changing nature of health professions education in general and pharmaceutical education in particular, examine forces of change in the stakeholders of pharmaceutical education, and recommend any changes in Association structure that may result from these discussions. The Commission considered its broad charge dictated by tradition and that given by the AACP President. We conclude that (1) the impending transfer of executive authority in the Association to a new Chief Executive Officer, (2) a technological revolution in the profession and pharmaceutical education of unparalleled proportions, and (3) an unprecedented workforce shortage in the profession and pharmaceutical education demands that Argus consider, as part of its environmental scanning, the prospect of how AACP should adapt to changes confronting it. AACP s Stakeholders Until very recently, AACP considered its stakeholders to include colleges, deans, other administrators, faculty, students, and the public. These remain as important beneficiaries of AACP s activities. However, as the profession has expanded, changed, and matured, other stakeholders have come forth as needing or requiring the Association s attention. This is conceptualized in the following schematic: Professional Education Pharmacy Schools Faculty Administrators Preceptors Students Postgraduate Education Residency Directors Residency Preceptors Fellowship Directors Fellowship Preceptors Graduate Faculty Practice Technician Educators CE Providers

2 The constituents identified as serving professional education and our graduate faculty (serving postgraduate education) are considered the primary stakeholders of AACP. The balance, those serving postgraduate education and pharmacy practice, have not been looked upon as being in AACP s constituency. The Commission believes that pharmacists who perform in these areas in fact function as pharmaceutical educators. As such, there is much that AACP can do to assist them in fulfilling their educational responsibilities. Students After AACP reorganized in 1973, it actively sought student membership. The Association formed a Council of Students, and students were appointed to AACP committees, and a student served on the AACP Board of Directors. Ten years later, the Association reorganized again and eliminated students as an active membership category. It turned out that students had limited time to participate in national professional organizational activity and AACP concluded that practitioner organizations should be the locus of student activity rather than AACP. While students were and still are a key stakeholder of pharmaceutical education, AACP products and services are targeted to those constituencies who are involved directly in delivering education rather than receiving it. The Academic Affairs Committee (1) considered the involvement of students with AACP. It recognized that both professional degree and graduate students are sources of future faculty, but it concluded that AACP should not restructure itself to include a separate organizational unit specifically for student members. Given the growing demand for faculty, especially clinical faculty, professional degree and graduate students are taking on added importance as sources for faculty. The Committee outlined a series of strategies to integrate students into the activities of the Association including: Use AACP News and other current and future communication vehicles (e.g., AACP Web page) to invite student opinion by (1) establishing a regular student column; and (2) issuing overt invitations for commentary for, about, and by students; In July of each year, provide the leadership of Association units (e.g., section, council chairs) with the names and addresses of student members of the particular units with encouragement to involve them in committees and activities; Facilitate the continued activity of the informal graduate student networking group; Facilitate interaction among students and educators and provide teaching skill development and mentoring programs at meetings of organizations in addition to AACP; Compile information about graduate student research interests and/or projects and distribute the list to AACP members to facilitate student-student and student-faculty communications; Ensure high faculty attendance at student-based AACP functions; and Explore the possibility of an on-line placement service. These strategies are as useful today as when they were developed in Some have been implemented; others have not. Recommendation I: Argus recommends that the AACP Board of Directors review these strategies with the objective of identifying and involving in the Association those professional 2

3 and graduate students who have an interest in teaching and research and have potential interest in pursuing academic careers. Recommendation II: Argus recommends that the AACP Board of Directors consider ways in which the Association can establish a presence at the regional student meetings sponsored by the American Pharmaceutical Association for purposes of further promoting careers in academic pharmacy. Recommendation III: Argus recommends that AACP invite graduate and professional students to AACP Annual Meetings and appropriate Teachers Seminars and present sessions designed to inform them of the values of academic careers. Recommendation IV: Argus recommends that AACP sponsor programs and forums to facilitate the sharing of successful strategies to enhance professional and/or graduate student interest in graduate education and academic careers. We believe that in each class, there are a small, but important, number of students who are attracted to teaching and the academic life. We must identify these students, mentor them, and provide resources so that they may improve their teaching skills while students. AACP s student scholar program sponsored by the Merck Foundation and the American Foundation for Pharmaceutical Education s Gateway program for student scholars are excellent methods to stimulate academic curiosity and a thirst to create new knowledge. In this regard, Argus is concerned with the apparent decline in student interest in these programs. Students will participate in these programs only to the extent that they know about their existence and are encouraged to do so by faculty. We urge all faculty to take upon themselves the responsibility to mentor promising students to become involved in student scholarship and educational activities. The evidence, anecdotal as it may be, is compelling that it works. Argus encourages colleges and schools to develop formal and informal experiences designed to stimulate and maintain student interest in becoming pharmacy faculty. Such experiences may be elective courses in pedagogy, academic clerkships, scheduled roundtable discussions on aspects of academic life, and peer teaching experiences. Coupled with individual faculty initiatives to nurture specific students, this would communicate a recognition and commitment by the institution to secure the future of pharmaceutical education by renewing its faculty. Argus agrees with the Academic Affairs Committee that the AACP need not restructure itself to serve better the needs of its student stakeholders. However, Argus is firm in the belief that AACP must pay more attention to student stakeholders. Preceptors Pharmacy practice preceptors, whether in community or institutional practice, perform a valuable educational function in the profession. Notwithstanding their value to pharmaceutical education and the profession, these practitioner educators generally have not looked to AACP for assistance in their educational efforts. Despite AACP s efforts to attract practitioner educators into membership, preceptors have not responded. AACP efforts in the late 1980s to deliver 3

4 preceptor-training programs at practitioner association meetings, while initially successful, became less so over time. On the other hand, individual colleges and schools successfully offer training programs for their preceptors and provide services such as complimentary continuing education. The Academic Affairs Committee also discussed the involvement of practitioner educators in the Association. It recommended that the Association should revitalize efforts to interest volunteer practitioner-faculty in the issues facing academic pharmacy and encourage their active involvement in school and Association affairs. Mechanisms by which this may be accomplished include: Provide programming on ways schools can develop teaching excellence in volunteer, as well as full-time, pharmacy faculty and incorporate their ideas and energies effectively into all aspects of institutional functioning. Programs should encourage the development of an academic culture where practitioner-educators are accepted as important members of the pharmacy faculty. Increase AACP involvement at national meetings of practitioners to provide programming, administered by staff and/or AACP members, designed to inform pharmacists of the benefits of involvement in the academic process and to assist pharmacists in developing effective teaching skills. The goal of such programming would be to encourage pharmacists to actively affiliate with academic institutions as practitioner-educators. Cooperate with state pharmaceutical associations and societies to assist them in promoting participation in practitioner-faculty programs among their constituents, and provide programming on effective teaching strategies in the practice environment. Encourage the development of productive relationships between school-based and practice site-based faculty to facilitate collaborative research and educational ventures. Argus believes that despite the failure of initial efforts to reach out to practitioner-educators, the recommendations of the Academic Affairs Committee are relevant to issues currently faced by AACP. Clearly, this cadre of practitioner-educators is critical to the success of our educational mission. Recommendation V: Argus recommends that the AACP Board of Directors review these recommendations and implement those that appear to be reasonable weighing the costs against the potential returns on AACP s investment. Recommendation VI: Argus recommends that AACP initiate discussions with practitioner organizations to which many preceptors belong with the objective of reaching this cadre of stakeholders through programming in collaboration with practitioner associations. Residency and Fellowship Directors and Residency and Fellowship Preceptors Residency and fellowship directors and preceptors engage in a unique and critically important form of pharmaceutical education. Much as we view traditional graduate school enrollment as part of the continuum that prepares students for research and teaching careers, residency training and educational programs are intended to prepare practitioners with advanced and/or specialized knowledge and skills beyond those provided to students at entry level. Fellowship training is 4

5 intended to further develop research skill development. In both cases, however, residency and fellowship directors and preceptors engage in pharmaceutical education and graduates of both types of these programs are among those with great potential interest in careers in academia. Both can benefit from AACP programs and services and AACP members will benefit from the interaction with residency and fellowship directors and preceptors. As the profession continues to expand, the number of residency and fellowship programs will continue to grow and their importance to the mission of the profession will continue to increase. Indeed, currently, residency and fellowship programs are major sources of clinical faculty in pharmaceutical education. Recommendation VII: Argus recommends that AACP initiate discussions with the American Society of Health-System Pharmacists (ASHP) and the American College of Clinical Pharmacy (ACCP) with the goal of improving the teaching skills of residency and fellowship preceptors, and partnering with them to actively encourage those residents and fellows with aptitude and interest to pursue an academic career. A substantial number of these are already in the academy. Our expanded focus should be on those who are not. Programming at ASHP and ACCP meetings for residency and fellowship preceptors may achieve this goal. Certainly the Teachers Seminars offered at AACP annual meetings would serve their educational needs as well. Should AACP be able to attract sufficient numbers of residency and fellowship preceptors to its annual meeting, it should consider special programming for this group. Technician Educators Pharmacy technicians are clearly becoming an increasingly important manpower resource in the profession, and the importance of technicians will grow as economic pressures continue to encourage increases in productivity within the profession. Currently, the Pharmacy Technician Certification Board (PTCP) has certified over 100,000 technicians, and the number continues to grow. The Argus Commission believes that forces for change in the profession will affect technician functions, numbers, and credentialing. Health care economics will continue to encourage the use of technicians. The functions that technicians perform will grow in technical complexity. This will force changes in the technician certification system, resulting in multilevel certification. The profession will demand that technician-training programs be accredited in a manner so that the profession has input into the development and application of educational standards for pharmacy technician training and education. Clearly, current technician training programs do or should involve pharmaceutical education. Much of what is contained in technician training programs was once included in entry-level pharmacy curriculums (pharmacy mathematics, dosage form recognition, etc.). Pharmacy technician educators are organized into the Pharmacy Technician Educators Conference (PTEC). The Argus Commission (2) discussed revising AACP s structure to accept pharmacy technician educators, but declined to do so recognizing that PTEC already existed to serve the needs of pharmacy technician educators. Argus suggested that AACP work 5

6 supportively with PTEC to assist it to fulfill its mission. AACP followed Argus suggestions and initiated a cooperative agreement with PTEC through which AACP serves as the mailing address for the young organization, kept its books, answered its telephone, and subsidized its annual meeting. With the exception of the 1999 Annual Meeting in Boston, PTEC has met jointly in recent years with AACP during its annual meetings. While these meetings were at the same time and in the same facility, they were separate in that PTEC and AACP members attended separate sessions, and little effort was made to integrate the two meetings. At a joint meeting of the AACP and PTEC Boards of Directors in 2001, PTEC expressed the desire to move closer to AACP organizationally so that PTEC members may avail themselves of AACP products, programs, and services. Plans are underway to schedule AACP annual meeting sessions so that PTEC members might attend them as well as their own. PTEC and AACP agreed to take steps to facilitate social and professional interaction between PTEC and AACP members. Recommendation VIII: The Argus Commission recommends that AACP and PTEC continue their discussions and negotiations that are designed to bring both organizations closer together. While AACP and PTEC are collaborating more, Argus believes that individual colleges and schools of pharmacy should begin to work collaboratively with individual pharmacy technician training programs. There is very little information on the degree of collaboration that currently exists, and AACP should endeavor to determine its current level and showcase innovative models for productive interaction, which will enhance the quality of technician education. Argus suspects that the current level of collaboration is low, too low for the importance that pharmacy technicians are having and will have in the profession. Recommendation IX: Argus recommends that AACP staff determine the extent of collaboration that exists between colleges and schools of pharmacy and technician training programs and develop strategies for consideration of the Board of Directors to facilitate collaboration among colleges and schools of pharmacy and pharmacy technician training programs. Continuing Education Providers The mandating of continuing pharmaceutical education in the 1970s stimulated the development of a large cadre of professionals who are involved in the planning, production, and delivery of continuing pharmaceutical education. These individuals are located in state and national pharmaceutical associations, pharmaceutical manufacturers, private for-profit companies, and colleges and schools of pharmacy. AACP s academic section on continuing pharmaceutical education is an active voice for continuing pharmaceutical education in colleges and schools of pharmacy. However, not all colleges and schools of pharmacy deliver CE to the profession, having decided that there are already ample sources of CE available through professional organizations, the pharmaceutical industry, and private companies. 6

7 The relatively recent decision by the American Council on Pharmaceutical Education (ACPE) to approve the providers of certificate continuing education programs demonstrates the growing importance of continuing pharmaceutical education to the mission of the profession. As health care grows more complex and as the profession follows, practitioner education will become critical means for professionals to maintain their competencies in differentiated practice areas or to acquire new skills in developing areas of health care. No single professional organization embraces the professional needs of all those who are involved with providing continuing pharmaceutical education. AACP, with its Section of Continuing Pharmaceutical Education, comes closest to filling that void. The Argus Commission believes that the AACP Section of Continuing Pharmaceutical Education could function as a home for those throughout the profession who are engaged in planning and delivering CE to practitioners. However, active membership in AACP is limited to those who are faculty members of regular institutional members. AACP s membership structure provides for affiliate and associate memberships that includes access to all AACP products and services. Because these membership categories are available, Argus hesitates to recommend restructuring of the association to provide for active membership for those not affiliated with a college of school of pharmacy. Recommendation X: Consequently, the Argus Commission recommends that the Section of Continuing Pharmaceutical Education reach out to the providers of CE throughout the profession by (a) conducting both comprehensive and focused needs analyses, (b) involving those providers not formally affiliated with academic institutions in program planning, and (c) programming specifically to meet their professional needs. No Margin, No Mission In today s changing economic and technological environment, there cannot be an expectation that AACP will develop and market new services to new populations without some assurances that these services will generate sufficient revenue for the Association to continue to function. The Association recently went through several years of deficit financing, which prompted individual and institutional dues increases. The Association s current dues structure is based upon a financial projection designed to support an infrastructure that provides core services to active and affiliate institutional and individual members and associate members. Any new services must be researched, planned, developed, and analyzed carefully on an incremental cost:benefit basis. Applying this philosophy to reach new categories of members or broadening the Association s reach to cover new groups of stakeholders or constituents requires a sound and thorough analysis of the costs and returns to the Association of such action. The analysis should include the projected numbers of individuals affected by the action, estimates of the economic status and strength, data demonstrating the willingness of the group to support the Association, and estimates of long-term viability. 7

8 Is it Time to Broaden our Mission? The prospect of attending to new constituents presents the question of whether the Association should broaden its mission. Argus believes that the AACP mission is relevant to its existing constituents and any new constituents that may appear in the near future. Indeed, if constituencies appear that lay claim to AACP products, services, and resources, the first thing the Board of Directors should do is ask whether AACP s current mission is consistent with the new constituency. If the answer is no, then Argus believes that the Association should not dilute itself by attempting to serve the new group. Stakeholders, Constituents, or Members? Conventional thinking would posit ways to restructure the Association to accommodate new categories of members. However, the results of the most recent review of the Association structure, chaired by Glenn Stimmel (3) suggest that the attitudes of association members appear to be changing. For example, across many associations, the attitudes of members have shifted from policy development and governance to networking and collaboration. Increasingly, individuals join associations not because it is their duty or to belong, but to derive benefits from affiliations with like-minded persons. Increasingly, members are viewing themselves as stakeholders or constituents, which their association must serve. Serving successfully this attitude of potential constituents requires vigilant attention to stakeholder needs and the ability to convert observed needs to demands, into which stakeholder/constituent/members will invest financially and emotionally. Should the Association change its structure? Argus believes that the number of individuals involved in pharmaceutical education will continue to increase. Further, Argus believes that those involved with delivering or providing pharmaceutical education who are located outside the environment of traditional colleges and schools of pharmacy will continue to grow. However, Argus does not believe that a change in AACP structure is warranted at this time to accommodate this trend. As these groups grow and begin to exercise their influence within the Association, consideration will be given to creating structural homes for them. In other words, Argus does not believe that if we build it, they will come. We believe that if they come, we should build it. Form (or structure in this case) should follow function. At such time as it is clear as to how newer classes of potential members are deriving benefit from AACP, it would be appropriate and necessary to revisit our structure. Recommendation XI: Argus recommends that the AACP Board and future Argus Commissions continually scan the profession s environment to identify potential stakeholders or constituents. Recommendation XII: Argus recommends to the Association s academic sections and special interest groups to reach out proactively to and embrace those who are involved in pharmaceutical education but not affiliated with a college or school of pharmacy. Implementing these two recommendations will require constant Board-section-special interest group communication and collaboration. 8

9 Other Elements of the Environment The Role and Responsibility of Leadership in Responding to Change Leadership development is the most critical attribute of any organization to respond successfully to change. Argus believes that in today s environment of change academic leadership and administrative skills are the most important tools that a dean, department head, or section head can possess. The AACP Board of Directors has made academic leadership its major goal for the academic year, and the 2002 Annual Meeting will feature academic leadership as its theme. Argus understands that AACP is planning two major leadership-training initiatives for new deans. One, in collaboration with the Federation of Associations of Schools of the Health Professions (FASHP), is a pilot project in which three deans from AACP will participate in a year long leadership training experience with colleagues from allopathic and osteopathic medicine, nursing, optometry, allied health, and chiropractic. The other is in collaboration with the American Dental Education Association, which will be a yearlong leadership training experience open to all new pharmacy and dental deans. Argus believes that academic pharmacy must pay attention to its potential leadership deficit that may be exacerbated by opening of new pharmacy programs, retirement of existing academic leaders, and the recruitment away of academic leaders into industrial and other positions. While focusing on new pharmacy deans meets an immediate need, Argus believes that we must broaden our attention to include experienced deans, department chairs, and faculty members who will at some point in their careers aspire to academic leadership. At the same time, we must provide leadership-training opportunities for professional degree students, graduate students, residents, and fellows. Argus defines leadership very broadly to include traditional definitions of leadership (e.g., doing the right things) as well as those functions more associated with academic administration or management (doing things right). Among the latter skills, Argus recommends that AACP should program in the following areas: Team-building skills (moving from me to we ) Change management skills Financial management skills Human resource management skills Fund-raising skills Negotiating skills Conflict management skills Argus recognizes that there will continue to exist a plethora of academic leadership and administration programs and primers available. We suggest that AACP gather information about them, categorize them, and make this information available to the membership. Too often faculty or administrators may fail to attend a program simply because they are unaware that it exists or uncertain of its quality or potential benefits. 9

10 AACP is valued highly by its members for its ability to provide a framework through which members may interact and network with their colleagues on a variety of specific issues. Argus believes that, within this context, AACP should develop systems through which academic leaders and managers may mentor their colleagues. Mentoring is a proven strategy for developing leadership, and we should capitalize on AACP s strength in providing the framework in which mentoring can occur. Mentoring and encouraging leadership among our graduate and professional degree students, residents, and fellows is as critically important as developing leadership in our faculty. There are a number of strategies that may accomplish this goal. Some faculty members offer courses on leadership for selected students. These courses focus on executive management, expose students to proven industrial and academic leaders, and attempt to demystify leadership. Student participation in student and practitioner pharmaceutical organizations provides them opportunities to develop and hone their leadership skills. Residencies provide excellent opportunities to develop leadership and management skills. Argus recommends that AACP work with the ASHP Commission on Credentialing to increase the leadership training opportunities in pharmacy residencies. Likewise, Argus recommends that AACP work with ACCP to include leadership-training opportunities in fellowship training programs. The Crisis of Scholarship within Pharmaceutical Education Scholarship is the sine qua non of the academy. It sustains us and validates our existence within our universities. Without it we will wither. Scholarship does not originate outside the academy; it begins and comes from within. Academic pharmacy can be proud of its record of scholarship especially in the sciences. However, Argus is concerned that scholarship may suffer in the near future due to a diminution in the apparent importance of scholarship within the academy, a decline in the number of scholars, and the dilution of existing scholars by the expansion of our enterprise. Argus believes that the crisis of scholarship is widespread throughout the pharmaceutical academy, but it is especially acute in the social and administrative and clinical sciences. Too few of our social and administrative and clinical faculty are successful in securing competitive, peerreviewed funding. AACP recently offered training sessions for faculty in these areas to improve their skills in grant writing. Those efforts must continue and expand. Our academic administrators must exert the leadership to stimulate their faculty to excel in scholarly efforts. At this time in our evolution, it is so critically important that we continue to generate new knowledge in the pharmaceutical sciences. No other enterprise will step in for us. The pharmaceutical academy must do it ourselves. Recommendation XIII: Argus recommends that a component of AACP s leadership initiative include ways to stimulate and assist faculty to engage in high quality, publishable scholarly work and improve their scholarship. 10

11 The Evolution of Organized Pharmacy AACP has continued to evolve as an organization throughout its 100-year history. But this evolution of AACP did not occur in isolation. It occurred in the context of the evolution of organized pharmacy. Argus has not studied this evolution, but it believes that an organized examination of the change and evolution of organized pharmacy over the last 100 years would provide valuable insights into organizational behavior and useful information regarding how the profession has changed over time. Moreover, such an analysis will provide valuable information to all pharmaceutical organizations to assist n their own strategic planning and future projections. AACP could benefit from such an analysis to assist in planning its own evolution over the next ten years. At this critical time in the Association s history when it will acquire a new chief executive officer, such forward thinking and planning must become a vital element of the Association s strategic planning. Recommendation XIV: Argus recommends that AACP initiate the leadership within the profession to secure the resources to conduct a study of the evolution of organized pharmacy since How Should AACP Respond to Change? This question is best answered by asking how AACP is assisting its member colleges and schools and individual members to respond to change. We have detailed in this paper some of the factors that we must address as we adapt to change. The expanding health care system is generating potential new stakeholders or constituents for AACP. We believe that the existing Association structure is capable of serving these constituents. Consequently, restructuring the Association is not the appropriate strategy at this time. However, we believe that the Association must scan its environment continually to identify new constituents and discuss with them the degree to which the Association may be able to serve their needs. Change demands astute, informed, and dedicated leadership among our faculty and academic administrators. AACP is responding by developing and offering leadership-training opportunities for new pharmacy deans. We believe that AACP s leadership agenda must expand to include leadership development for department chairs and faculty. The expansion of our enterprise and the stresses created by the pharmacy workforce shortage has created a pharmacy faculty supply crisis in academic pharmacy. We believe that the academy must respond by increasing the rate it creates its own faculty. AACP should respond by considering professional degree students, graduate students, residents, and fellows who have interests in academic careers among its constituents. Some AACP services may be applicable to students, residents, and fellows. Others could be developed after their needs are determined. Finally, Argus believes that AACP must continue to track the scholarship environment. Academic pharmacy must increase the level and quality of its scholarship. Reports from the AACP Research and Graduate Affairs Committees document this crisis on an annual basis. 11

12 Argus applauds AACP s efforts to improve the grant-writing skills of faculty, and encourages the Association to continue to stimulate and assist its members to improve their scholarship. References 1. Roche, V.F., Chair Report of the AACP Academic Affairs Committee, AJPE, 60, 5S-9S, Benet, L.Z. A New Structure for AACP. Report of the Argus Commission, AJPE, 59, 7S-9S, Stimmel, G.L., Report of the AACP Board of Directors Committee on Organization and Structure, September 29, American Association of Colleges of Pharmacy, Alexandria, VA. Argus Commission Members for : Charles O. Rutledge (Chair) Jordan L. Cohen Hugh F. Kabat Victoria F. Roche Robert E. Smith 12