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Currents in Pharmacy Teaching and Learning

journal homepage: www.elsevier.com/locate/cptl

Experiences in Teaching and Learning

Evaluation of a mock interview session on residency interview skills

Kelsey Buckleya, Samantha Karra, Sarah A. Nislyb, Kristi Kelleyc,⁎

aMidwestern University College of Pharmacy – Glendale, 19555 N 59th Avenue, Glendale, AZ 85308, United States bWingate University School of Pharmacy, 220 North Camden Road, Wingate, NC 28174, United States cAuburn University Harrison School of Pharmacy, 1323 Walker Building, Auburn University, AL 36849, United States

A R T I C L E I N F O

Keywords: Pharmacy residency Education Pharmacy Interview Postgraduate residency training

A B S T R A C T

Background and purpose: To evaluate the impact of student pharmacist participation in a mock interview session on confidence level and preparation regarding residency interview skills. Educational activity and setting: The study setting was a mock interview session, held in con- junction with student programming at the American College of Clinical Pharmacy (ACCP) Annual Meeting. Prior to the mock interview session, final year student pharmacists seeking residency program placement were asked to complete a pre-session survey assessing confidence level for residency interviews. Each student pharmacist participated in up to three mock interviews. A post-session survey evaluating confidence level was then administered to consenting participants. Following the American Society for Health-System Pharmacists (ASHP) Pharmacy Resident Matching Program (RMP), a post-match electronic survey was sent to study participants to de- termine their perception of the influence of the mock interview session on achieving successful interactions during residency interviews. Findings: A total of 59 student pharmacists participated in the mock interview session and completed the pre-session survey. Participants completing the post-session survey (88%, n = 52) unanimously reported an enhanced confidence in interviewing skills following the session. Thirty responders reported a program match rate of 83%. Approximately 97% (n = 29) of the re- spondents agreed or strongly agreed that the questions asked during the mock interview session were reflective of questions asked during residency interviews. Discussion: Lessons learned from this mock interview session can be applied to PGY1 residency mock interview sessions held locally, regionally, and nationally. Summary: Students participating in the ACCP Mock Interview Session recognized the importance of the interview component in obtaining a postgraduate year 1 (PGY1) pharmacy residency.

Background and purpose

The recognition of the value of formal postgraduate training by major pharmacy organizations and the evolving role of phar- macists in direct patient care likely influence student pharmacists to pursue residency and fellowship training.1 Compared with previous research, surveyed pharmacy residents and fellows indicate that they understood [it] as a prerequisite for certain jobs when questioned about motivating factors for pursuing residency and fellowship training.1 Despite the increasing number of residency

https://doi.org/10.1016/j.cptl.2017.12.021

⁎ Corresponding author. E-mail addresses: [email protected] (K. Buckley), [email protected] (S. Karr), [email protected] (S.A. Nisly),

[email protected] (K. Kelley).

Currents in Pharmacy Teaching and Learning 10 (2018) 511–516

1877-1297/ © 2017 Elsevier Inc. All rights reserved.

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programs and positions over the last several years, pharmacy residency program placement continues to be highly competitive, resulting in a large number of unmatched candidates annually.2 Nationwide, the success rate of securing a postgraduate year 1 (PGY1) residency was approximately 64% in 2014.2 A focus on residency application and interview preparation efforts has been occurring among both clinicians and academicians in pharmacy practice in recent years.

A survey study by Dunn et al.3 found that colleges of pharmacy have a variety of informal programs and/or information sessions in place (lecture seminars, panel discussions, small group activities) promoting residency training. Recent efforts have also focused on residency interview preparation. Data has indicated that a higher number of interview offers may increase the likelihood of an applicant to match with a PGY1 program.4 The interview component of the application provides an opportunity for residency program directors and preceptors to gather holistic information, such as nonacademic qualities of candidates, not otherwise evident from the application packet.5–7 Several interview preparation efforts have been published.

In 2012, Phillips et al.8 described an elective course using a variety of teaching methods (short lectures, group discussions, mock match, and mock interview) at the University of Georgia College of Pharmacy. Post-semester surveys (n = 36) demonstrated a statistically significant increase in students’ abilities to not only understand the purpose and components of a residency training program, but also the actual steps in the residency application process. Student participation within residency application preparation sessions also appears to have a positive correlation with the American Society of Health-System Pharmacists (ASHP) Resident Matching Program (RMP) match rates. In 2012, Caballero et al.9 described a residency interviewing preparatory seminar elective at Nova Southeastern University College of Pharmacy with five of the ten course hours dedicated to interview preparation. Survey results demonstrate improvement in students’ (n = 10) confidence and ability to interview and prepare for the ASHP Midyear Clinical Meeting (MCM). Seven of ten students (70%) participating within the elective secured ASHP-accredited residencies. At Drake University College of Pharmacy and Health Sciences, a faculty-led mock residency interview exercise was described by Koenigsfeld et al.10 Twenty-seven (of 28) students participated in a post-ASHP RMP survey, with 25 (92.6%) indicating they had secured a residency position. Recently, Rider et al.11 described a collaborative approach to residency preparation programming between students and faculty from The Ohio State University College of Pharmacy and pharmacy residents and residency preceptors from The Ohio State University Wexner Medical Center. Of the four programming components (Curriculum Vitae Critique, Mock Residency Interviews, Residency 101, and Midyear to Match), Mock Residency Interviews received the highest ranking, in terms of value, by students completing an anonymous post-programming survey (n = 57). There were 26 survey participants seeking a residency and 20 of these (77%) obtained a position.

The Education and Training (EDTR) Practice and Research Network (PRN) of the American College of Clinical Pharmacy (ACCP) was developed to provide an opportunity to network with others who share similar interests and to work collaboratively to develop programs and projects to advance pharmacy education and training. Each year since 2004, the EDTR PRN holds a mock interview session at ACCP's Annual Meeting. The purpose of the mock interview session is to provide current student pharmacists seeking PGY1 residency positions, PGY1 pharmacy residents seeking PGY2 residency positions, or residents and fellows seeking employment the opportunity to participate in mock interviews with an ACCP member. Interviewers are typically active ACCP members who are seasoned practitioners and educators. Additionally, many are also PGY1 or PGY2 directors representing various residency programs in the United States.

No specific information on a mock interview session conducted at a national level was found in the literature. Thus, the purpose of this research was to evaluate the impact of final year student pharmacist participation in the mock interview session on confidence level and self-reported preparedness regarding residency interviewing skills. In addition, this study set out to explore if an im- provement in confidence and preparedness for interviews correlated with ASHP RMP applicant match rates.

Educational activity and setting

Advertisement of the program

Student pharmacists, residents, and fellows who attended the 2014 ACCP Annual Meeting were eligible to participate in the mock interview session. Interested participants were made aware of the mock interview session via advertisements on the electronic registration webpage for the Annual Meeting, flyers handed to pharmacist trainees at the meeting registration booth, and verbal announcements made to students who attended the national meeting residency preparatory session. The Student College of Clinical Pharmacy (SCCP) chapters of ACCP at schools and colleges of pharmacy in the United States were also provided with information regarding the mock interview session to share with their student members.

Recruitment of interviewers began approximately one month prior to the Annual Meeting via email. The email request came directly from many PRN chairs and/or vice chairs, requesting volunteers from within their PRN membership. Volunteers were eligible to participate as an interviewer if the member was a pharmacist or pharmacy educator. To maximize the student's experience within the mock interview session, the study aimed to recruit an equal number of volunteer interviewers to student participants. To re- cognize the need to recruit a large number of interviewers, the time commitment involved in interviewing, and the opportunities for networking missed by interviewers who could not attend other PRN sessions during the same time slot, interviewer participation was supported in various ways. In addition to recruitment by PRN leadership and members, interviewers attending the mock interview session were encouraged to enter into a raffle for one of two gift cards in the amount of $50.

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Consent and randomization

This study was approved by the Investigational Research Boards (IRBs) of all universities for which study investigators were affiliated with or employed. Student pharmacists, residents, and fellows were eligible to participate in the mock interview session. However, only final year student pharmacists seeking PGY1 residency program placement were eligible to participate in the survey component of this research. The subsequent details surrounding the mock interview session are illustrated in Fig. 1. For all perception questions, a 4-point Likert scale (strongly disagree, disagree, agree, strongly agree) was utilized. This was done to limit neutrality and gather concrete opinions from participants.

Before receiving a pre-session survey, a written statement approved by the IRBs was provided to all interested research parti- cipants. The statement notified student pharmacists that participation in the survey indicated informed consent for research. Study investigators then administered a pre-session survey to assess initial confidence for residency interviews (Appendix 1). Surveys requested a self-generated study code for each participant (utilizing the last four digits of the participant's mobile phone number) in order to match pre-session, post-session, and post-match survey data while maintaining subject anonymity.

Preparing for the session

Each student participant was provided with an interviewing tip sheet (developed by members of the EDTR PRN in 2008) for guidance on how to prepare for an interview, actions to take and to avoid on the day of interviews, and what to expect and follow-up on after an interview (Appendix 2). The volunteer interviewers were provided with a preparatory sheet for mock interviewers, also compiled by members of the EDTR PRN (Appendix 3). The preparatory sheet provided guidance to interviewers on general inter- viewing tips, sample questions to ask residency applicants, and topics to avoid (e.g., religion, marital status). Interviewers were encouraged to ask additional questions, beyond those on the preparatory sheet, as time permitted.

After providing consent, taking the pre-session survey, and receiving the interviewing tip sheet, each student participant then received a random assignment to an interviewer at a numbered table. Students were encouraged to avoid interviewing with faculty or preceptors that they knew. In the case of random assignment to a known interviewer, students were reassigned.

Conducting the mock interview session

After randomization, interview sessions commenced. Designed to simulate one-on-one postgraduate program interviews, each session lasted approximately ten minutes, followed by interviewers providing participants with approximately five minutes of im- mediate feedback on interviewing skills. Participants were then randomly assigned to the next interviewer. Student pharmacists could participate in up to three mock interviews.

Fig. 1. Flow Chart of Mock Interview Session. ASHP=American Society of Health-System Pharmacy; min=minutes.

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Post-interview session

After completing interview sessions, participants were asked to complete a post-session survey (Appendix 4). This survey at- tempted to evaluate the student pharmacist's confidence level in interview skills, assessment of interview questions asked, and opinion of the helpfulness of guidance received during the mock interview session.

Post-match survey

A subsequent survey utilizing Qualtrics software (version 9506381) was sent via email to study participants following release of results of the ASHP RMP match in March 2015 (Appendix 5). This anonymous post-match survey attempted to determine perceptions of the EDTR PRN Mock Interview Session after completing residency interviews. To encourage participation, students could enter into a drawing upon completion of the post-match survey. Two participants were randomly selected to receive one of two $50 gift cards.

Descriptive statistics were used to analyze nominal data. Non-parametric data was compared across surveys using the Wilcoxon Signed Rank or Spearman's Correlation Coefficient, as appropriate. IBM SPSS software (version 22) was used to analyze data. All survey data were kept confidential and no name or contact information was recorded on any survey instrument. The student gen- erated survey code was used to match pre-session, post-session, and post-match survey data.

Findings

A total of 59 final year student pharmacists participated in the mock interview session and 59 (100%) completed the pre-session survey. Throughout the study period, the majority (>75%) of responders were female with an average age of 27 years. Pre-session respondents noted the primary reason for attending the EDTR PRN's Business and Networking meeting was to participate in the mock interview session (95%, n = 56). Survey completion diminished slightly following the mock interview session, with a total of 52 student responders (88%). Of those completing the post-session survey, 83% (n = 43) reported completing at least two rounds of mock interview sessions and 30% (n = 16) reported completing three rounds of interviews. Participants unanimously reported an enhanced confidence in interviewing following the session. From the open-ended question on the post-session survey regarding what was most valuable about the mock interview session, the highest percentage of participants (25%) mentioned enjoying receiving specific, con- structive feedback from interviewers and the next highest percentage (8%) mentioned the opportunity for multiple mock interviews. From the open-ended question regarding suggested areas of improvement for the mock interview session, the highest percentage of participants (30%) indicated nothing and the next highest percentage (10%) indicated the wait time before starting interviews and between interviews. All respondents reported having interest in receiving additional residency preparatory information from ACCP.

Survey data captured following the ASHP RMP match was the lowest of the three surveys with 30 total responders (51%). The program match rate for responders was reported at 83% (n = 25), with the majority experiencing success during Phase I of the ASHP RMP process (n = 24). Applications submitted per respondent were consistent with national averages; over 50% (n = 18) of respondents applied to ten or more programs. During the pre-session survey, participants (n = 29) reported intentions of applying to seven to nine residency programs. This changed during the post-match survey to 10 or more programs, although the change was non- significant (p = 0.058). On the post-match survey, approximately 97% (n = 29) of the respondents agreed or strongly agreed that the questions asked during the mock interview session were reflective of questions asked during residency interviews, which was a slight decrease from 100% (n = 52) of respondents who agreed or strongly agreed for the same question on the post-session survey. This decrease was statistically significant (p = 0.003) when survey matched pairs (n = 27) were analyzed. Additionally, all respondents indicated they would recommend the session to other students interested in pursuing a residency. Respondents overwhelmingly used

Table 1 Percentage of respondents participating in additional interview preparatory activities.

ACCP=American College of Clinical Pharmacy; ASHP=American Society of Health-System Pharmacy; MCM=Midyear Clinical Meeting.

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multiple preparatory activities to prepare for interviews (Table 1). Importantly, there was no statistically significant correlation between the number of preparatory activities completed and student confidence in interview skills prior to the mock interview session. However, when asked if the mock interview session was beneficial for residency preparation, 80% (n = 24) responded agreed or strongly agreed. Lastly, approximately 97% (n = 29) of the respondents on the post-match survey agreed or strongly agreed that the interview portion of the residency application process is significant to obtaining a residency.

Discussion

The students that participated in the ACCP EDTR PRN Mock Interview Session in Fall 2014 portrayed similar student char- acteristics to those applying for residencies with the study population weighted more towards females (83%).4 The average age (27 years) was consistent with other studies investigating residency preparation among student pharmacists.9

The growing number of students that are pursuing residencies is creating an even more competitive ASHP RMP process. In the post-match survey, most participants reported that they had applied to ten or more PGY1 programs. As such, student pharmacists are looking for opportunities to increase their chances of matching to a residency position. In a recent national survey assessing mentor involvement with student pharmacists pursuing postgraduate residency training, at least half of the overall student sample indicated a desire for increased mentorship in the area of interviewing.12 Mock interviews are one method to help students prepare. In this study, the majority (97%) of students agreed or strongly agreed on the post-match survey that the interview component of the residency application process is an important element in obtaining a residency position. Reports indicate that interviews continue to be included in the PGY1 selection process and remain the top factor in selecting candidates for a residency program.5–7 If aware of the available resources at the local, state, and national level, students seeking residencies may be more likely to pursue opportunities to participate in mock interviews. Eighty-three percent of respondents in our study successfully obtained a residency position following the ASHP RMP match. This is compared to the national reported success rate of securing a PGY1 residency of approximately 65% in 2015.2 Although there was a high ASHP RMP match rate for those students that participated in the EDTR PRN's Mock Interview Session, it is unclear whether this participation or alternative preparatory activities had the largest impact on ASHP RMP match rates. On the post-match survey, respondents indicated that they participated in additional interview preparatory activities after attending the mock interview session. This could indicate the mock interview session encouraged them to seek out additional preparation for residency interviews. A confounding factor is that students that participate in mock interviews may be more motivated candidates. Students who attend pharmacy meetings may also have strengths, such as leadership experience, which make them more qualified candidates for residency positions.

When student pharmacists who participated in this research were asked about the most valuable aspect of the EDTR PRN's Mock Interviews Session, almost half identified receiving specific, constructive feedback from the interviewers as most valuable. On the post-session survey, all participants responded agree or strongly agree that the questions asked during the mock interview session were reflective of actual residency interview questions. It should be noted, however, that participants had no residency interview experiences at the time of post-session survey completion. A slight decrease was noted on the post-match survey with approximately 97% (n = 29) of the respondents indicating agree or strongly agree that the questions asked during the mock interview session were reflective of questions asked during residency interviews. This suggests that on-the-spot interviewing without dedicated interviewer time to review candidate materials in advance can still provide a valuable experience for the learner.

Although students unanimously reported enhanced confidence in interviewing following the session, they identified some specific areas for improvement in the mock interview session, similar to what ACCP members who had conducted the mock interviews had identified. Members have been conducting mock interviews at the ACCP Annual Meeting for over ten years, demonstrating the organization's commitment to providing this opportunity for student pharmacists, residents, and fellows. Similarly, other national and state organizations as well as schools and colleges of pharmacy offer mock interviews in preparation for pharmacy residency program application.9,10,14 In 2015, Powell et al.13 described a mock interview session held in conjunction with the Arizona Phar- macy Association Annual Convention. Although an objective method to measure residency preparation was not identified, post- session surveys (n = 33) indicated that more students felt confident in their ability to interview, as compared to pre-session surveys. A subsequent study in 2017 by Ulbrich and Boyle14 found that the mock interview included in their institution's local residency boot camp activity was deemed most the most helpful program aspect by the majority (n = 5) of students participating.

Interestingly, when students participating in the EDTR PRN Mock Interview Session were asked about their participation in local chapter or state organization efforts, few respondents had participated in these preparatory activities despite the overwhelming use of alternative residency application preparatory activities. The procedures described in this research study could be replicated by local student chapters and pharmacy organizations, providing resources to student pharmacists and residents unable to travel to national conferences. Additionally, there may be available resources at the local or state level for students to secure additional opportunities to participate in mock interviews over the course of their final professional year, leading up to actual residency interviews. Having multiple chances for students to participate in mock interviews may also allow for them to prepare for mock interviews ahead of time.

This analysis is not without limitations. Students from across the country are included, although the limited sample size and decreasing participation makes the external validity limited. The 4-point Likert scale in this study did not include an option for neutrality. Forcing either positive or negative responses without offering a neutral response could induce a potential bias, however, it has been shown that the overall difference in response between a 4-point and 5-point Likert scale is negligible.15 Lastly, recruitment of a sufficient number of qualified interviewers may limit applicability to smaller organizations.

The lessons learned from student surveys in this study can be applied to local or state organization efforts as well. Students reported that they would like to have a longer time to interview than the allotted time of ten minutes with an additional five minutes

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for feedback. This length was consistent with the time specified in Rider and colleagues11 description of mock interviews that involved a similar number of students. Although time constraints are always an issue, students may prefer to increase the amount of interview time to a total of 12–15min with only three minutes for feedback. Additionally, if a different environment is available, the time for each individual mock interview possibly could be lengthened to 20–30min and a quieter space utilized rather than the large ballroom traditionally provided for the EDTR PRN Mock Interview Session. Often, the length of the mock interview limits the number of mock interviews for participants. Given the nature of a national mock interview session, it can be logistically challenging to provide resources to students ahead of time. However, at the local/state level, holding a formal session to prepare students for interviews or provide interview tips may ease the students’ minds and increase their comfort level going into mock interviews. Even though a majority of participants responded agree or strongly agree that the questions asked during the mock interview session were reflective of residency interview questions, a statistically significant reduction was noted when the same paired survey questions were compared between post-session and post-match responses. This may suggest that some participants did not perceive mock interview questions to be representative of actual questions received during residency interviews. Future residency preparatory efforts and research may aim to more closely align mock interview questions to those asked in residency interviews.

Summary

Student pharmacists participating in this study recognized the importance of the interview component in successfully matching with a PGY1 pharmacy residency. As such, they were eager to participate in the mock interview session and reported that receiving specific, constructive feedback from interviewers was helpful in preparing for the residency application process. Findings from this mock interview session research

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