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Currents in Pharmacy Teaching and Learning 4 (2012) 84 –91

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Research
Assessment of factors influencing recent graduates’ selection of a
community pharmacy practice site as their first practice position
Kristen L. DiDonato, PharmDa,†,
Kristin A. Casper, PharmDa,*, Jennifer L. Rodis, PharmD, BCPSa,
Tara R. Green, PharmDa,b, Katherine A. Kelley, PhDa
a
College of Pharmacy, The Ohio State University, Columbus, OH
b
Kroger Patient Care Center, The Kroger Co., Lewis Center, OH

Abstract

Objectives: To identify factors that influence recent college graduates’ selection of first practice position in a community pharmacy and
determine whether exposure to or engagement in pharmaceutical care services during advanced pharmacy practice experiences (APPEs) or
internship experiences correlate with any of the identified factors.
Methods: A web-based survey that corresponds to the stated objectives was developed, pilot tested, and distributed in January 2009 to
pharmacists graduating within the last five years (2004⫺2008) from participating colleges of pharmacy in the state of Ohio and five of The
Ohio State University College of Pharmacy’s peer institutions. Survey data evaluated first practice site selection and correlation with APPEs
and internship.
Results: Four-hundred twenty respondents (16% response) completed the survey instrument, with 201 (48%) practicing in community
pharmacy as their first practice position. The top factors influencing selection of first community practice position were salary, geography,
schedule, benefits, and a positive experience with the company through internship. Seventy percent of participants were involved in
pharmaceutical care services during APPEs vs 57% during internship. Those having exposure and involvement with patient education
associated with point-of-care testing (POCT) during APPEs were significantly more likely to list “established pharmaceutical care services”
as a top factor in selecting their first practice position.
Conclusions: Although pharmaceutical care was not a significant factor for community pharmacists selecting a practice site after
graduation, providing more opportunities for POCT during APPEs or internship experiences may result in an increased desire to provide
these services.
© 2012 Elsevier Inc. All rights reserved.
Keywords: Community pharmacy; Career choice; Pharmacy internship; Pharmaceutical care; Advanced pharmacy practice experiences

Background make. An analysis of the factors that influence career

choices can assist employers with recruitment and retention
Choosing a career path within the profession of phar- of employees. In addition, colleges of pharmacy can use this
macy is an important decision pharmacy graduates must information about graduates’ career choices to help guide

†
Kristen L. DiDonato is currently Clinical Assistant Professor,
School of Pharmacy, University of Missouri–Kansas City.
Previous presentations of this research: Poster (research in
progress) at the American Pharmacists Association Annual Meet-
ing, San Antonio, Texas, April 3⫺6, 2009; poster at the Ohio
Pharmacists Association Annual Meeting and Trade Show, Colum-
bus, Ohio, April 17, 2009; poster at the Ohio State University
Research Day, Columbus, Ohio, May 20, 2009; podium presenta-
tion (research in progress) at the Great Lakes Pharmacy Resident
Conference, West Lafayette, Indiana, April 30, 2009; poster (con-
tributed papers) at the American Pharmacists Association Annual
Meeting, Washington, DC, March 12⫺15, 2010; poster at the
University of Missouri–Kansas City Schools of Pharmacy and
Nursing Research Day, Kansas City, April 21, 2010.
* Corresponding author: Kristin A. Casper, PharmD, College of
Pharmacy, The Ohio State University, Parks Hall Room A220, 500
W. 12th Ave., Columbus, OH 43210.
E-mail address: casper.17@osu.edu

1877-1297/12/$ – see front matter © 2012 Elsevier Inc. All rights reserved.
doi:10.1016/j.cptl.2012.01.010
 K.L. DiDonato et al. / Currents in Pharmacy Teaching and Learning 4 (2012) 84 –91 85

the experiences students gain from didactic and experiential services during APPEs or internship experiences correlate
work. Studies identifying factors influencing career choices with any of the identified factors.
have been assessed across a number of health care profes-
sions, including dentistry, radiology, pharmacy, nursing,
and several medicine specialties, such as surgery, internal Methods
medicine, and pediatrics.1–11
This study was submitted to The Ohio State University’s
Three key studies have been published that evaluated the
Institutional Review Board and was approved as exempt
factors that influence career choices in the pharmacy pro-
research. A list of 24 peer institutions was compiled, con-
fession. A study by Besier, et al evaluated practice area
sisting of colleges of pharmacy that are similar to The Ohio
choices by entry-level pharmacy students in their final year
State University in public perception, academic quality of
of study at 12 pharmacy schools in the Midwest in Novem-
programs, research focus, publications, accreditation, and/or
ber 1988 to January 1989. This study showed that chain
community residency programs. The programs selected
community pharmacy was chosen most frequently when
were derived from the perception rankings of U.S. News and
assessing first practice choice, and that the three most in-
World Report, The Annals of Pharmacotherapy “Ranking of
fluential factors affecting practice choice were personal ful-
US pharmacy schools based on perception, funding, and
fillment, salary, and the opportunity to use one’s abilities
publications,” American Society of Health-System Pharma-
and education.3 A study by Piercy, et al in 2008 assessed
cists’ (ASHP) Online Residency Directory list of Commu-
whether specific factors have influenced pharmacists to
nity Pharmacy Residencies, the Big 10 Conference Schools,
choose retail pharmacy over academia. This study found
and a listing of Ohio colleges of pharmacy.14 –17 Each in-
that an average of 89% of retail pharmacists agreed that
stitution was contacted via e-mail requesting e-mail ad-
salary was the greatest factor influencing their decision to
dresses of alumni graduates from the years 2004-2008.
work in retail. Both groups felt they were adding value to
Seven of the 24 institutions agreed to participate in the
their institution.4 A study by Savage, et al in 2008 evaluated
study, and all external participating institutions requested to
factors that influenced career goals of pharmacy students in
distribute the survey directly to their alumni rather than
each of the four professional pharmacy years at the research
releasing the addresses to investigators.
institution. This study found that the most important factors
A nonvalidated web-based survey tool was developed to
that influence career goals were the work environment and
collect the data necessary to meet the stated objectives.
benefits, with most respondents indicating that the retail
Survey questions were predominately multiple choice and
chain setting would be their projected area of practice.5
yes/no format. Questions pertaining to APPEs and intern-
Although these studies assessed many factors that influ-
ship experiences were adapted from a pilot survey devel-
ence career choices, factors specifically aimed at the com-
oped by a faculty member and previously distributed to
munity pharmacy setting are not predominant despite the
graduating PharmD students at The Ohio State University.18
fact that nearly two-thirds of the pharmacy workforce is in
Selection factors were determined through an evaluation of
a community pharmacy practice setting.12,13 Specific links
the literature.3,4,18,19 To include a variety of factors, several
among advanced pharmacy practice experiences (APPEs),
categories were considered: characteristics of a job, incen-
internship experiences, and factors that influence career
tives of a job, pharmaceutical care factors, and internal
choices in community pharmacy have also not been as-
factors. Factors were not separated into categories within
sessed. In addition, evaluation of pharmaceutical care ser-
the survey to avoid possible influence on participants’ re-
vices as an influencing factor for practice site selection
sponses. Terminology included a mixture of factors from
seems to be absent from the existing studies, yet many
previous studies and factors developed by the authors. Pre-
pharmacies are providing pharmaceutical care services,
vious studies assessed a variable number of factors, ranging
such as medication therapy management (MTM) and point-
from 10 to 21. Nineteen factors were selected for analysis in
of-care testing (POCT) for patients. This study took stu-
this study, with a variety to represent the four categories
dents’ experiences and pharmaceutical care services into
mentioned above. The number of factors was limited be-
account when evaluating factors that influence career
cause of the desire to keep the length of the survey at a
choices and practice site selection in a community phar-
minimum in hopes that participants would complete it in its
macy practice setting.
entirety. A complete listing of factors can be found in Table
1. The survey tool was pilot-tested by a small group of
community/ambulatory pharmacists (n ⫽ 12) and then mod-
Rationale and objectives ified to ensure clarity and relevance of questions. Modifi-
cations were minor and primarily consisted of clarifications
The primary objective of this study is to identify factors in wording of questions. The survey instrument used Zoo-
that influence recent college graduates’ selection of first merang (http://www.zoomerang.com; MarketTools, Inc.,
practice position in a community pharmacy site. As a sec- San Francisco, CA), a web-based survey tool.
ondary objective, collected data were assessed to determine Contacts from participating institutions received an in-
whether exposure to or engagement in pharmaceutical care vitation e-mail providing a brief explanation of the research
86 K.L. DiDonato et al. / Currents in Pharmacy Teaching and Learning 4 (2012) 84 –91

Table 1 cally on data from community pharmacy practice settings.

Frequency of factors influencing selection of first community The first set of survey questions assessed the pharmacists’
pharmacy practice position for community pharmacy survey first practice position after graduation from pharmacy
respondents (n ⫽ 201) school, as well as factors that influenced the selection if
Factor n (%) their first practice position was in a community pharmacy.
Participants could choose up to 6 factors from a list of 19.
Salary* 110 (55%)
This assessment of factors in community pharmacy was
Geography* (location of the pharmacy) 91 (45%)
then followed by a question asking whether participants
Benefits* (eg, health insurance, retirement 90 (45%)
planning) provided pharmaceutical care services while employed at
Positive experience with the company through 86 (43%) their first pharmacy practice site, with pharmaceutical care
internship(s)* services defined as pharmacy services offered above and
Schedule* (eg, hours in a workday, part-time, 82 (41%) beyond required patient counseling as defined in the Om-
flexibility) nibus Budget Reconciliation Act of 1990.20 The next ques-
Previous experience in provision of pharmaceutical 49 (24%) tion set related to APPEs during the last year of pharmacy
care services with selected first community school. APPEs were defined within the survey as unpaid
pharmacy position experiential rotations each student completes during his/her
Sign-on bonus 47 (23%)
last year of pharmacy school. Exposure to and involvement
Positive interpersonal interactions with pharmacy 43 (21%)
with pharmaceutical care services during these experiences
staff at selected first community pharmacy
position was assessed. Exposure and involvement were not defined
Vacation 40 (20%) within the survey. It was intended that exposure meant the
Company philosophy 38 (19%) student witnessed or observed the provision of these ser-
Characteristics of pharmacy patient population 37 (18%) vices, but did not participate in the encounter. Involvement
Obligation to company because of tuition 37 (18%) meant the student participated in the interaction with the
reimbursement patient and provided a component of the pharmaceutical
Opportunity to be involved in the development 36 (18%) care service to the patient. Questions regarding exposure to
and/or expansion of new pharmaceutical care and involvement in pharmaceutical care services during
services
paid internship experiences then followed, including an as-
Opportunities for advancement within the company 36 (18%)
sessment of whether participants’ first position was with the
Staffing 29 (14%)
Prescription volume 26 (13%) same company as the internship experience, and whether
Positive experience with the company through 24 (12%) tuition reimbursement was accepted. Internships were de-
APPEs fined as paid pharmacy work experience completed while in
Other 17 (8%) pharmacy school. The last portion of the survey consisted of
Established pharmaceutical care services at 16 (8%) demographic questions.
pharmacy Survey responses were summarized by reporting fre-
Precepting opportunities 13 (6%) quencies and proportions for each answer. Factors that in-
* Selected significantly more often (p ⬍.05). fluence selection of a community pharmacy practice site
were reported as proportions and ranked in order of fre-
quency. McNemar tests were performed to compare the
most frequent influential factor responses to the other re-
project and a URL link to the survey tool, to be forwarded
sponse options, using Holm’s step-down testing procedure
directly to participants. Completion of the survey instrument
to adjust for multiple comparisons. Fisher’s exact ␹2 tests
served as consent to participate in the study. Participants
were also used in secondary analyses to evaluate associa-
were informed that the responses would be kept confidential
tions between first practice site selection factors and the
and that data would be reported in aggregate. An incentive
influences of APPEs, internships, and demographic charac-
was offered for completion of the survey in the form of a
teristics. Within each factor, Bonferroni adjustments were
drawing for three gift cards in the amount of $50 each. The
made to control type I error. Survey results were down-
survey was distributed to participating institutions in Janu-
loaded from Zoomerang and statistical analyses were per-
ary 2009 and participants were given four weeks for com-
formed using the SAS System version 9.1 (SAS Institute,
pletion based on distribution date. Reminder e-mails were
Cary, NC).
sent to the institution contacts at two weeks with a request
for redistribution of the invitation. The survey was closed in
early March 2009. Results
Participants from all practice settings were invited to
complete the survey because surveys were distributed di- A total of 2582 survey invitations were distributed
rectly from the participating institutions and the researchers among recent graduates from seven participating institu-
had no way of pre-identifying the practice setting of the tions in Arizona, Minnesota, North Carolina, Ohio, Tennes-
graduates. The intention of the study was to focus specifi- see, and Virginia. Between January 15, 2009 and March 2,
 K.L. DiDonato et al. / Currents in Pharmacy Teaching and Learning 4 (2012) 84 –91 87

Table 2
Distribution and response of surveys by state

State where attended pharmacy school State of current residence

Noncommunity Community Noncommunity

Total surveys sent Community practice practice setting practice setting practice setting
States (n ⫽ 2582) setting (n ⫽ 182)*† (n ⫽ 196)‡ (n ⫽ 182)* (n ⫽ 196)‡

Arizona 302 10 (5%) 22 (11%) 7 (4%) 13 (7%)

Minnesota 552 39 (21%) 43 (22%) 36 (20%) 34 (17%)
North Carolina 414 25 (14%) 23 (12%) 19 (10%) 18 (9%)
Ohio 610 57 (31%) 52 (27%) 46 (25%) 44 (22%)
Tennessee 574 29 (16%) 41 (21%) 26 (14%) 26 (13%)
Virginia 130 22 (12%) 13 (7%) 23 (13%) 15 (8%)
Other — — 2 (1%) 25 (14%) 46 (23%)

* 182 participants completed demographics (vs total n ⫽ 201).

† “Community Practice Setting” identifies survey respondents who are currently working in a community pharmacy setting.
‡ 196 participants completed demographics (vs total n ⫽ 219).

2009, the survey was completed by 420 participants, giving munity pharmacy practice position. Responses of commu-
a 16% response rate. Table 2 shows the distribution and nity pharmacists can be found in Table 1. When using the
response by state. Among the 420 respondents, 201 (48%) McNemar test with Holm’s adjustment, the factors “salary,”
practiced in a community pharmacy setting as their first “geography,” “benefits,” a “positive experience with the
practice site. These sites included community pharmacy company through internship,” and “schedule” were each
chains, grocery/supermarkets, independents, and mass mer- selected significantly more often than each of the other
chandisers. Most community respondents were female (n ⫽ factors (adjusted p ⬍.001 for each pair). The frequency of
128; 70%), the predominant age range was 25–29 years these top 5 factors did not differ significantly.
(n ⫽ 117; 64%), and 32% (n ⫽ 59) graduated from phar- Factors related to pharmaceutical care were not found to
macy school in 2008. Most of the participants attended be significant influences when selecting a first practice po-
pharmacy school in Ohio and are living within the same sition in community pharmacy. “Previous experience in
state. The remaining demographic characteristics for re- provision of pharmaceutical care services with selected first
spondents practicing in community pharmacy can be found community pharmacy position” was the sixth most fre-
in Table 3. quently selected factor with 49 respondents (24%), and
Survey participants were asked to select (but not rank) “opportunity to be involved in the development and/or ex-
their top six factors influencing selection of their first com- pansion of new pharmaceutical care services” was thirteenth
with 36 respondents (18%). The last of the factors related to
pharmaceutical care was “established pharmaceutical care
Table 3 services at pharmacy,” and this factor ranked eighteenth of
Demographics of community practice survey respondents
the 19 specified factors with 16 respondents (8%). Although
(n ⫽ 182)*
these factors were not significant influences when selecting
Variable n (%) a practice site, 53% (n ⫽ 106) of community respondents
Men 54 (30%) provided pharmaceutical care services while employed at
Women 128 (70%) their first practice position.
Age (y)
20⫺24 5 (3%)
25⫺29 117 (64%)
30⫺34 44 (24%) APPEs
35⫺39 11 (6%)
40⫺44 4 (2%) Survey participants were asked to provide the number of
45⫺49 1 (1%) completed APPEs in community pharmacies during the last
Year of graduation from pharmacy school year of pharmacy school, followed by the number of these
2004 30 (16%) experiences where pharmaceutical care services were pro-
2005 25 (14%) vided. Most participants had two (31%) or three (22%)
2006 35 (19%) community APPEs, yet 31% of participants revealed that
2007 33 (18%)
none of their sites provided any pharmaceutical care ser-
2008 59 (32%)
vices. The predominant number of community APPE rota-
* 182 participants completed demographics (vs total n ⫽ 201). tion sites that provide these services was 1 (n ⫽ 63, 33%).
88 K.L. DiDonato et al. / Currents in Pharmacy Teaching and Learning 4 (2012) 84 –91
Each survey participant was asked a series of questions
to assess both exposure to pharmaceutical care services
during community pharmacy APPEs, and involvement
with these services. Specific services listed included
comprehensive medication reviews, immunizations, a va-
riety of point-of-care experiences, and disease state man-
agement. The distribution of responses can be found in
Table 4. Overall, 70% of participants were involved in
pharmaceutical care services during APPEs. The most
common area of exposure and involvement was in POCT,
with 47% being exposed and 42% being involved in this
service. Survey participants with exposure to POCT dur-
ing APPE (adj. P ⫽ .03) and those with involvement in
POCT (adj. P ⫽ .048) during APPE were significantly
more likely to list “opportunity to be involved in the
development and/or expansion of new pharmaceutical
care services” as a top factor in selecting their first
practice position.
Twenty-nine percent (n ⫽ 55) of respondents took their
first job with the same community pharmacy where an
APPE rotation was completed. These respondents were sig-
nificantly more likely to list positive APPE experience as a
leading factor (adj. p ⬍.001) for practice position selection.
Internships
Participants who engaged in paid pharmacy internship
experiences during pharmacy school were asked to define
their pharmacy setting(s). Participants could select more
than one setting if applicable. This distribution can be found
in Table 5. Overall, 82% of participants engaged in a paid
pharmacy internship, with 79% practicing in a community
setting. The most common community setting was a chain
pharmacy (n ⫽ 88, 44%).
The results of the assessment of exposure and involve-
ment in pharmaceutical care services during internship
experiences can be found in Table 4. Overall, 57% of
respondents were involved in pharmaceutical care ser-
vices during internship experiences. The most common
area of exposure and involvement was immunizations,
with 30% being exposed to and 22% being involved with
this service.
Sixty-eight percent (n ⫽ 104) of respondents took their
first community position with the same company as their
internship experience, and 45% (n ⫽ 53) of respondents
received tuition reimbursement from the company. Survey
participants taking their first practice position with the same
company where they completed a paid internship (adj.
p ⬍.001), those who received tuition reimbursement for an
internship position (adj. p ⬍.001), and community pharma-
cists engaged in paid pharmacy internships in the grocery/
supermarket setting (adj. p ⬍.03) were significantly more
likely to select “obligation to the company due to receipt of
tuition reimbursement” as a top factor in selecting their first
practice position. Respondents whose first pharmacy job
was with the company where they completed a paid intern-
ship were significantly more likely to list “positive intern-
ship experience” as a leading factor (adj. p ⬍.001) and less
likely to list “schedule” as a top factor (adj. p ⬍.001).
Discussion and conclusion
There are a variety of factors that influence pharmacy
graduates’ choice of first practice position. This study eval-
uated the top factors selected by new graduates when choos-
ing a community pharmacy practice site as their first prac-
tice position.
The overall top factor selected by survey participants for
this study was “salary.” In the studies by Besier, et al and
Carter et al, salary and financial rewards were top factors for
community pharmacists when selecting their first practice po-
sition.3,21 Furthermore, salary was found to be the greatest
factor influencing decisions to work in community pharmacy
over academia in the study by Piercy, et al.4 According to the
2011 Pharmacy Compensation Survey Fall Edition, conducted
by Mercer, the annualized base pay weighted mean was
$118,700 for staff retail pharmacists and $112,000 for staff
hospital pharmacists.22 Although this difference in salary is not
large, this evidence shows community pharmacists are gener-
ally paid higher salaries. Selection of salary as a top factor may
suggest that pharmacists are seeking financial stability, partic-
ularly after an extensive education that may have left them
with significant amounts of debt.
It is not surprising that “geography” is a top factor,
selected by 45% (n ⫽ 91) of participants, because job
seekers are often limited to a certain area based on personal
preferences. Although Besier, et al did not assess geography
as a factor, Savage et al found that as students advance in
their pharmacy curriculum, geographic preference becomes
a more important job consideration, with fourth-year stu-
dents considering geographic preference of high to very
high importance in their career goals.3,5 Furthermore, stud-
ies by Carter, et al and Traynor, et al showed that geo-
graphic location was of great importance and a strong in-
fluence when accepting a first practice position.21,23 As
pharmacy jobs become saturated in select geographic loca-
tions because of changes in the economy and the increasing
number of new pharmacy schools, it will be interesting to
see whether this factor becomes less important. Students
may need to be more open to the possibility of moving to
secure a job in pharmacy practice.
“Benefits” are also an important consideration for recent
graduates. Forty-five percent (n ⫽ 90) of participants se-
lected this factor as being influential in their choice of first
practice position. This may suggest that health care needs
and retirement planning are top priorities for new practitio-
ners. “Benefits” was one of the most important factors for
pharmacy students in Savage’s study as well.5 It was either
not specifically assessed or not found to be significant in the
other studies.3,4,21,23
Results of this study showed that a “positive experience
with the company through internship(s)” was a top factor
 K.L. DiDonato et al. / Currents in Pharmacy Teaching and Learning 4 (2012) 84 –91 89

Table 4
Exposure and involvement with pharmaceutical care services during APPEs and internship experiences

APPEs (n ⫽ 190)† Internship (n ⫽ 190)‡

Pharmaceutical care service Exposure Involvement Exposure Involvement

POCT 94 (47%)* 85 (42%)* 33 (16%) 31 (15%)

(Adj. p ⫽ 0.03) (Adj. p ⫽ 0.048)
Immunizations 89 (44%) 62 (31%) 60 (30%) 45 (22%)
Disease state management 76 (38%) 60 (30%) 22 (11%) 18 (9%)
Patient education associated with POCT 74 (37%) 72 (36%) 27 (13%) 26 (13%)
Comprehensive medication reviews 69 (34%) 63 (31%) 24 (12%) 20 (10%)
Pharmacist-initiated follow-up with POCT 42 (21%) 37 (18%) 10 (5%) 9 (4%)
Not applicable 52 (26%) 60 (30%) 73 (36%) 87 (43%)
Other 5 (2%) 3 (1%) 3 (2%) 1 (1%)

* Significantly more likely to list “opportunity to be involved in the development and/or expansion of new pharmaceutical care services” as
a top factor.
† 190 participants completed APPE questions (vs total n ⫽ 201).
‡ 190 participants completed internship questions (vs total n ⫽ 201).

for new community practitioners. This finding is similar to
what was expected because it is presumed that an internship
site is selected with the same mentality that a person would
choose a new practice position. It is interesting to note that
68% (n ⫽ 104) of respondents took their first job with the
same company where they completed an internship, yet only
45% (n ⫽ 53) of respondents received tuition reimburse-
ment from the company. This suggests that half of the
interns who continued to work for the same company were
not committed before graduation and perhaps were uncer-
tain of their postgraduation plans. This could be a focus area
for recruitment efforts, both early in pharmacy school when
internships are being selected, as well as in the months
before graduation. Retaining interns may reduce training
costs and capitalize on employee experience with the com-
pany, which can be invaluable for pharmacy employers.
Pharmacy schools could consider providing guidance to
students early in the curriculum about selecting a quality
internship position, and encourage participation in school
Table 5
Distribution of pharmacy settings for internship experiences
(n ⫽ 190)*
Pharmacy setting n (%)
Community pharmacy, chain 88 (44%)
Community pharmacy, grocery/supermarket 45 (22%)
Community pharmacy, independent 13 (6%)
Community pharmacy, mass merchandiser 14 (7%)
Hospital pharmacy 27 (13%)
Long-term care pharmacy 2 (1%)
Mail-order pharmacy 2 (1%)
Other 4 (2%)
* 190 participants completed internship questions (vs total n ⫽
201). Participants could choose more than one response for this
question.
career fairs where possible internship and future employ-
ment opportunities would be showcased.
Because schedule can largely affect lifestyle, the type of
schedule, flexibility, the number of hours in the workday,
the timing of the shifts, or perhaps the ability to work part
time, may all be considerations when selecting a position.
Schedule, in terms of flexibility, was evaluated in the stud-
ies mentioned here, but was not found to be significant. In
this study, flexibility was assessed under the factor “Sched-
ule (eg, hours in a workday, part time, flexibility).” “Sched-
ule” was found to be a significant factor influencing selec-
tion of first practice position, with 40% (n ⫽ 82) of
participants selecting this factor. Further research is needed
to determine specifically which aspects of schedule are most
important to community pharmacists.
An important consideration regarding these “top factors”
is whether these are the factors that we want our students to
have as they enter the workforce. Salary, geography, bene-
fits, and schedule are factors that may be outside of our
influence as educators. These may stem from values and
experiences that have been impressed upon the student early
in life through family and culture. The top factor—“positive
experience with the company through internship(s)”—
might suggest the importance of mentoring and providing
quality experiences to students during internship.
Of particular interest to the authors was the area of
pharmaceutical care. With changes in the profession to
focus more on patient-centered care, it was hoped that these
factors would be more influential. One consideration is
whether students may not feel prepared to provide these
types of services. Alternatively, perhaps pharmacy practice
may be a few steps behind the advanced training we are
providing to students in the curriculum, making it difficult
to visualize and pursue this type of practice. Determining
the reasons why these services are not more important
90 K.L. DiDonato et al. / Currents in Pharmacy Teaching and Learning 4 (2012) 84 –91
factors in first practice position selection is an area for
future study.
One important finding related to pharmaceutical care
was that pharmacists who had been exposed or involved in
POCT during APPE were significantly more likely to list
“opportunity to be involved in the development and/or ex-
pansion of new patient care services” as a top factor. Find-
ing ways to provide more exposure for students and interns
may allow pharmaceutical care services to be more influ-
ential to their practice site selection. This may involve
schools of pharmacy being more selective when approving
rotation sites, focusing more on those that offer these ser-
vices, or implementing activities within the curriculum to
allow students to observe or practice their skills. Exploring
student attitudes toward expanded services and how to mod-
ify those attitudes may be beneficial as well.
Table 4 illustrates that APPEs provide many more op-
portunities for exposure and involvement with pharmaceu-
tical care services than internships. Overall APPE involve-
ment was 70%, compared with 57% of respondents having
involvement during their internship. This is not unexpected
because often interns may be hired to assist with day-to-day
activities within the pharmacy and learn the processes in-
volved with dispensing prescriptions vs spending time in-
volved with the provision of more expanded/advanced pa-
tient care services. Involving pharmacy interns in the
provision of patient-centered care may lead to a more robust
internship program, which could potentially improve reten-
tion of interns for company employers.
The use of an e-mail survey provided a number of
limitations, including limited access to alumni e-mail ad-
dresses, incomplete e-mail lists for all classes, and confi-
dentiality issues, meaning surveys were distributed to recent
graduates via a primary contact person at participating in-
stitutions. This allowed for the possibility of surveys being
undeliverable because of spam filters and invalid addresses.
The low response rate, lack of geographic diversity, and
nonresponse bias may limit external applicability. Another
limitation to the survey is recall bias, because participants
were asked to remember their perceptions from one to five
years ago when they graduated from pharmacy school and
accepted their first practice position. Exclusion of introduc-
tory pharmacy practice experiences (IPPEs) as influential
factors could be considered a limitation in this study as well.
IPPEs may influence graduates’ job selection, particularly
because they occur earlier in the pharmacy curriculum dur-
ing a time when students may be more impressionable.
An understanding of the factors that influence recent
graduates’ selection of their first community pharmacy
practice position is an important consideration for colleges
of pharmacy and pharmacy employers. Despite the shift in
the pharmacy profession from product provision to more of
a focus on patient care, in this study pharmaceutical care is
not a significant factor for recent graduates when selecting
a first practice position in community pharmacy. With 53%
of participants providing pharmaceutical care services at
their first practice positions and increased emphasis on phar-
maceutical care through didactic education, it is important
to evaluate why this factor is not a more significant influ-
ence. If recent graduates have little to no interest in provid-
ing patient-centered care or if they do not feel well-pre-
pared, this could affect the future of our profession.
Providing more opportunities for POCT during APPEs or
internship experiences may enhance student understanding
and interest in providing patient care services. In addition,
pharmacy employers could consider placing more emphasis
on internship programs and providing interns with more
exposure to and involvement in pharmaceutical care ser-
vices. Increasing the number of opportunities and the desire
to provide pharmaceutical care services among pharmacy
students and interns is necessary to grow the number of
community pharmacists offering expanded patient care ser-
vices and to advance the profession of pharmacy.
Acknowledgments
We acknowledge Colleen (Clark) Dula, PharmD, for
support with this project, and Kyle Porter, MAS, for statis-
tical support.
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