Abstract
Objective
To design and evaluate a student leadership retreat focused on: leadership regardless of position or title, the need for passionate commitment to excellence, the importance of teamwork, and the value of self-reflection.
Design
Students in their second, third, and fourth year of a doctor of pharmacy (PharmD) program were invited to participate in an off-campus leadership retreat that combined organized learning activities and social/networking opportunities. Retreat content utilized didactic, experiential, and self-directed learning activities.
Assessment
Forty-two students participated in the retreat and were surveyed pre- and post-retreat. A student-led group evaluation and course evaluations were also utilized. Responses on the post-retreat evaluation suggested an increased belief in their ability to influence change and an enhanced awareness of the role of self-reflection in creating excellence in the profession.
Conclusion
An off-campus overnight retreat has value in challenging student perceptions about leadership and promoting reflection on their personal role in leading change within the profession Continued exploration and development of this format is warranted for commitment to excellence programming and also for additional leadership topics and audiences.
Keywords: leadership, pharmacy students, retreat, excellence, team, self-reflection
INTRODUCTION
Meeting the profession's expectations for the delivery of comprehensive pharmaceutical care will require an unprecedented level of leadership.1 Pharmacists will need to create pharmacy practices consistent with this vision. Recognizing this need for leadership, the Accreditation Council for Pharmacy Education (ACPE) creates the expectation for faculty and administrative commitment to fostering leadership development in students in Guideline 23 of the ACPE Standards and Guidelines.2,3 Furthermore, Guideline 26.1 states that programs for faculty development should “provide strategies to develop consistent socialization, leadership, and professionalism in students throughout the curriculum,”3 Thus, all schools and colleges of pharmacy must consciously consider methods for supporting the leadership development of pharmacy students.
There are numerous opinions on how to develop “change agents” and the source material from which instructors can draw upon is abundant. Before engaging in course instruction related to leading change, it is important to ensure that a baseline foundation of beliefs and knowledge exists. First, pharmacy students must understand what leadership is and from where it comes. Most importantly, pharmacy students must hold a personal belief that they can influence positive change regardless of their position or title. Students must also recognize the need for personal accountability, particularly with respect to making a commitment to excellence and making a difference. Without an underlying belief in what they can accomplish as an individual and the need to make a personal commitment to embody the change that they hope to see in the profession, it is unlikely that leadership development activities will result in notable change in the individual's activities or behaviors.
This paper outlines the structure of a 28-hour leadership retreat for pharmacy students. It also describes experience to date, delivering foundational content focused on non-positional leadership. Retreats have been utilized by other disciplines to address leadership training and team building with reported success.4,5 Concentrated leadership development programs in pharmacy have been described by other authors, and often these initiatives have been collaborations between schools of pharmacy and state pharmacy associations.6-9 However, the leadership retreat described here is unique in its focus (ie, personal accountability for making a difference); the source material used as the framework for the retreat; and its open access to all pharmacy students (as opposed to being limited to elected student organization leaders or to those invited via a selection process). Although the retreat was developed as a standalone learning activity for all pharmacy students, it is also a required activity for those who are enrolled in a 2-credit elective course, Phar 6237: Leading Change in Pharmacy I.
DESIGN
Retreat Structure
The leadership retreat was offered for the first time in fall 2007 at the University of Minnesota, as part of a larger College commitment to the development of emerging leaders. In addition, a series of 2 elective courses, entitled Leading Change in Pharmacy, are available to students. These courses plus the retreat described here serve as a foundation for an 18-credit emphasis area in leadership development that students can elect to pursue within the doctor of pharmacy (PharmD) degree program.
The leadership retreat was available for all students in their second, third, or fourth years of the PharmD curriculum on both the Twin Cities and Duluth campuses. The retreat was held in a camp setting that was intended to facilitate a sense of being “away from campus.” The retreat was 28 hours in length with all participants staying at the camp overnight, allowing for a mix of organized learning activities with opportunities for peer-peer and student-faculty socializing. The time and distance from the campuses required a commitment by both students and facilitators. However, it also created an opportunity to clearly focus on the content and activities of the program.
The title of the first leadership retreat was “Transforming Attitude and Passion - TAP into your leadership potential.” Over the course of the retreat, 4 objectives were addressed. Specifically, the retreat was designed and content chosen so that, at the conclusion, students would be able to: recognize the ability to lead regardless of position or title, describe the need for passionate commitment to excellence and professional service, explain the power of relationship building and teamwork, and recognize the value of and exercise skills in self-reflection. These objectives formed the basis for the 4 themes of the retreat, which are outlined with their related activities in Table 1 and discussed below. Table 2 provides an outline of the retreat agenda.
Table 1.
Summary of Activities at a Leadership Retreat for Doctor of Pharmacy (PharmD) Students
Table 2.
Schedule for the Transforming Attitude and Passion (TAP) – TAP into your leadership potential! Leadership Retreat
A pre-retreat assignment was used to jump start the retreat. The source material for 2 of the 4 retreat themes was the book The Fred Factor, which contains a short story with a powerful message about how an average postman took responsibility for making a difference for those he served. Students were assigned to read this book and complete a reflection assignment as their “entrance ticket” to the retreat (Table 3). Rather than beginning with a lecture covering the book's content, students were asked to take responsibility for learning the story of Fred prior to arrival, through self-study.
Table 3.
Pre- and Post-Retreat Reflection Questions
Upon arriving at the retreat center, students were assigned to groups, which they worked within for the entire program. The assignments ensured that groups contained students from multiple years of the curriculum. Some groups also included a pharmacy practice resident. Students remained in these groups for nearly all activities to facilitate relationship-building. Students were not provided with an agenda for the weekend to prevent worrying about like or dislike of future activities and concerns about time.
Retreat Content
At the opening of the program, students engaged in activities designed to address the first theme: recognizing an individual's ability to lead regardless of position or title. Participants engaged in personal, small group and large group activities that required them to evaluate their perceptions and biases regarding where leadership comes from and the type of individuals who demonstrate it. Through this work, the facilitator generated a discussion that compared and contrasted positional and non-positional leadership.
Additional activities within this theme also helped students to discover the need for leadership and reasons why they must commit to leading change. In addition, participants completed activities that required them to consider what may be different in the way health care is delivered 10 years into their careers and how pharmacy will respond to these changes. Students were also asked to consciously consider how their education and expectations for pharmacy practice differ from those pharmacists who graduated 10 years prior to their admission to pharmacy school. Because we had observed that students often (1) expected change to be led by those who entered the profession before them, and (2) lacked an appreciation for the unique knowledge and skills they were gaining in a contemporary curriculum, these activities were designed to help students recognize that they have a unique set of abilities and motivations that can be used to advance pharmacy practice after graduation or even while they are still students.
A second theme was passionate commitment to excellence and professional service. Participants built on their pre-retreat assignment by participating in large group activities designed to link themes from this book to leadership and to pharmacy practice. In addition, students were divided into small groups to prepare and deliver a skit based on a scenario relevant to pharmacy that illustrated principles described in The Fred Factor (Table 4).
Table 4.
Outline of Leadership Retreat Skit Assignment
A series of team-building games addressed the third theme. These group activities were selected to engage students in functions where teamwork is necessary for the most effective outcome or where clear communication is critical. Each activity was facilitated by a pharmacy practice resident. Time was allotted within each activity for a short debriefing session where the facilitator helped students articulate the important teamwork concepts illustrated by the activity. An overview of the team-building games utilized is provided in Table 5.
Table 5.
Summary of Team-Building Activities Used in a Leadership Retreat for Pharmacy Students
The fourth theme focused on internalizing the need for self-reflection. The Fred Factor was an important contributor to this theme. In addition, clips from the movie About Schmidt were viewed over the course of the weekend, telling the story of an individual who has reached his retirement and is reflecting on the dreams and aspirations he had when he was young. Students learned that the protagonist regrets how he did not make the most of his opportunities to achieve those dreams. Armed with the empowering stories of Fred and Schmidt, students were sent “into the woods” for an extended reflection period, which was supported by a reflection guide (Table 3). During this reflection, students were asked to write a letter to themselves that outlined a personal commitment to making a difference in health care. These personal letters were submitted to the instructors in a sealed envelope and mailed back to students 1 month after the retreat to remind students of the experience and their commitment.
Several points of follow-up were designed into the program. About 10 days after the retreat, all participants received a bookmark, reiterating the principles from The Fred Factor, in their campus mailboxes. Approximately 30 days following the retreat, students received the letter written to themselves in the mail. At this same time, students were invited to participate via e-mail in a post retreat survey.
Retreat Facilitators
Three faculty members with experience teaching leadership, as well as leading change within different pharmacy settings, served as the retreat facilitators. In addition to these faculty members, 4 pharmacy practice residents participated in the retreat in a blended learning/facilitating role. Residents served as facilitators for the group team-building games but also as examples of the “transition” from student to practitioner. Resident presence and participation in activities and discussions enhanced the ability of students to see connections between retreat themes and the work that they would engage in after graduation.
Since design of the retreat was highly participatory, with student learning occurring almost entirely through self- and group discovery, faculty members served primarily as facilitators and provided very little direct instruction. To create this type of learning environment, numerous learning activities were developed and significant preparation time was invested in defining the flow of the retreat prior to its initial offering.
Use of evaluative course information was reviewed and exempted from full committee review by the University of Minnesota Institutional Review Board Human Subjects Committee.
EVALUATION
Forty-five students registered to attend the fall 2007 leadership retreat; however, 3 students were ultimately unable to attend due to unexpected circumstances. Thirty-five of the 42 participants were from the College's Twin Cities campus and 7 from the Duluth campus. Thirty-one participants were in their third year of the PharmD program, 7 attendees were in their fourth year, and 4 were in their second year. Because this learning opportunity was concentrated into a 28-hour experience and the themes were facilitated through self-discovery, assessment was from student self-reported learning, in addition to instructor review of pre-retreat work and direct observation.
The pre-post retreat evaluation consisted of several Likert-type statements. The evaluation was presented to retreat participants during the registration process, prior to receiving the pre-retreat assignment, and then again approximately 30 days following the Retreat. The same statements were used in both assessments, allowing facilitators to assess changes in student perceptions. Forty-two participants (100% of attendees) completed the pre-retreat evaluation and 19 completed (45% of attendees) the post-retreat evaluation. Two additional mechanisms were used for evaluation: (1) a student-led group evaluation at the conclusion of the retreat, and (2) evaluative questions included in a course evaluation for students enrolled in the Leading Change in Pharmacy course.
The student-directed group evaluation was completed onsite at the conclusion of the retreat. Two student facilitators were chosen to lead this group evaluation without the presence of the retreat facilitators. Finally, 27 of the 42 retreat participants were enrolled in the elective course Leading Change in Pharmacy, and because the retreat served as a component of this course, evaluative questions related to the retreat were included in the final course evaluation.
Theme 1: Recognizing the Ability to Lead Regardless of Position or Title
After leading a discussion to examine student perceptions of leadership myths, such as “leaders are born not made,” “leadership comes from the top down,” and “charisma is a prerequisite for leadership,” retreat facilitators introduced leaders as people who create positive change and motivate others to participate in that change regardless of position or title. In the post-retreat evaluation, students were asked: “In your estimation, what were the benefits of the retreat to others (ie, other individuals, classes, campuses, organizations, student body, college)?” Several responses suggested that the concept of leadership regardless of position was a benefit to themselves or other participants. These comments included: “Being a leader doesn't mean just being the one in charge.” “Seeing the potential to lead in their fellow colleagues that are not necessarily in the forefront of leadership roles within the student organizations.”
In addition, 77% of pre-retreat respondents moderately or strongly agreed that: “As a new practitioner, I will be able to shape my practice environment regardless of my role, position, or title.” Moderate and strong agreement to this statement increased to 95% among post-retreat respondents (Table 6).
Table 6.
Pharmacy Students' Responses Before and After Attending a Leadership Retreat, %
aPercent of students strongly and moderately agreeing
Theme 2: Passionate Commitment to Excellence and Professional Service
This theme was initially introduced via the pre-retreat reflection assignment that asked students to consider how they anticipated making a difference and creating value through their work as a pharmacist. Eighty-nine percent of both pre- and post-retreat respondents indicated that they believed they could begin to effect change in the profession as a student (Table 5).
Furthermore, at the conclusion of the retreat, students went on to outline changes they wished to see. A student-led group evaluation of the retreat produced action items including: (1) bring a positive attitude back to college; (2) recognize “Freds” around school – find ways to do this weekly/monthly at Minnesota Pharmacy Student Alliance meetings; (3) create a “Thank You Board” to recognize students and faculty members for “Fred-like” service; and (4) have each student sign and give their copy of The Fred Factor to a peer.
Theme 3: The Power of Relationship Building and Team Work
Via team-based problem-solving activities, group discussion and performance of skits, students were exposed to the importance and value of building relationships and working as a team. This was evident within and across campuses from observation of interactions during the scheduled activities, but also around an evening bonfire and during recreation.
On the post-retreat survey instrument, students were asked to comment on the benefit of the retreat to them personally. Seven respondents (37%) spontaneously reported the value of meeting others, particularly from other classes or the alternate campus. In responding to the question “what were the benefits of the retreat?” several participants highlighted learning from their peers and the opportunity to network with students from different years of the PharmD program and across campuses. In addition, several students commented informally to the facilitators that they saw the relationship-building aspects of the retreat being important in other areas of the College's professional program. In particular, students indicated that using a retreat format for the College's incoming student orientation program would likely increase positive relationships between students across campuses.
Theme 4: Internalizing the Importance of Self-Reflection
Self-reflection was an important component of the retreat. Self-reflection opportunities spanned the pre-retreat assignment and small group activities and culminated with the extended reflection time at the end of the retreat. As much of this reflection was intended to be highly personal, evidence of self-reflection was not collected, maintaining this as a private activity.
In the students' group evaluation of the retreat, the opportunity for reflection was cited as an aspect of the retreat that they appreciated. In addition, in the post-retreat evaluation, respondents were asked to comment on the benefit of the retreat to them personally. Eleven (58%) respondents spontaneously commented on reflection in this open-ended response, with individuals noting that they often do not take the time to engage in reflection. Further, they stated that the manner in which the retreat removed distractions and created an environment conducive to reflection was highly valuable.
Student-led Group Evaluation
Feedback received from the student-led group evaluation of the retreat included aspects of the retreat that participants appreciated and areas/ideas for improvement. For example, even though students expressed mild discontent when the skit assignment was introduced, it ended up being one of the activities participants appreciated most. Participants also appreciated the variety of activities, including social activities, the timing of the retreat in early fall, the 28-hour length, not being given an agenda (something that concerned some participants early on), and, as stated above, the opportunity for reflection.
Ideas for change included potentially inviting faculty members (not just the presenters), creating more opportunities to be outdoors, “going a little lighter on the Fred theme,” and considering an inter-professional retreat.
Aside from faculty time, the retreat was not prohibitively expensive to offer. For about 50 individuals, costs for the retreat were approximately $2700, which included food, housing and meeting space. An initial financial investment was made in some materials used for the team-building games.
DISCUSSION
In addition to the unique content, the retreat's structure was a combination of didactic, experiential, and self-directed learning. The didactic portions of the retreat included mini-lectures combined with individual and group activities. Experiential learning took place during the team-building activities and facilitated debriefing. Students experienced the power of a team by working together and then examining the dynamics of the team. Self-directed learning was accomplished through use of a popular film to stimulate reflection and writing, which culminated in a letter describing a personal commitment to engage in excellence. The retreat was also designed to extend beyond the scheduled 28 hours to foster further reflection and review of retreat content.
Response Rate
Several factors may have contributed to the 45% response rate to the online post-retreat evaluation. First, the online evaluation was not conducted until 30 days following the retreat, after the reminder bookmark and letter were delivered. As a result, the evaluation was delivered at midterm of the fall semester, when many other demands were competing for students' attention. In addition, students already had the opportunity to discuss the retreat with their peers and provide feedback to the instructors via a student led group evaluation immediately following the retreat. Finally, using an online survey instrument for the evaluation may have contributed to a lower response rate. Studies have shown that in-class surveys result in higher response rates.10 However, related research has compared online and traditional in-class evaluation means and demonstrated that even though an online course evaluation may have lower response rates there was not an affect on mean scores.11
Summary of Student Evaluations
The retreat increased the proportion of students who strongly or moderately agreed that “leadership can be taught” and that they would be able to shape practice regardless of position. Although attending the retreat did not increase student perceptions of their ability to affect change as students, this can be attributed in part to students' already high level of agreement (95% of respondents strongly or moderately agreeing) with this statement on the pre-retreat survey (Table 5).
Personal commitment to change was assessed by investigating commitment to “re-inventing oneself,” which was a concept discussed in The Fred Factor. Changes pre- and post-retreat were minimal. As a result, this aspect of the retreat and students' understanding of the question require further consideration.
Although the retreat did not address role models specifically, the discussions on leadership and requests for examples likely brought role models to mind. This may partially account for the increase in the proportion of respondents strongly and moderately agreeing post-retreat.
The retreat created camaraderie among the participants. A camp environment allowed time for volleyball and dodge ball, among other activities. Casual conversations occurred over meals and the bonfire, allowing students to see their colleagues as people, not just future and current practitioners. In particular, the retreat was a rare opportunity for extended time together for students from 2 campuses.
Though not assessed in the pre- and post-retreat evaluations, the number of spontaneous comments highlighting the value and importance of self-reflection was notable. From an instructional design perspective, self-reflection was recognized as a necessary step in internalizing one's commitment to excellence. However, it was not anticipated that students would see reflection as a highlight of the program. These comments suggest that future offerings of this retreat should evaluate the role of reflection more formally.
Elements of Success
Reflecting on the overall planning and delivery of the retreat, several elements of the retreat can be highlighted that contributed significantly in achieving success. Individuals seeking to develop a similar event should consider these.
The number of facilitators present, as well as the experience of this group, was essential for success. Managing the logistics and content of a 28-hour program is significant. Having at least 2 facilitators allowed for faculty breaks and adequate staffing to circulate among groups of this size. Facilitators should not only have a passion for the development of leadership skills in students, they must have a thorough knowledge of the designated leadership materials and be able to present these materials in the context of the current and future state of pharmacy practice. Furthermore, it is important for facilitators to be able to speak to both the positional and non-positional aspects of leadership through personal experience. Pharmacy residents were also excellent additions to the staff for the retreat, developing and delivering the team-building games, participating as members of groups, and sharing their leadership experience during a short presentation.
With respect to facilities, identifying a location where students can be housed overnight, and engage in both academic and social activities, was critical. Securing a location away from campus that promoted a sense of relaxation, “togetherness,” and time to reflect contributed greatly.
Finally, advanced planning was vital. The retreat was a significant undertaking with numerous logistical requirements. The right site at an appropriate cost had to be identified. While many sites might be feasible, the restrictiveness of student, faculty, and site calendars made scheduling extremely difficult. In addition, there were instructional materials to be produced, media requirements, meals to be planned and team-building games to be organized. Faculty facilitators began planning for the retreat months in advance, identifying and visiting sites to identify a quality location. Preparation of the agenda and learning materials began in earnest nearly 2 months prior to the retreat, knowing that participants would need time to complete a pre-retreat assignment. The availability of administrative support to assist with student communications and registrations, communications with the retreat center staff, organizing materials to bring to the site, etc, would be most helpful to faculty facilitators. Certainly the workload for delivering the retreat a second time is decreased, particularly with respect to preparing for content delivery and activities; however, many of the logistical elements remain with each offering.
Future Implications
Having the experience and evaluative information from the first delivery, potential changes for future offerings are being considered, such as removal of one “Fred-based” activity in response to the student-led group suggestion to “go a little lighter on the Fred theme.” While it is expected that the goal and desired outcomes originally outlined will remain the same, new resources, which may allow for an even stronger experience for students, will continue to be reviewed. In particular, the addition of a mini-lecture on team building is also being considered.
A second annual retreat with a different purpose has recently been added to efforts focused on leadership development. While an “open access” retreat in the fall semester focusing on non-positional leadership will continue to be available to all pharmacy students, the authors also have developed a retreat that addresses organizational leadership. This retreat is directed at newly elected student organization leaders and is delivered in the late spring/early summer, and also uses the overnight retreat vehicle. Initial observations and feedback from participants has indicated that each retreat is distinctive and there is a need and desire for both to continue, creating a complementary approach to leadership development.
Finally, because of the students' perceived value of the retreat atmosphere for facilitating networking and understanding across campuses, several student participants of this retreat worked to adapt the College's traditional orientation for incoming students to utilize a similar retreat format. This revised orientation format was delivered during the summer of 2008.
SUMMARY
An open access, dual-campus leadership retreat was developed and implemented. Four themes focused on: leadership regardless of position or title, the need for passionate commitment to excellence, the importance of teamwork, and the value of self-reflection. The design of didactic, experiential, and self-study components, including pre-retreat work and post-retreat reminders, was essential to the retreat's success. The cost of the retreat was manageable and student response to the retreat was positive, with additional feedback for improvement. The retreat was successful in unanticipated ways, including generating student dialogue and collegiality. The success of the retreat is an impetus for continued use of this format for commitment to excellence programming and also in addressing additional leadership topics and audiences.
ACKNOWLEDGMENTS
The authors wish to acknowledge the support of Wal-Mart Stores, Inc, for providing an endowed gift to the University of Minnesota College of Pharmacy supporting student leadership development. This gift supported the costs associated with the leadership retreat and the acquisition of resources used in the development of instruction.
REFERENCES
- 1.Wells BG. Leadership: Our hope for transformation. Am J Pharm Educ. 2002;66:436–9. [Google Scholar]
- 2.Leadership: the nexus between challenge and opportunity. Reports of the 2002-03 Academic Affairs, Professional Affairs, and Research and Graduate Affairs Committees. Am J Pharm Educ. 2003;67(3) Article S5. [Google Scholar]
- 3. Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree. Accreditation Council for Pharmacy Education. Available at: http://www.acpe-accredit.org/pdf/ACPE_Revised_PharmD_Standards_Adopted_Jan152006.DOC. Accessed February 6, 2009.
- 4.Stoller JK, Rose M, Lee R, Dolgan C, Hoogwerf BJ. Teambuilding and leadership training in an internal medicine residency training program. J Gen Intern Med. 2004;19(6):692–7. doi: 10.1111/j.1525-1497.2004.30247.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Watson S, Vasilieva E. “Wilderness Thinking”: inside out approach to leadership development. Ind Commercial Thinking. 2007;35(5):242–5. [Google Scholar]
- 6.Chesnut RJ, McDonough R, Moulton J. Student leadership conferences: collaborative approach framework for state associations and colleges of pharmacy. Am J Pharm Educ. 1997;61(4):98S. [Google Scholar]
- 7.Fassett WE, Nelson SD, Murphy NL, Gross DE, Kaye S. A successful pharmacy student leadership conference. ASHP Midyear Clinical Meeting. 2002;37(DEC):P-185. [Google Scholar]
- 8.McKenzie MW, Klapp D, Wood T, Pevonka P, Schwartz M. Enhancing leadership in pharmacy students and alumni: role of annual leadership conferences. Am J Pharm Educ. 1995;59(4):116S. [Google Scholar]
- 9.Purcell RK. Creation of a TSHP pharmacy spirit weekend. ASHP Midyear Clinical Meeting. 1997;32(Dec):AS3. [Google Scholar]
- 10.Dommeyer CJ, Baum P, Hanna RW, Chapman KS. Gathering faculty teaching evaluations by in-class and online surveys: their effects on response rates and evaluations. Assess Eval Higher Educ. 2004;29(5):611–23. [Google Scholar]
- 11.Layne BH, DeCristoforo JR, McGinty D. Electronic versus traditional student ratings of instruction. Res Higher Educ. 1999;40(2):221–32. [Google Scholar]