Academic Entitlement and Academic Performance in Graduating Pharmacy Students

Abstract

Objectives. To determine a measurable definition of academic entitlement, measure academic entitlement in graduating doctor of pharmacy (PharmD) students, and compare the academic performance between students identified as more or less academically entitled.

Methods. Graduating students at a private health sciences institution were asked to complete an electronic survey instrument that included demographic data, academic performance, and 2 validated academic entitlement instruments.

Results. One hundred forty-one of 243 students completed the survey instrument. Fourteen (10%) students scored greater than the median total points possible on 1 or both of the academic entitlement instruments and were categorized as more academically entitled. Less academically entitled students required fewer reassessments and less remediation than more academically entitled students. The highest scoring academic entitlement items related to student perception of what professors should do for them.

Conclusion. Graduating pharmacy students with lower levels of academic entitlement were more academically successful than more academically entitled students. Moving from an expert opinion approach to evidence-based decision-making in the area of academic entitlement will allow pharmacy educators to identify interventions that will decrease academic entitlement and increase academic success in pharmacy students.

INTRODUCTION

Academic entitlement is a propensity to hold an expectation of academic success without taking personal responsibility to achieve said success.¹ The concept of academic entitlement is frequently associated with the millennial generation of college students.^1-3 There is a theme of increased academic entitlement resonating among the current generation of students compared to previous generations.^1,4 There are several postulated theories relating the perceived rise of academic entitlement with the established increase in generational narcissism.⁵ The most commonly cited theories are shifts in educational paradigms, and the influence of technology and the media.⁶ Students now matriculate through a student-centered educational model with high levels of positive reinforcement and inappropriate grade inflation.^6,7 Students are also accustomed to self-promoting media outlets, such as YouTube and Facebook, which allow and embrace self-glorification. These factors may have helped create “Generation Me,” which has been referred to as the most narcissistic and generally entitled generation to date.⁸

Academic entitlement is not to be confused with general entitlement. General entitlement is typically associated with narcissism, in that entitled persons believe they deserve a particular outcome because they are superior to others.^9,10 Academically entitled students believe they deserve an outcome, not necessarily because they feel superior to others, but because of their role as a customer in the sense that they have paid for their education. This is commonly referred to as student consumerism and occurs when students perceive their education as delivered goods exchanged for tuition dollars.^11,12 Many institutions rely upon tuition as a main source of revenue and, thus, treat students as customers by catering to their academic desires, which in turn amplifies this belief.¹³ This approach can result in students treating their education as something that is owed to them rather than an opportunity for learning and earning a degree.³

When considering possible explanations or causes for the increase in academic entitlement over time, this progression is entirely theory based and objective data comparing academic entitlement across generations do not exist. In an effort to address this gap in the literature, several validated instruments have been created to measure academic entitlement.^1,3,6 In 2009, Chowning and Campbell created and published one of the more commonly cited academic entitlement instruments.¹ It consists of 15 items intended to quantitatively measure academic entitlement and has been validated multiple times in undergraduate college students. Two years later, Kopp and colleagues developed an instrument containing 8 items that also has been validated in undergraduate college students. Both of these instruments quantified the level of academic entitlement in students.³ However, neither of these authors, nor any other experts in the field, have determined a measurable definition that would ultimately identify a student as academically entitled. Consequently, students who have been identified as academically entitled have not met any objective threshold. Despite this, multiple publications openly reproach the current as generation predominately consisting of academically entitled students.

To our knowledge, neither the Campbell nor the Kopp academic entitlement instruments have been administered and evaluated in health professions students at the doctoral level. Still, academic entitlement has an established history in healthcare-related education and was first discussed in a letter to the editor in The New England Journal of Medicine in 1986.¹⁴ In the past 5 years, there has been a multitude of editorials in the healthcare literature linking academic entitlement to decreased academic performance, but none have provided evidence for their claims.^4,15-17 There are consequences to this opinion-based approach. As a result of assuming a link between entitlement and performance, theoretical interventions to decrease academic entitlement or better educate students with high levels of entitlement have been posed without the means to assess or measure intervention effectiveness. Also, educators may be falling into a trap of devaluing the accomplishments of younger generations and making blanket statements regarding academic entitlement without gathering objective data to support these claims.⁵

The primary aim of this study was to establish an objective definition of academic entitlement and measure academic entitlement in graduating pharmacy students. Our second aim was to compare the academic performance of students identified as being more academically entitled to students identified as being less academically entitled. We hypothesized that less academically entitled students would perform better academically because of a propensity to place the onus of learning and success on themselves rather than relying on outside influences to deliver knowledge to them. This hypothesis was based on the association between academic entitlement and student consumerism. Furthermore, we hypothesized that more academically entitled students would take a more lackadaisical approach to their education and rely upon the university and professors to deliver their education to them, with little personal responsibility to earn the education themselves.^11,12

METHODS

The College of Pharmacy at Roseman University of Health Sciences, a private institution, has 2 campus locations. Typical enrollment is 145 students at campus 1 and 115 students at campus 2. The 3-year PharmD program uses a “pass/no pass,” mastery learning educational model delivered in a block curriculum.

In this block curriculum, the students in this study completed 1 course at a time and then progressed to the next block. There were also a few longitudinal courses in the curriculum to ensure correlation of each block. Successful mastery of program content was determined using a combination of testing and performance-based assessment. Students were deemed to have achieved mastery when they scored 90% or higher on assessments. The pass point for all courses in the program was 90%. Within a block, students were assessed every other Friday. Students who did not pass the initial Friday assessment were reassessed the following Monday. If they still did not pass, they were required to complete summer remediation. For the 2011-2012 academic year, pass rates for the Friday assessments ranged from 46% to 100%. Pass rates for the Monday reassessments ranged from 86% to 100%. The on-time graduation rate for the college was 81%, and the overall graduation rate for the college was 88%.

This study was a descriptive analysis with the primary goal of measuring and defining academic entitlement in graduating PharmD students. To test the hypothesis that students with lower levels of academic entitlement were more academically successful, students were placed into 2 groups, more entitled and less entitled, based on their responses to 2 academic entitlement instruments. Multiple measures of academic performance between the 2 groups were compared.

The survey instrument created for this study contained 33 items in 4 content areas: demographic data (3 items), academic performance (4 items), student satisfaction (3 items), and all items from 2 previously validated academic entitlement instruments (23 items). The first (instrument A) of the 2 academic entitlement instruments included was validated using data from 1,805 undergraduate students enrolled in an introductory psychology class at a state university. It contained 15 items¹ with questions grouped into 2 categories, externalized responsibility and entitled expectations in an effort to identify subgroup characteristics of academic entitlement. The externalized responsibility items focus on placing the responsibility for education on others. The entitled expectations items focus on the classroom and grading policies. The second (instrument B) academic entitlement instrument included was validated using data from 2,152 incoming freshman students at a public university, and contained 8 items.³ Respondents were asked to rank each item in instruments A and B using a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree).¹⁸ The survey instrument, e-mail text, and study protocol were submitted to and approved by the Roseman University of Health Sciences Institutional Review Board.

SurveyMonkey (SurveyMonkey Inc, Palo Alto, CA) was used to administer the survey. Study participants were recruited via an e-mail sent to 243 students at campus 1 and campus 2 who were completing their third and final year of the pharmacy curriculum. Students were on campus to complete their final capstone course, which took place the week prior to graduation. The e-mail, titled “Student view on education,” asked students to participate anonymously in a survey to better understand students’ point of view about their education. The same day the e-mail was sent, the deans of each campus visited the students in the classroom and verbally asked them to participate. Reiterating the e-mail text, the campus deans explained that the survey was not a part of the capstone course, students were not required to complete the survey, and all participation was anonymous and voluntary. Three e-mail reminders containing the same title, text, and SurveyMonkey link were sent every 3 days for the 10-day period that the survey remained open. For their responses to be included in the final database used for analyses, respondents had to rate all academic entitlement statements. Completion of items regard demographics, academic performance, and student satisfaction were not required for inclusion.

To meet the definition of “more entitled,” students had to score above the median of the total possible points for each academic entitlement instrument. Using a scale of 1 to 7, the minimum score for instrument A was 15 points, and the maximum score was 105 points, resulting in a median of 60. The minimum score for instrument B was 8 points and the maximum score was 56 points, with a median of 32 points. Instrument A was validated using 2 reverse entitlement statements. Student scores were reversed in our database as they were in the original study by Chowning and Campbell for all calculations and comparisons. The reversal of scores was necessary to unify interpretation of lower and higher scores of agreement about entitlement, where lower scores were associated with less entitlement and higher scores were associated with more entitlement.

Academic performance was characterized by the self-reported number of Monday reassessments and summer remediations required during the first-year (P1) and second-year (P2) curriculum. To meet the criteria for being higher academic achievers, students must have completed the P1 and P2 curriculum without the need for reassessment or summer remediation. Students were placed in the lower academic achievers group if they required at least 1 reassessment or summer remediation during their first or second year of study.

Survey responses were downloaded from SurveyMonkey as an SPSS file and the data were categorized as nominal or scale. Likert data from instruments A and B were labeled as scale, and means and standard deviations were calculated for each academic entitlement item. Frequencies, means, and standard deviations were calculated for demographic data, academic performance, and student satisfaction responses. To address the secondary goal of the study of comparing the academic performance of less-entitled and more-entitled students, all academic performance variables were categorized as nominal or scale. Nominal variables were compared using a chi-square or Fisher exact test, when cell count was less than 5. Scale variables were compared using a Student t test. The same statistical methods were used to compare differences between lower and higher academic performers. The alpha was set at 0.05 and P values less than 0.05 were identified as significant. Statistical analysis was performed with SPSS, version 19.0 (IBM Corp, Armonk, NY).

RESULTS

One hundred forty-one of 243 students responded to the survey (a 58% response rate) and 138 of those students completed all survey items. The sample size necessary to avoid a nonresponse or sample bias was 122 (a 50% response rate).¹⁹ Three students did not complete either the demographic or academic performance sections. Their responses to the academic entitlement items from instruments A and B were included. Means and standard deviations in order of highest to lowest score for instruments A and B are reported in Table 1 and Table 2, respectively. In both academic entitlement instruments, students reported the most entitlement for items related to the role of professors in students’ academic performance. The only academic entitlement items from instruments A or B that scored higher than the median of 4 on the 7-point Likert scale were, “My professors are obligated to help me prepare for exams,” and “Professors are employees who get money for teaching.” The academic entitlement items students ranked the lowest were related to their own academic responsibilities. They strongly disagreed that they deserved passing grades because they paid tuition or that if they missed class it was someone else’s responsibility to get them the notes. Additionally, students strongly disagreed with items indicating that there was not a need to be an active participant in group work.

Table 1.

Academic Entitlement Item Analysis of Instrument A (N=141)

Table 2.

Academic Entitlement Item Analysis of Instrument B (N=141)

Respondent demographic data, student satisfaction responses, and academic performance are listed in Table 3. The mean score of 7.0±1.8 for faculty efficacy was determined with a question in which students were asked to rate how effective faculty members were as educators. A 10-point scale was used on which 1 represented not effective and 10 represented extremely effective. The mean scores of education value prior to starting the PharmD program (7.7±2.01) and after completion of the curriculum (6.9±2.1) used a 10-point scale on which 1 represented poor and 10 represented excellent. There were 17 assessments each academic year, yielding a reassessment rate of 17% for each year based on a mean of 3. The number of summer remediations in the P1 and P2 years was 0.67±1.27 and 0.58±1.28, respectively, for a rate of 3.5%.

Table 3.

Student Demographic Data, Academic Performance, and Satisfaction Survey Responses (N=141)^a

The demographics, academic performance, and student satisfaction of students identified as less entitled and more entitled were compared (Table 4). Fourteen (10%) students scored greater than the median total points possible on either instrument A or B, and were, therefore, categorized as more entitled. Eleven of the 14 students (7.8%) were identified as more entitled based on scores on both instruments A and B. The significant differences found between more academically entitled and less academically entitled students were the number of P2 reassessments, P1 and P2 summer remediations, and total summer remediations. While more entitled students scored the efficacy of faculty members and educational value provided by the institution lower than did less entitled students, the difference was not significant.

Table 4.

Comparison of Student Characteristics and Academic Performance of More Entitled and Less Entitled Students for Academic Entitlement Instruments A and B

To explore the relationship between academic performance and entitlement further, a comparison between lower academic performers and higher academic performers was conducted. There were no statistical differences in demographic data or satisfaction scores between the groups. Significant differences in mean scores for academic entitlement items from instruments A and B are given in Table 5 from largest to smallest differences between groups. The top 2 differences between these groups were statements related to course or assignment grades.

Table 5.

Differences in Academic Entitlement Instrument Statements (N=141)

DISCUSSION

Using 2 previously validated academic entitlement instruments, we found that a large majority of graduating PharmD degree students had high expectations for themselves and for their professors. As a whole, students felt stronger about their own responsibilities than the responsibilities of their professors. The statements with the lowest scores in both academic entitlement instruments related to the students’ own responsibilities. Students identified that they were responsible for participating in group learning, procuring their notes, and seeking help when needed. The statements with the highest scores were all related to students’ perception of what the professor should do for them, including prepare them for examinations, teach for pay, be entertaining, and seek out struggling students.

Only 14 (10%) respondents met the definition of being academically entitled. This finding may be surprising as multiple institutional and student characteristics theorized to be associated with high levels of academic entitlement and student consumerism exist within this university. For example, the university is a private institution reliant upon tuition for most of its budget, which likely creates a setting for student consumerism and academic entitlement to flourish. Additionally it is a health sciences university, which may attract students with the higher levels of entitlement commonly seen among healthcare professionals.^20-22

This inverse relationship between academic entitlement and academic success aligns with our hypothesis. The null hypothesis can be rejected as more academically entitled students performed worse in all measures of academic performance collected, including the number of reassessments in each of the first and second years, total P1 and P2 reassessments, summer remediations in each of the first and second years, total P1 and P2 summer remediations, a summer remediation in either the first or second year, and 3 or more summer remediations in the first and second years. Contrary to previous findings, there was not a difference in age between more and less academically entitled students; however, the number of entitled male students was numerically higher than entitled female students, which is in line with prior study findings.²³

Of the students who completed academic entitlement instrument A, graduating pharmacy students’ levels of academic entitlement differed from undergraduate students.¹ The mean externalized responsibility and entitled expectations scores for undergraduate students were 2.3 and 4.5, respectively. The mean externalized responsibility and entitled expectations scores for graduating pharmacy students were 2.1 and 3.5. This indicated graduating pharmacy students at a private institution felt more entitled about what a professor should do for them but less entitled about their own responsibilities than undergraduate students at a state university. Similar findings were noted when the mean scores on instrument B by Kopp and Finney’s population, which consisted of a random sample of college sophomores and juniors, were compared to those of our population. Graduating pharmacy students in our study had lower scores of academic entitlement for all 8 statements except for the highest scoring statement, “If I am struggling in class, the professor should approach me and offer to help.” This repeated outcome of pharmacy students expecting or believing they were entitled to a professor who is responsible for their academic success is a pattern worth exploring further.

Key differences between previously studied students and the students in this study include demographics, institution characteristics, and academic path. Undergraduate students attending public institutions completed both academic entitlement instruments A and B. Our population consisted of older doctoral students at a private health sciences university and thus their responses may not be generalizable to other students. Generalizability to other pharmacy students is also debatable as this study was performed in a tuition-funded private university that used a 90% pass/no pass block curriculum in a 3-year accelerated program. It is unknown how these variables impacted academic entitlement. Students attending a private university may be more academically entitled because they typically pay more for tuition and academic entitlement has been linked to students believing they are customers who pay for grades. However, this attitude does not appear to be prevalent in the private university pharmacy students in this study as this question was 1 of the lowest-scoring items of both academic entitlement instruments. What is not addressed by either instrument is the existence of a link between paying tuition and deserving professors whose job requires them to accommodate a student’s academic desires.

Perhaps the most interesting finding of this investigation was the relationship between academic entitlement and academic performance. While this theory is not new in the literature, this is the first time it has been objectively measured for this student population. Based on the results of this investigation, academic entitlement or the development of academic entitlement beliefs may be more accurately linked with academic performance. Academic entitlement may be fluid and could possibly fluctuate over time as students perform well or poorly. In courses where students perform poorly, they may exhibit more behaviors and beliefs of academic entitlement. In courses where students perform well, academic entitlement behaviors and beliefs may wane. This is an association that deserves further investigation.

Further research should focus on faculty and staff members’ sense of academic entitlement. For example, an item from academic entitlement instrument A states, “Professors must be entertaining to be good.” Faculty members are likely to feel that students who believe this to be true believe they are entitled to have professors who are entertaining. Do professors believe they have no obligation to be entertaining in order to be good? Should they not have some responsibility to engage in activities and behaviors in the classroom that pique and keep the interest of students? If they do not feel that they have this responsibility and that students should feel they are good in spite of whether they are entertaining, are they also not exhibiting their own version of academic entitlement?

Given the current cultural belief that academic entitlement is pervasive among the millennial generation, these results may be surprising. One explanation for the majority of pharmacy students not meeting the definition of more entitled may be the age and experience of the students. Life experience may have provided lessons that demonstrated the need to work for and earn what one desires. Also, given the existing environment of assessment and measurement in higher education, pharmacy students probably complete many survey instruments prior to matriculation and during their pharmacy education. This experience with surveys may provide graduate-level students with the ability to decipher the intention of a survey instrument—an ability that undergraduate students may not yet have acquired. Thus, in our study, the pharmacy students may have discerned the purpose of the survey and chosen their answers so that they appeared to feel less entitled than they actually did.

This study had several notable limitations. The survey instrument was sent to students in an e-mail during their capstone course prior to graduation, a period when they were pressured to split time between class and graduation preparation. Completing this survey instrument may not have been given priority status because of these competing pressures. The 58% response rate ensured there was not a sample bias; however, students with the highest level of academic entitlement may have chosen not to complete the survey instrument based on a belief that their participation in such activities was not a reasonable request as they saw themselves as the party which should be placing the requests in their academic relationship with the college. If this occurred, our results may have underreported the level of academic entitlement in comparison to surveys in which survey completion was required, as in the surveys conducted to validate academic entitlement instruments A and B. Limitations of the data collected included the self-reporting of academic performance. To maintain anonymity, we were unable to match student academic performance with survey instrument responses. Lower-performing students may have underreported the number of reassessments or summer remediations earned. Perhaps with more accurate reporting, the academic performance gap between less and more entitled students would have been even larger. The inclusion of reverse questions in instrument A should be noted as a limitation of the accuracy in which these questions were answered. Five students were identified as being outliers for reverse questions as they scored all academic entitlement statements low, including revered academic entitlement statements All responses were kept as entered by students to ensure the integrity of the database.

To our knowledge, this is the first study that determined a measurable definition of academic entitlement and then compared academic performance between students who felt more and less academically entitled. These hypothesis-generating findings lead to the question of causation; ie, did the graduating pharmacy students with higher levels of academic entitlement develop this because of their poor academic performance or did they perform poorly because of their attitude of academic entitlement? To delineate this relationship, the same survey instrument will be administered to a cross-section of students in all phases of the curriculum. If students develop a sense of academic entitlement while enrolled in a PharmD program, efforts could be made to avoid this phenomenon. If students are entering colleges or schools of pharmacy with a sense of academic entitlement, a discussion about this perspective and the negative impact on academic performance could be integrated into the curriculum and orientation.

CONCLUSION

Only 10% of graduating pharmacy students who completed a comprehensive survey that included 2 previously validated instruments were identified as feeling academically entitled, suggesting that the broad characterization of the millennial generation as academically entitled may be unfounded and incorrect. Higher academic entitlement levels were inversely related to academic success. It is unclear whether the relationship between academic entitlement and academic success is related to causation or if it is simply an association between the 2. To better address the issue of academic entitlement, pharmacy educators must move from expert opinion to evidence-based decision making when assessing the problem. With objective data, pharmacy educators can identify interventions that will decrease these beliefs and increase the academic success of future pharmacy students.