University of Iowa College of Pharmacy Collegiate Review · 2. Strategic Plan The COP has been...

University of Iowa College of Pharmacy Collegiate Review Review of Academic Programs

College of Pharmacy Executive Summary:

Combined Report of Internal and External Reviewers

November 2006

Members of Internal Review Team Minnetta Gardinier (Chair) – Associate Professor (Pharmacology, CCOM) Charles Eastham – Information Technologist (Health Care Information Technologies,

UIHC) Barry Greene – Professor and Interim Head (Health Management & Policy, COPH) Mark Young – Associate Professor (Chemistry, CLAS) Members of External Review Team Marilyn K. Speedie, Ph.D., Dean, University of Minnesota College of Pharmacy J. Lyle Bootman, Ph.D., Dean, University of Arizona College of Pharmacy Supported by the Office of the Provost: Stephen Rhodes, Secretary William Reisinger, Associate Provost for Academic Programs Laura Zaper, Secretary Patricia Cain, Vice Provost

Background

The Internal Review Committee was appointed in the spring semester, 2005, for the purpose of assisting the University in reviewing the performance of the College of Pharmacy (COP). The Committee sought to evaluate the effectiveness of COP activities towards the advancement of their three primary missions – teaching, research and service. In this regard, the Committee has reviewed self-study materials (Aug 2004; Feb 2005), information from a recent Accreditation Council for Pharmacy Education (ACPE; Jan 2004), collegiate information available from their web site, and met with COP leadership and other relevant personnel (administration, faculty, students, staff) interested in providing their insights and input during this process. The Committee initially met with Associate Provost Reisinger and Provost Hogan to receive its charge and then read and familiarized themselves with an extensive packet of materials from the COP consisting of self-study materials and a national accreditation review. The Committee then undertook a lengthy series of interviews and committee discussions focusing on personal interviews with a broad spectrum of collegiate personnel, including the following:

• Dean of the College • Academic leadership (Deans Kelly, Duffel, and Seaba) • Research leadership (Division Heads Rice, Sorofman, Svensson) • Service leadership (Division Heads Poust, Botha, Seaba)

College of Pharmacy Review (2005/2006) of 21

• Students (Pharm.D. and graduate students) • Faculty (tenured, untenured, clinical) • Staff • Donald Szeszycki (Assoc. Vice President & Director of Administration and

Planning) The Committee then prepared a preliminary report which was shared with the external reviewers, Drs. J. Lyle Bootman (Dean and Professor, College of Pharmacy, Univ Arizona) and Marilyn Speedie (Dean and Professor, College of Pharmacy, Univ Minnesota), who provided independent perspectives on the COP relative to peer Pharmacy schools in the U.S. In collaboration with these external consultants, the Committee sought to organize and integrate the information collected in order to provide the University with an overview of the strengths and challenges of this collegiate unit. Every effort was made to protect the confidentiality of our discussions and to provide a constructive, fair and balanced assessment of the College. The external reviewers spent two days in Iowa City, January 30 and 31, 2006. visiting at the College of Pharmacy. The met with College leadership, faculty, staff and students, and shared their perceptions with the Internal Review Committee and Vice Provost, Pat Cain. This executive summary is a combined report setting forth the recommendations of the Internal Review Committee followed by the comments of the External Reviewers and responses of the College of Pharmacy as to each of the ten recommendations of the Internal Committee (see sections 1 – 6 of the report). The report will then set forth two additional recommendations that were made by the External Reviewers followed by College of Pharmacy comments.

1. Collegiate Mission and Goals “The College of Pharmacy serves the state, nation and world by: a) enhancing human health through the creation and dissemination of knowledge in discovery, development and evaluation of new drugs and drug delivery systems, optimization of safe and effective drug use, and improvement of pharmaceutical services through pharmaceutical care delivery; b) preparing outstanding pharmacists and pharmaceutical scientists to meet the health care needs of the diverse populations of the state and society and enhancing the delivery of essential pharmacy services for all citizens; and c) developing and transferring new advances in pharmaceutical science and technology to strengthen and support the State of Iowa and society.” (Pharmacy web site, Dec 2005) In its 2000-2005 Strategic Plan, the College of Pharmacy set a long-term goal of becoming one of the top 10 Colleges of Pharmacy in the United States, as recognized by its peers. During the past five years, it has made significant advances towards achieving that goal, yet considerable work remains for both the College and the University in marshalling the assets necessary to reach this milestone.


2. Strategic Plan

The COP has been working under guidelines laid out in their 2000-2005 Strategic Plan, which was aligned with the University plan entitled “New Century Iowa: Bridges to the Next Horizon (2000-2005).” For complete details, the full strategic plan is available on the College of Pharmacy web site (http://pharmacy.uiowa.edu/about/administration-plan.htm). The goals were stated as follows:

a) Professional program experience that enables students to fulfill their intellectual, social, and career objectives. The College sought to achieve a contemporary curriculum, enhance the educational environment, and advance their teaching effectiveness.

b) Increase the quality and reputation of our graduate and post-graduate (continuing education) programs.

c) Distinguished research and scholarship. The College focused on increasing the productivity and quality of their research mission, as well as upgrading the infrastructure needed to move their research to the next level.

d) Enhance interdisciplinary activities. These actions involve efforts made to expand networks across both academic and service divisions within the College, across other units on campus, extend beyond the University reaching out to pharmacists across Iowa and outward to industry. In the context of COP’s educational programs, efforts were made to design dual degree paths between Pharmacy and other Colleges.

e) Improve efficiency and productivity. In order to optimize their success in achieving the goals set out in the Strategic Plan, careful consideration was given towards maximizing their efficiency and productivity across all aspects of the College.

The Internal Review Committee has used these principles and guidelines as a framework to assess the strengths and weaknesses of the College and in making recommendations to the University as to how Pharmacy might continue to move forward most successfully.

3. Pharm.D. Program and Students Recommendation 1: The dynamics and rapport between faculty and students could be improved by delineation of an organized, more formal career advisory process. In particular, students could benefit from assigned faculty mentors who would meet on a regular annual (or semiannual) basis to ensure good progress through the program and promote enhanced professional development of these students. Students should be educated about the full range of career opportunities and more actively mentored towards achieving their career aspirations.


External Reviewers’ Comments: Advising of doctor of pharmacy students generally takes two forms: curricular advising and career advising. In most schools of pharmacy, the curricular advising is best done by professional advisors in offices analogous to Iowa’s Office of Academic Affairs. The students we interviewed were very complimentary of that process at the University of Iowa College of Pharmacy. We see no need for change. Career advising is not provided as systematically and can be the more appropriate advising role for faculty members, or at least the ones who are well versed in the pharmacy profession. However, there are other ways for students to receive this information and advice, including coursework, contact with faculty members, or contact with preceptors or pharmacists. We understand that Dean Cohen teaches an elective designed to address this area and that students are exposed to pharmacists in various practice areas through the therapeutics courses and their rotations. They seemed to be aware of residency opportunities as well.

Students also were praiseful of the availability and flexibility of faculty members who were teaching courses and felt they could always get their questions answered. Junior faculty who are not pharmacists seemed willing and committed to learning enough about the profession to make sure their lectures are current and relevant.

Nevertheless, students felt there could be better faculty-student interactions. Specifically, advisors of student organizations need to be committed to showing up and helping students in the organizations they have agreed to advise. We also recommend that the college consider some curricular component (e.g., portfolios, senior papers, etc.) that requires each faculty member to supervise the work of 2-3 students each year. This one-on-one relationship allows each student the opportunity to get to know at least one faculty member well prior to their clinical (P4) year, provides venues for career advising discussions, and encourages faculty and students to gather together on other occasions. College of Pharmacy Response: We had recognized a need to enhance professional mentoring for our Pharm.D. students prior to our ACPE self study preparation and have been working on a new model to deliver a better program. To that end the Success Center for Student Professional Development & Mentoring has been created and the first group of students [this year’s P1 class (Class of 2010)] is participating. The program links interested students with a faculty mentor. The faculty mentors are volunteers who will help to guide professional development, stimulate curiosity in career opportunities, and encourage independent thinking on the part of the student. Mentors have received training to ensure their competence. Faculty will set the type and number of mentoring contacts that best fits the student’s schedule while considering their needs during the pharmacy program. Examples include face-to-face meetings during designated office hours or by appointment, group meetings, and e-mail or telephone contact. Students will continue with their faculty mentor throughout their time in the program. This should help strengthen already positive relationships between the students and faculty. Curricular advising will continue to be managed through the Office of Academic Affairs.


Recommendation 2: Consider whether tuition should be adjusted during the P3 and P4 years of training, while students are off campus obtaining their clinical experiences. External Reviewers’ Comments:

Only the P4 year is a experiential education year. Students complete some early experiences during their third year in the college but much of the year is spent in didactic classes. It makes no sense to reduce tuition for the P4 year. It is, in fact, quite expensive to administer, even with a group of volunteer preceptors and clinical faculty participating in the clinical training. There are significant numbers of clinical track faculty supported by the college to develop high quality practice sites and precept students in those sites and there is a substantial infrastructure that supports the matching of students with sites and the monitoring and evaluation of students and faculty. Furthermore, it is not feasible in this time of financial constraints, to reduce the tuition collected to acquire the Pharm.D. degree. If the P4 tuition were reduced, the tuition for other years would have to be increased. We doubt that this would be a popular move! College of Pharmacy Response: An adjustment to the tuition for students in their final year is not practical. This point was well made by the external reviewers. As they mentioned, the final year is quite expensive to deliver. There are considerable administrative costs and most of the College’s clinical track faculty members dedicate a major portion of their teaching commitment to experiential education in the final year. Our model is similar to our own Colleges of Medicine and Nursing which also rely heavily on volunteers to deliver their experiential education. The College does not do a good job of explaining the costs of experiential training to our students and doing so may help them better understand our tuition policies. Students that are away from campus for an entire academic session do qualify to have some of their student fees waived. Recommendation 3: The Pharm.D. administration should reinvigorate their efforts to increase diversity among their Pharm.D. students. They might coordinate efforts with the Opportunities at Iowa and the newly organized Office for Ethnic Inclusion. They also need to be more directly and proactively involved in promoting this change – emphasizing the advantages of pharmacy as a career, the strengths of the UI Pharmacy program specifically, and employing successful strategies used by other University departments. Recognizing the importance of diversifying the student body, for not only Pharm.D. but also graduate students, it might be worthwhile to identify an individual in the College who would focus on this initiative. External Reviewers’ Comments:

We understand that there are about 12% students of color in the professional student body and that efforts to increase this percentage have not been successful. We were told of an effort to use high school faculty in Chicago to help recruit diverse students to the University of Iowa College of Pharmacy, with some success, but much more must be done. It appears that efforts will most involve attracting out-of-state students and making sure there is a welcoming and supportive environment for them in


Iowa City. Out-of-state tuition is very high and if it is possible to waive out-of-state tuition (or give a tuition scholarship for the out-of-state differential) for highly qualified minority candidates recruited from out-of-state, rates of enrollment may increase. Efforts must also be made by the university and the college to reach into high schools so prospective students receive adequate pre-pharmacy preparation.

There is a new elective course in cultural competency in health care that has been developed by Christine Catney and that will eventually be interprofessional. This is an excellent effort to prepare pharmacists who will be able to work with a diverse group of patients.

Graduate student diversity is a somewhat different issue since the collegiate graduate programs have traditionally attracted a significant portion of international students who tend to provide diversity. The Medicinal Chemistry program has tried and succeeded in recruiting a pool of domestic applicants, including domestic minority students. Domestic students are preferred because of their eligibility for federally sponsored training programs, thus allowing more students to be supported. While, in general, we applaud the recruitment efforts, the program needs to make sure that outstanding international candidates are also included in the program, both for the sake of diversity and for the importance of the university’s standing in global education.

One note – the college needs to retain the few faculty members they have that are of underrepresented minorities and to help ensure their success at the university. It might be wise to do a salary equity study to be sure that everyone is being paid fairly and to ensure that everyone is sufficiently valued. College of Pharmacy Response: Improving diversity is a challenge and a goal for the entire University. In the Fall of 2005, the Dean appointed a standing Diversity Committee consisting of students, faculty, staff and alumni and they have been working on a contemporary diversity agenda that includes helping change the college climate. A representative from the Office of Academic Affairs participates in all of the University-sponsored recruiting trips that are focused on identifying students from minority populations in Iowa and surrounding states. Two members of our College are active participants on the University Diversity Committee. Our admissions committee is very aware of the importance of diversity. While it is too early to identify a trend, the most recently admitted first year class had improved diversity. Eighteen students identified themselves as non-white. This represents 16.4% of the class of 110. Of these, nine identify as members of underrepresented minorities. The College will continue to give serious consideration to all underrepresented minorities that meet our minimum admission standards. The external reviewers suggest that we look at ways to make students from underrepresented minorities eligible for in-state tuition. We do not have sufficient resources within the College to accomplish this. Some of the tuition set-aside dollars have been used to create diversity scholarships that were awarded during the current academic year.


4. Research and Ph.D. Programs

Recommendation 4: CAP is the largest of the three research divisions in Pharmacy – any failure to build and maintain excellence in this Division would create a significant burden on the College’s effort to climb in national prominence. The perception of inequity held by members of the division (e.g., that the CAP head was hired internally rather than externally) is an issue that must be addressed directly and soon. This perception of inequity significantly impairs the College’s potential for change and improvement. Solving this problem, which involves such a large number of faculty, is of the highest importance for the Division, the College, and the University. External Reviewers’ Comments: We interviewed Bernard Sorofman and found that he was both aware of the concerns of the tenure track clinical scientist faculty members and that he had plans to adjust their requirements for clinical service and experiential education. He and Dean Cohen also stated that there were four open positions in the division. Clinical Pharmacy/Pharmacy Practice department heads are difficult to find and recruit and Dean Cohen had hired Barry Carter relatively recently, so we do not fault the internal appointment of Dr. Sorofman. That said, we found that the communication of expectations and anticipated changes was deficient. Division members, particularly the tenure track faculty, did not seem to know of plans that Dr. Sorofman told us were in place. There apparently has not been shared strategic planning within the division, which would create buy-in to future plans and would achieve some shared expectations for performance. At the same time, the tenure track faculty will have to expect that if they are given increased time to do research by reducing their clinical loads, they will have to develop significant research programs with external funding. This is the right time for that to happen, with the embracing of clinical and translational research by NIH and Iowa’s planning to acquire a Clinical Translational Research Award. However, these faculty members are, for the most part, not in position to acquire such funding and will need to develop individualized, as well as group plans, to develop their programs. Dr. Carter should be of significant help in this regard and should be expected to play a mentorship role for his colleagues. We also found lack of a shared vision among the three faculty groups within the division. While the morale and productivity among the social and administrative science faculty and the clinical non-tenure track faculty appeared to be much higher than the tenure-track clinical scientist faculty, they also did not seem aware of overall plans for the division. A serious strategic planning and community building effort is warranted. We believe the current leadership is capable of pulling the division together and should perhaps seek outside facilitators to help get the process started. Part of the strategic visioning and planning should be an honest identification of strengths for each of the subgroups; we were surprised to find little internal recognition of the strength of the community pharmaceutical care development work of one group of faculty within the division. We believe that this is perhaps what the University of Iowa College of Pharmacy is best known for and is a strength that should be recognized, celebrated and further developed. Strategic planning also needs to seriously address realistic performance expectations;


Clear, agreed upon, and realistic-but-ambitious performance expectations, with sufficient flexibility to allow each person to contribute from his/her areas of strength, will help everyone feel they can make a valued contribution to the overall achievement of the division and the college. College of Pharmacy Response: CAP is the largest of the three academic divisions. Each academic division is charged with undertaking teaching (professional and graduate), scholarly activity, and service. The College does not have research divisions. At the outset it should be pointed out that the Collegiate Review Committee may not have fully grasped the multiple missions and faculty title series housed in CAP designed to achieve a very diverse mission, and one that differs markedly from the traditional academic departments in most other colleges at UI. In the face of financial pressures these multiple faculties and multiple missions will inherently create tension over resource allocation and teaching/service load decisions. This recommendation addresses a large number of points that can be categorized into two different issues – perception of inequitable treatment between academic divisions by the Dean and communication of the vision for the division. The first factor associated with the inequitable treatment was the appointment of the current division head. Indeed, some CAP faculty were disappointed when the division leadership shifted from one internally appointed person to another. There was a strong expectation and initial planning by division leadership for a national search and a hope that the outcome would garner significant new resources for the division, similar to what was accomplished for the other two academic divisions. The appointment of a division head without a national search left the perception in some faculty that the division was not being treated fairly compared to the other academic divisions. A second factor mentioned in the report regards the burden of the clinical teaching loads of the tenured faculty who are associated with the ‘clinical pharmaceutical scientist’ program. This faculty has traditionally had a responsibility to supervise 1-3 students on 5 week experiences in clinical practice settings. Over the years the time commitment has been as high as 40 weeks of teaching and was at 20 weeks when the external review was being done. Although their teaching loads in didactic professional and graduate education were lighter, this obligation did not allow several of the faculty to accomplish their laboratory-based research goals. The previous division head had begun the process of reducing rotation obligations for this faculty and at the time of the review the load was still higher than faculty desired and had expected. Since that review faculty have been added to teach the experiential rotations (see comments on recommendation #10) and the entire clinical science tenure-track faculty have been given the opportunity to reduce their experiential rotation teaching to zero starting in AY08. Practicality dictates however, that laboratory-based clinical science tenure-track faculty who opt to reduce clerkship teaching must be actively seeking extramural funding for their research that includes appropriate salary offset, and to date limited success has been achieved in this group. The recent recruitment of a new junior faculty member to the clinical science group with excellent NIH funding potential is aimed at creating a different culture relative to funded research in this group of faculty. Three have taken the zero option; the rest have reduced


their obligations by 5 weeks. Individually CAP faculty teaching obligations in the professional program, both experiential rotations for tenured faculty and CAP overall, are higher than the obligations in the other two academic divisions, yielding a perception of inequity in time for research and professional productivity and difficulty in achieving scholarly outcome expectations across the college.

Communication is critical in such a large, academically and geographically dispersed group. CAP has an active, monitored strategic plan. When the current division head accepted the position, he met with faculty and provided a vision for the transition to new leadership. During that meeting faculty were told the CAP strategic plan was still in operation and would drive division progress and planning. Annually, the division head provides a perspective on the success and future of the division. Additionally, at each monthly faculty meeting time is available to discuss anything of interest to the faculty. The CAP administrative team monitored the strategic plan and there was a CAP faculty committee that met in 2006 to discuss the future of the current strategic plan. In February of 2005, just prior to the Provost committee’s visitation to the college, CAP had a retreat that discussed in detail the faculty’s expectations of themselves for teaching, scholarly activity (research/professional productivity) and service. At the retreat the discussions of service expectations were not completed and were still open when the Provost committee was doing its review. For the components on research and teaching expectations, faculty members had the opportunity to contribute to these discussions and were provided with the results. An external consultant has been hired to help build a common vision among the CAP faculty who are diverse in training and mission within the division. He will begin his process in the fall, 2006, have a retreat in January 2007 and meet as a follow-up with divisional leadership in May 2007. Some efforts have been completed – a stakeholder’s committee now reviews program similarities and differences, the overall budget has been made transparent. Recommendation 5: As recognized in the College’s own self-study, it is imperative to the success of the College’s research enterprise that domestic graduate students of high quality are recruited into the Ph.D. programs and that reliance on foreign graduate students is significantly decreased to achieve better balance between both domestic and international pools. MNPC has made substantial efforts in this area with implementation of new strategies, and PCEUT is adopting similar tactics. Recruitment efforts must be expanded and, although the disciplines may be quite different, coordination of recruitment efforts would highlight the breadth and depth of opportunities in the College of Pharmacy. A full time staff person should be assigned to coordinate and implement recruitment efforts across the College. Significant financial resources must be earmarked to support “open house” recruitment weekends, recruitment materials (e.g., posters, web sites), and subsidies for travel of the top prospective students to visit the campus. Faculty must also invest in this effort by giving talks at feeder colleges, hosting faculty from these same colleges for visits and seminars, and making personal contacts with applicants. Successful recruitment is critically dependent on graduate student stipends that are competitive with peer programs; further incentives may be considered to attract the very best candidates in the applicant pool. Use of discretionary funds (e.g., foundation sources, indirect cost recovery) should be utilized to create fellowships and


stipend supplements for the most outstanding students, as is being done by MNPC and PCEUT. The Review Committee wishes to highlight this issue and to recommend that it become a top priority on the College’s agenda. External Reviewers’ Comments: Upon review of the recommendation there was not much disagreement across the reviewers. However, as previously mentioned proper balance between domestic and foreign student admissions is important to insure proper diversity. Additionally, the recommendation indicated that a full time staff person should coordinate the recruitment efforts for the graduate programs. This is certainly possible and actually is accomplished at many such programs through the assistant/associate dean for research. This oftentimes helps to improve interdisciplinary efforts and camaraderie. The new Clinical Sciences Ph.D. program in the CAP Division is an excellent step toward producing clinical scientists for industry and academia and the faculty stated that applications for it were of excellent quality. The graduates of such a program will be highly sought after. We recommend that the program be sufficiently supported in its infancy to guarantee its success. It will require adequate support of students while new faculty are hired into open positions and while research funding is building among the program’s faculty. Perhaps incorporating student stipends into start-up packages would be one way to accomplish this. Eventually the faculty will need to support their own graduate student stipends, at least to the extent of the other programs, but an investment at the beginning of the program will pay off in the long term. College of Pharmacy Response: We agree with the recommendation of the review committee that graduate recruiting should be a top priority on the College’s agenda. The recommendation of additional support staff for graduate recruiting is fully consistent with the College’s most recent (October 2006) strategic assessment provided to the Provost wherein a current weakness of the College is the lack of sufficient support staff. We also agree with the suggestion of the external reviewers that the support staff might be located within the office of the Associate Dean for Research and Graduate Affairs. The additions of support personnel for research and graduate affairs, including those for graduate recruiting and for grant and contract administration, is essential for the future growth of graduate education and research in the College of Pharmacy. We also agree that identifying resources and investing additional financial support for recruitment efforts, fellowships, and stipend supplements is critical for maintaining and increasing both the excellence and diversity in graduate recruiting. For example, stipend support for graduate students will increasingly be accomplished through multiple mechanisms. This will also include identification of new funding sources for many of these mechanisms. As suggested by the external reviewers, one of these mechanisms will include continuation of our commitment to provide graduate student stipends as one of the components of new faculty start up packages. We feel strongly that this is an important part of helping new faculty quickly initiate their research and graduate student mentoring as they begin seeking extramural support for their research and their graduate students. It should be noted in this regard that the Division of Medicinal and Natural Products Chemistry has made significant


progress in the recruitment of domestic students and highly qualified underrepresented minorities. The strategies used by this division are being examined relative to other graduate subprograms to try to replicate this initial success. The College overall has risen greatly among those colleges of pharmacy that compete for AFPE support for graduate fellowships as well as seeing a marked increased in University awarded fellowships to students of the highest merit. Recommendation 6: While PCEUT has made significant advances, it may become severely constrained in its ability to further advance its research stature with only one remaining hire as the current projection. In order to achieve a critical mass among active researchers within the Division and to increase extramural funding, the Committee asks consideration for recruitment of 1-2 additional faculty members with expertise in biomolecular sciences who would also foster additional interdisciplinary ties across the University. PCEUT tenured faculty have been challenged to meet clearly defined standards and to undergo more rigorous performance reviews, resulting in adjustments for increased teaching duties. The resulting allocation of differential teaching loads should be used to accord research-active faculty some teaching relief so that they can further enhance the quality and quantity of their scholarly endeavors. External Reviewers’ Comments: The University of Iowa College of Pharmacy has long had a national reputation for its education and research in the physical pharmacy area of pharmaceutics. With the hiring of Craig Svensson, the college chose to balance that strength with the biological component of the discipline, with a focus on transport and drug delivery. It does not appear that this move was a choice of the division members, arrived at during strategic planning, but rather was the. top-down direction imposed by the Dean. Nevertheless, it appears to be a valid choice that will strengthen the division in the long run, increasing opportunities for interdisciplinary research across campus units and increasing opportunities for extramural funding. The problem with it being imposed top-down is that many of the faculty members appear to feel threatened and undervalued with the changes, in part because they do not have a clear picture of what the balanced division will look like. It is important to have mutual respect across the focus areas of the division/discipline and that involves a recognition of differing values (education vs research, NIH funding vs industry funding) and interests. It is essential that this group undertake a planning and community building effort to arrive at a mutually-agreed upon vision for the future of the division. Agreement on performance expectations would also help stimulate cohesiveness and mutual respect. One essential component of this communication must be clarification of funding expectations for research support. This is complicated by the fact that money is informally “transferred” from Pharmaceutical Services to researchers in the division and not counted in extramural funding, even though it has come from external sources. A more rigorous subcontract from the service unit would lead to both accountability and credit. Also, when funding sources are diverse and a potential source of conflict, it might be wise to place more emphasis on quantifying research productivity in other ways, i.e. publications. It is unwise to only value NIH funding, especially when it is not


appropriate across all parts of the division and is not a particularly stable source of funding these days. Diversity in funding sources is more likely to lead to continuous levels of funding in the long run. It appears that graduate students are also being polarized in their choices of “tracks” within the program and are entering into the polarization within the division. Our recommendation would be an integration of the tracks so that students acquire a broader knowledge of the discipline and are capable of working across the focus areas. They will more desirable to employers and will be better scientists in the long run. College of Pharmacy Response: We appreciate the recognition by the reviewers of the exceptionally strong national and international reputation for excellence enjoyed by the division of pharmaceutics in areas of education and research related to physical pharmacy, and their general support of the ongoing efforts to expand areas related to transport, drug delivery, and tissue engineering. While the strong preference to enhance the biological interface in this Division may have emanated from the Dean’s office, there was support among some pharmaceutics faculty as well as other science leaders in the College. Since the review occurred in the 2005-2006 academic year, it is important to provide an update relevant to some of the recommendations. The recruitment mentioned at the beginning of recommendation #6 is now complete, and this outstanding new faculty member (jointly recruited with the Department of Chemical and Biochemical Engineering in the College of Engineering) joined the division in August, 2006. We now have plans for recruitment of another faculty member who will be jointly appointed in Pharmaceutics and Engineering. We are very enthusiastic about expanding the critical mass of faculty in these interdisciplinary areas of pharmaceutics. Since the recommendations of the reviewers were written, Dr. Craig Svensson has become Dean of Pharmacy and Allied Health Sciences at Purdue University. In the interim, Professor Rolland Poust is serving as division head, and an external search for a new Division Head in Pharmaceutics will be initiated in the Spring semester of 2007. This will allow the current search for Dean of the college to reach a point consistent with an effective search for a new division head. The upcoming search for a new division head, along with the newly initiated search for a new director of Pharmaceutical Services will provide an excellent opportunity for extensive discussion and strategic planning for the direction of research and graduate education in the division, as well as interactions between Pharmaceutics and Pharmaceutical Service. Finally, we agree with the reviewers on the need for diversity in research funding sources. Efforts to diversify funding in the Division of Pharmaceutics by enhancing one source are not intended to eliminate or devalue research funding from other sources. The overall goal is to have long term continuous and sustainable levels of funding for research and graduate education with appropriate support of faculty effort and graduate students on extramurally funded projects. These expectations have been communicated to the faculty from both Dean Cohen and Division Head Svensson and are consistent with expectations for all tenure track faculty in the College.


5. Service Programs Recommendation 7: The College should aggressively seek a more substantive and extensive association between the academic and service Divisions of the College. Failure to take advantage of the College’s unique service operations to offer their students professional experiences in these arenas represents a significant lost opportunity for them. GMP should be recognized as a necessary component in student education. PS will soon seek a new Director, and this search may provide an opportunity for an expanded dialogue on the future programmatic direction of this facility and its ties to the College. The Dean has discussed linking a new faculty hire with activities in PS in order to enhance research connections. Given the commonalities between the missions of PS and CADD, it would be advantageous to involve both units jointly in this search process that will chart the course for their future growth and development. Closer ties and interactions between PS and CADD might also strengthen and benefit these two service divisions, perhaps creating a synergy between them. We encourage the Collegiate leadership and the Directors of PS and CADD to consider these ideas and, similarly, to seek to introduce programs that take advantage of PS and CADD for educational opportunities that can benefit graduate and professional students in the COP. Both service Divisions could benefit from a more specific focus on strategic alliances with and development of explicit business models to guide their futures. External Reviewers’ Comments: (see below, combined with 8) College of Pharmacy Response: The college is working to increase communication and understanding of mutual interests and capabilities between the service divisions and faculty in the academic divisions. One component of this is the strong role of academic division faculty in the just-initiated search for a new director of PS. This is an outstanding opportunity for shaping the future of interactions between the academic and service divisions, as well as among the service divisions. It should be noted that there is already an exceptionally strong relationship between CADD and PS, and they currently work together very closely. While their missions are different, they are complementary, and it is common for potential clients to be referred from one to the other for specific parts of the drug development and manufacturing process that are most appropriate. Indeed, a large majority of CADD’s work comes from PS, and about half of PS’s analytical support comes from CADD. We also see the potential for these synergistic interactions to increase as both CADD and PS interact more with the Center for Biocatalysis and Bioprocessing (CBB) due to the CBB adding cGMP production facilities for biologicals. This represents a substantial area for growth of interactions among all three units and is highly consistent with the Economic Development Goals of the University in general and the Vice President for Research in particular. The Associate VP for Economic Development in the VP for Research Office is also a member of the search Committee for the new PS director. Finally, the suggestions of the review committee regarding development of strategic alliances and business models will be pursued in consultation with the College’s Industrial Advisory Council. This distinguished panel plays an active role in advising the College on emerging trends in technology, drug discovery and development, healthcare, and the


pharmaceutical industry. Such insight by external consultants allows the College to anticipate and adapt to change while staying true to our core missions of education, research, and service. Recommendation 8: The College must manage the service Divisions with the goal that they augment the financial base of the College and not be allowed to become an economic drain for Collegiate resources. As already noted, the existence of these Divisions sets Iowa’s COP apart from its peers, and the College should seek to protect and enhance these assets that also greatly benefit the State and the University. Presently, PS is “land-locked” on the main campus without possibility of meaningful expansion – an observation also noted in the 1987 review. It has demonstrated a sound fiscal operation over its history, and if afforded an opportunity to grow, would likely achieve greater success with a new, expanded facility at Oakdale. Such a move would clearly require a substantial capital investment from the State, yet a review of the benefits garnered from the State’s initial investment decades ago suggests that a new resource allocation would boost PS (and CADD) to further successes in the 21st century. Their missions are entirely consistent and integral with the goal of fostering economic development in the State and attracting high technology industry to Iowa. The Oakdale campus has undergone tremendous growth in the last decade and represents the nexus between fledgling start-up industries here in Iowa and the University. In planning for future growth, both units might benefit from hiring an external marketing consultant who could develop sound expansion strategies – perhaps via collaboration with the Tippie College of Business. While both PS and CADD have proven track records, both nationally and internationally, each seemed at a loss with a marketing strategy that would allow them to grow. This problem is tightly linked to their current lack of space and facilities for growth. Building upon their reputations, it would be logical, efficient and mutually beneficial for both Divisions to be located together on the Oakdale campus. They might both promote further growth of new enterprises here in this technology corridor. Relocation of PS to Oakdale would then have the added benefit of freeing up space on the Iowa City campus for the academic Divisions to grow. External Reviewers’ Comments: (7 and 8):

In general, we agree with this recommendation. It is critical that a closer tie between the academic and service divisions be further examined and implemented. It was not clear as to the reason for separation of the two divisions (PS and CADD). As new leadership is needed serious thought should be given to combining the units. The academic affiliation should revolve around all three components of the mission, teaching, service and research. There is tremendous opportunity as well with regard to continuing education programs for the industry. Finally, as mentioned, much more serious attention to business model development and refinement with serious attention to strategic planning needs to occur for all three divisions. This would include a physical requirement needs assessment and an assessment of unmet needs (current and future) of industry. For example there is great need to further the efficiency and effectiveness of the development phase (Phase I-IV) and Iowa may be positioned to respond. Most likely planning and serious business modeling will indicate potential for tremendous growth in the enterprises. This most definitely will require assessment of the physical plant for each the


divisions. Though separation to Oakdale is not the most desirable situation, a move may help to meet the physical needs but also serve (as many research parks do) to communicate the business mission to those it serves. This should be part of the marketing strategy that is most needed for future success. College of Pharmacy Response: We are glad that the reviewers appreciated the longstanding success and sound financial operation of the service divisions of the college. We agree that strong strategic planning for the future is essential. With regard to comments by the reviewers on the need for strategies for marketing and strategic directions, we are actively engaged with the Pappajohn Entrepreneurial Center as well as our Industrial Advisory Council to aid in providing external perspective for determining new directions for both services and facilities, as well as new opportunities in continuing education targeted to industry. The advantages and disadvantages of the potential option of relocating PS to the Oakdale campus are being explored. We recognize, as did the external reviewers, that gains in physical space and flexibility for new directions and growth by building new facilities on the Oakdale campus would come with very significant needs for financial investment and potential costs in the ease of interaction between the academic and service divisions. Within the context of these considerations, the external reviewers’ comments regarding the future relationship between PS and CADD (i.e., potential positive and negative effects of combining the two) are also being considered.

6. Faculty Recommendation 9: Faculty across all Divisions need a greater voice and a direct dialogue with Collegiate leadership. Other Colleges benefit from a Faculty Council that provides an open and more direct avenue for dialogue between the faculty at large and their Dean. It relieves the pressure of the Dean receiving all information only through Division Heads and his administrative staff. It also affords faculty another route to communicate their concerns and ideas to their peers, who in turn will meet with the Dean on a frequent basis (e.g., weekly, monthly). Faculty play an active role in the strategic planning of the College. Currently, only one faculty member rotates on an Executive Committee that meets with the Dean. Sometimes this member might be a less experienced, untenured faculty member, who may not be as effective a voice for the faculty overall. An elected faculty group representative of all ranks, of all tracks (tenure, clinical), and of all Divisions (academic and service) would provide a better and more effective voice in the Dean’s office. This elected faculty group could serve as an advisory committee to the Dean in matters of the promotions and tenure process, as well as other issues of importance across the College – various models are used in other Colleges at the University. External Reviewers’ Comments: The issue of improved faculty participation at many levels such as P and T decisions, planning, and overall faculty governance was brought up on several occasions. It appears that at the department level there is variance as to frequency of meetings and extent of communications, certainly around future plans and around planning in general. There was


a definite need at the division level and the college level for more encompassing and comprehensive strategic planning. It was stated that more frequent college faculty meetings need to occur. Though much appears to be communicated between dean and division heads, the proper and timely conveyance of information to faculty via the heads was not as clear. With reference to P and T review of faculty, there is in each division a committee that reviews dossiers of faculty under consideration with further review and recommendation of the division head and the respective division committee to the dean. Upon receipt, the dean makes further recommendation to the provost with input and recommendation from a college level committee. This seems standard but further assessment may be warranted to insure proper faculty participation in this most critical area of decision making. College of Pharmacy Response: The college agrees with the general lack of faculty participation in planning and values the feedback from the two review teams. While the monthly meetings of the College’s executive committee are comprehensive and the minutes are detailed and distributed throughout the college clearly many faculty still feel out of the loop. The election of a faculty member to the committee has helped and all have had good input into major planning and budgeting processes. We have “floated” the idea for an elected faculty council several times but generally there was (and still is) little enthusiasm as the faculty are small in number and are worried about extensive service and administrative responsibilities. This feedback however should be helpful as the College completes major searches in the next several months and the new Dean and Division Head can help establish an improved forum for increased faculty input. Having acknowledged all of this clearly the faculty have been extensively involved in both Accreditation planning as well as in all of the extensive curricular changes that have occurred over the past 5 years. We have worked hard over the years to enact a promotion and tenure process that meets all of the University requirements and are surprised at the confusion expressed by some during the review. The college complies will all faculty adopted processes to assure stepwise peer review through the Divisional Consulting Groups (DCG) and the Collegiate Consulting group (CCG). The Dean is not involved at all until receiving a final dossier from the CCG and he then makes a recommendation and forwards the completed dossier with Divisional and Collegiate recommendations as well as external letters to the Provost. There have not been any instances of concern expressed by anyone about the fairness or structure of this process over the past 7 years. On occasion our small numbers require the inclusion of external members of the DCG due to lack of sufficient tenure faculty at various ranks to fill the required membership. In all cases however, faculty up for review are fully informed and have the ability to respond to the selections for these committees when outside members are brought in. This is a particular challenge in the promotion discussion of clinical track faculty, yet these too have been handled effectively and in compliance with all college and university procedures. Recommendation 10: CAP faculty need a substantial commitment to rebuild and reinvigorate their Division – as with MNPC and PCEUT, Division leadership must


receive a substantial Collegiate commitment that will enable it to positively engage its faculty in a partnership to map out a viable and successful future. CAP Divisions are typically found at peer institutions, and clearly other institutions have achieved success in this arena. In order for the COP to move up in the national rankings, it is imperative that it considers its peer programs and that, in partnership with CAP leadership, it identifies a strategy to move CAP to a performance level at least comparable to the other two academic divisions. The current CAP strategy appears to focus on “shared opportunities” for new faculty hires, which puts these faculty in the position of pleasing two masters with their joint appointments. While joint appointments emphasizing teaching and clinical practice allow “2-for-1” hires where COP only pays for half the faculty member’s salary, this strategy does not promote an environment for these faculty members to focus and achieve excellence and success in an area of scholarship. This Division might benefit greatly from bringing in an external consultant to chair a strategic planning retreat that would focus on an open dialogue among the faculty to identify a roadmap they might follow to build a more cohesive and collaborative Division. External Reviewers’ Comments:

As previously stated with regard to the CAP Division, morale and productivity is an area that needs to be addressed. The variance within the division is significant. The non- tenure-track clinical faculty along with social/administrative faculty appear to be on track; however the clinical tenure track faculty are not at the same level. This type of issue is not uncommon across similar departments and requires special administrative attention to avoid further problems and issues. Creative managerial strategies should be implemented to achieve a more cohesive, productive, and efficient department. This may include more deliberate pairing of non-tenure-track and tenure-track clinical faculty. For example a non-tenure-track faculty member may be hired to provide teaching and service in the cardiovascular area and be paired with the teacher/researcher tenure-track faculty member who provides minimal or no clinical service but is responsible for leading the research projects. The non-tenure-track partner may assist with the research projects, but probably won’t lead them, resulting in scholarship opportunities for the non-tenure-track faculty member, and access to patients for the tenure-track faculty member It appears that some of this is happening with non-tenure-track clinical faculty and the social/administrative faculty. It is often a myth that significant differences exist between social/administrative faculty, who for the most part are former clinicians but certainly are trained in pharmacy, and those who have a strict interest in the clinical sciences. Iowa already has evidence to support this in that many of the non-tenure-track clinical faculty have “clinically related” research projects with the social/administrative faculty members. The same model can be expanded to the clinical tenure-track faculty members who are engaged in more patient-specific research instead of population-based outcomes research. College of Pharmacy Response: The CAP faculty overall have been very productive and their performance levels meet or exceed the other academic divisions. In 2005 (the most recent report year), the faculty represented 16 board certifications, 13 professional fellows, 5 recipients of major 2005 national awards and two recipients of 2005 college teacher of the year awards. CAP delivers and/or manages about 75% of the Doctor of Pharmacy program, two PHD


programs, and 4 different types of post-PharmD residencies. In 2005, the average faculty on the clinical track authored 2.1 publications, 2.15 presentations nationally/ internationally and 2.15 regionally/ locally; average tenure track authored 4.4 publications, 5.3 nationally/ internationally and 2.4 regionally /locally. CAP faculty generated over 60% of college academic division research funding in 2005. For service the faculty provided 4.9 FTEs of delivered care to Iowans, 3.6 FTEs of service to the University and professions and 4.7 FTEs of administration for the University. Shared faculty appointments are a successful component of the CAP division. These faculty not only have strong roots in the practice settings in which they work but they also take on significant teaching loads for the college. Nearly all the appointments are for clinical track. These faculty are required to undertake professional productivity activities to some level (range 1% to 20% of effort) and the success of their efforts were reported in the previous paragraph. The shared nature of the appointments leads to opportunities for success and national recognition as academic practitioners (e.g., board certification, profession fellow status). Only two shared faculty appointments are for tenure track faculty. In each case, the faculty have significant extramural funding. Additionally, creating the shared positions allowed the CAP division to create a sufficient number of clinical experiential rotations to remove that obligation from all tenured faculty who wish to focus on their research (see recommendation #4). As stated in recommendation #4, the CAP division has retained a facilitator to work with the division. The first stage is a shared vision; the second will be a new strategic plan. As stated in the report, morale for one segment of the division was at a low point during the visit of the review committee. The clinical tenure track faculty have been able to refocus their activities and the experiential rotation teaching has been moved to an optional teaching activity in order to manage time and research effort. We anticipate one new faculty member will be hired in this group before the end of 2006 and plans to hire more faculty in the future are being discussed. The clinical tenure track faculty will continue to have stress due to the implementation of a new PHD program that is in its second year. However, once the program has been fully implemented and additional faculty hired, the stress is expected to be greatly reduced.

Additional Recommendations and Comments from External Reviewers

General recommendations: Role of College in Health Care Planning for Iowa: During the past five years many reports have been released by the Institute of Medicine that identify the problems of quality and error in the American health care system. There has been a major call for leadership from our academic health centers to assist in addressing these most critical issues of quality. Every region and state in the country is challenged to improve access, cost and quality. As of yet, few, if any, academic health centers have seriously organized and formally put forth plans of action. The University of Iowa College of Pharmacy has actually made nationally and internationally recognized


efforts for improvement relative to pharmaceutical needs and has outstanding ties to the state pharmacy organization and the state’s practitioners. . It is apparent to us that many outside the college recognize this strength. However, much has been accomplished in isolation from other professional schools. The University of Iowa has all of the components and environment (state government) to develop a model inter-professional approach to improving health care in America. The leadership effort must begin at the presidential and governor’s level. However the initial proposal and plan can come from the respective colleges of the university that comprise the Iowa Health Sciences Center. This opportunity should not be missed. The timing is great. The CTSA RFA from NIH is just a small step in the direction of improved healthcare research, but the needs are even greater at the teaching and patient care level. The economics of poor quality alone are staggering and ignoring a situation that results in diminished quality of life is not tolerable. We would encourage action on this front as soon as possible. College of Pharmacy Response: As the reviewers point out the faculty at the College have been strongly engaged with the profession of pharmacy in Iowa for many years. Faculty were instrumental in designing and implementing the Iowa Center for Pharmaceutical Care and more recently in developing, implementing and evaluating a unique Pharmacy Case Management project with Iowa Medicaid. More recently the College and the Association have jointly proposed and pursued funding for a major Medicare Part D pilot Medication Therapy Management Services (MTMS) project to be conducted over our entire 7 state Medicare Region. Other examples of strong linkage and leadership within Iowa include establishment of the nations first multi- site community pharmacy residency programs, establishing faculty at 6 off site UI Family Medicine Residency Program clinic sites, direct involvement to facilitate collaborative practice authority for pharmacists in Iowa, having faculty serve as officers and IPA Board Members constantly and most recently creating a unique Continued Pharmacy Education partnership between the College and the Association focused on practice development. While our Colleges at Iowa tend to operate in a very decentralized manner much progress has been made on the interdisciplinary fronts as well and we agree fully with the importance of picking up the pace in these areas, not only in Iowa but at the National level. We have a unique Dental Pharmacy with two shared faculty and continuous rotation of pharmacy students through dental clinics and have had 4th year pharmacy students working with medical students and residents on clerkship at the Family Medicine residency sties across the states for 15 years. We are currently looking at an AHEC like model where by Nursing, Public Health and Dental students can only be integrated into this patient care model. More recently we have launched a unique joint Pharm.D.-MPH with one graduate in 2006 and 7 students currently enrolled. In June, 2007 fourth year pharmacy and 2nd and 3rd year medical students will work together in a module to help familiarize both to each others practice capabilities prior to the medical students entering clinical clerkships. The college has led the development of an interdisciplinary health disparities course and Dean Cohen has been working under the auspices of the Office of the Provost to facilitate further interdisciplinary education


activities aimed at developing all of our graduates with the ability and confidence to function as members of the health care team. Campus-wide Incentives for and Facilitation of Interdisciplinary Research: While it is evident that collaboration among faculty of different colleges is occurring, collaboration appears to be, for the most part, on an individual basis in areas that are chosen by the individuals involved. With the current (and growing) emphasis on interdisciplinary science in federal funding agencies, it seems wise for the university to invest in broader interdisciplinary initiatives that facilitate the coming together of faculty across the various units. Incentives from a central level could include seed grants for interdisciplinary projects, seminar support and administrative support for groups who want to assemble and explore their commonalities. Also, administrative support for groups that are assembling large program project grants should be provided. Some interdisciplinary efforts will require some key hires to provide particular expertise or provide leadership to a group that wants to work together and some will require support of new equipment or core scientific services. There are many RFPs for multi-investigator projects emerging from the NIH Roadmap initiative, as well as from other funding agencies, and no university has to respond to all of them. However, with funding levels falling for individual investigator grants, it is essential to support some well-chosen interdisciplinary areas and to encourage faculty members to submit multi-investigator grant proposals. It does require an investment of funds, but it is a well-spent investment in the future of the university. This may be happening but it was not apparent to us, nor to the faculty members with whom we talked. Our perception is that the pharmacy disciplines are well-positioned to be contributors to many of the areas that other universities are pursuing and we would encourage the pharmacy faculty to be responsive if such a central university effort is mounted. College of Pharmacy Response: While it is a bit difficult to respond for central administration the College clearly agrees with these observations and has moved strongly to focus and prioritize our research programs which are inherently multidisciplinary. Over the past 4 years all of our new or replacement faculty hires have involved joint appointments in other colleges aimed at focusing on major interdisciplinary program with the NIH road map in mind. Thus Dr. DJ Murry was jointly recruited with the Cancer Center and Drs. Ali Salem and Jennifer Fiegel were jointly recruitment with the College of Engineering with a goal to build a significant program in tissue engineering and drug delivery. In addition our Medicinal Chemistry faculty have been integrated into the College of Medicine Pharmacological Sciences Training grant and had 3 trainees out of a total of 6 in the program and have long been associated with our biotechnology training grant in the Center for Biocatalysis and Bioprocessing. In the area of Pharmaceutical Socioeconomics (PSE) significant interaction and joint grants have been developed with faculty in the College of Public Health and in the Department of Internal Medicine focused on economics and health outcomes research and research in community practice. Most recently Dean Cohen has been actively involved in the section on translational technologies for our CTSA here at Iowa and serves on the institutional advisory


committee for the grant which just missed funding in the initial round and is being resubmitted in January, 2007. Other pharmacy faculty are involved in the sections on education and core laboratory development and a new clinical science faculty recruit will likely be also appointed in the newly developed translational research institute being developed within this grant structure. The college’s strong drug development and FDA approved service division capabilities (PS and CADD) are also linked strongly to this multidisciplinary grant application. In summary both from the perspective of forming strong critical masses and in terms of economy of scale in recruitment and developing start up packages, we have been focused on interdisciplinary research initiatives exactly along the lines discussed in the Roadmap, FDA Critical path and touched on by the collegiate review team. Summary: In general, the review was a very positive experience for all. The recommendations are all put forth for improvement of the affairs of the college as it attempts to fulfill its mission. None were so serious that one should question the balance of strengths and weaknesses. All are meant to facilitate further success of the college and the university and health sciences center in particular. The faculty and staff who participated and provided information were all dedicated to improving matters. The students, who benefit directly from such reviews and recommendations, were superb overall in terms of their contributions and sincerity.


University of Iowa College of Pharmacy Collegiate Review · 2. Strategic Plan The COP has been...

Documents

Transcript of University of Iowa College of Pharmacy Collegiate Review · 2. Strategic Plan The COP has been...