CHAPTER 1

1.0

INTRODUCTION

A pharmacist is a professional scientist who possesses the skills in all aspect relating
to the design, development, delivery, supply, control and the usage of drugs (USM,
2008). Generally, training education for pharmaceutical course will take about four to
six years all over around the world (Palmdoc, 2006). It is depending on the
universitys educational program. Currently, pharmacy education is one of the
demand courses among the school leavers especially in developing country such as
Malaysia. The competition for entry into pharmacy program is very intense. As an
example, every year, more than 5000 applicants competes for only 115 places in
School of Pharmaceutical Sciences, Universiti Sains Malaysia which is the pioneer
institution in offering pharmacy degree program in Malaysia since 1972. Thus, many
individuals who may meet minimum admission requirements (USM, 2008) do not
gain admission to the program as majority of applicants do possess a very high
admission than the baseline cut off points set for admission purpose.
The curriculum design of pharmaceutical program varies among countries (BLS,
2009). At Universiti Sains Malaysia, the school is currently using an integrated
approach in teaching and learning since pharmacists need to acquire a broad range of
scientific education. The Bachelor of Pharmacy (B-Pharm) correlates scientific
findings with a strong foundation of core science courses. Besides that, in related to
social pharmacy, social integration of subjects are also embedded well in the current
curriculum (USM, 2008) in order to prepare a well rounded pharmacist in the future.

In many parts of the world, completion of a pharmacy degree does not automatically
qualify an individual for licensure (Palmdoc, 2006). In most cases, a post graduation
(pre-registration) in-service training period often referred to as internship which
been mostly regulated by the provincial licensing body rather than the local
educational institution is required. The length of this internship varies across the
country, but it is generally 12 months in duration (Palmdoc, 2009). In addition to this
in service training period, candidates for licensure are required to complete a series of
provincial and national examinations (Austin and Ensom, 2008). The pre-registration
period currently represents the vital transition from university based to practice-based
learning (Royal Pharmaceutical Society of Great Britain, 2004). Currently in
Malaysia, a pharmacy graduate is required to undergo a period of houseman ship or
pupillage for 12 months at any general or private hospital, pharmaceutical industry
or at any retail pharmacy recognised by the Pharmacy Board of Malaysia upon
completion of a recognised pharmacy degree. The objective of the houseman ship is
for graduates to undergo a planned training programme on aspects of pharmacy
practice under the supervision of a registered pharmacist. After passing the Forensic
Pharmacy examination and completing one year of houseman ship, graduates are
eligible to register with the Pharmacy Board of Malaysia and may practise as a
registered pharmacist in Malaysia (Palmdoc, 2006).

Pharmacist nowadays was said to be the best profession since it would give high
income and have good future. For example, pharmacists in developed country such as
in Canada practice in a wide array of fields, ranging from dispensary to community to

ambulatory to primary, secondary or tertiary care settings (Austin and Ensom, 2008).
It is due to significant attention paid to the strong demand for pharmacists across the
country over the past decade; we appear now to be moving towards a more balanced
supply-demand situation, particularly in urban areas (Austin and Ensom, 2008). Since
pharmacists profession has a very high expectation from society, so the future
pharmacists need to be well prepared via vigorous training before they enter the
workforce.
1.1

Background of the study

Generally, thousands of pharmacy students will graduate from varies universities in

this world. In Malaysia for in instance, every year more than 600 new pharmacy
graduates normally guaranteed to enter pharmacy workforce and they need to
translate what they have learnt for the past four years to practice. Furthermore, since
2004, the government had mandated a 1+3 years of compulsory service to the new
pharmacy graduates (MOH, 2010). In the first year upon graduation, a new
practitioner has to undergone one year of standard internship programme at
government hospitals and upon successfully complete this internship period, they
have to serve the government for the next three years before they can be fully
registered.
As the role of a pharmacist deals with patient care, they need to be really competent
and able to undertake some of activities related to patient care (Brazeau, Meyer,
Belsey et al, 2006) independently by using their skills which they acquired during
their educational period (Austin and Ensom, 2008). Within this context, it is very

important for pharmacy graduates to ensure that they really had prepared themselves
before they enter pharmacy workforce in order to achieve the missions of providing
the best patient medication and health related activities.
This is relatively important and need to be taken seriously among graduates because
public who demand pharmacists services to improve their health will be the judge to
determine either it really fulfil their high expectation towards pharmacists. Therefore,
this survey at least will help us to assess the preparedness of pharmacy graduates
from Universiti Sains Malaysia (USM) to enter pharmacy workforce. Besides, we
also can identify the barriers of unpreparedness and will make efforts to overcome
those barriers.
1.2

Rationale and significance of the study

According to the record, around 100 students of School of Pharmaceutical Sciences,

Universiti Sains Malaysia will graduate for every academic session, and then they
will enter the workforce in either public or private sectors (USM, 2008). However,
the question is whether the graduates from School of Pharmaceutical Sciences,
Universiti Sains Malaysia really had prepared themselves to enter the real world of
practice. Furthermore, in the Malaysian pharmacy education context, there is no
published study assessing perceptions towards preparedness among recent pharmacy
graduates to enter the workforce. Beside that to what extent the recent graduates
satisfaction towards the entire pharmacy curriculum in preparing them for practice is
not well explored. The satisfaction of students on educational program is very

important since this will determine their preparedness to enter workforce (Hogan and
Lundquist, 2006).
There are some studies that have assessed the preparedness of graduates to enter job
market in other health-science profession such as among psychiatric nurses and
physicians (Waite, 2004; Blumenthal, Gokhale, Campbell and Weissman, 2001).
Hence, there is a need to conduct our own survey to glimpse the real scenario in
pharmacy local setting. In order to achieve this aim, this research is conducted, so that
we can assess the level of pharmacy graduates preparedness, identify the barriers that
affect the preparedness and find the solutions as well to make sure that the students
graduate from School of Pharmaceutical Sciences in Universiti Sains Malaysia are
really prepared to enter workforce. This cross-sectional survey on a sample of
pharmacy graduates from Universiti Sains Malaysia (USM) will provide benchmark
data on self-reported towards the preparedness to enter workforce.
1.3

Literature review

Evaluation of preparedness to enter workforce had been reported in various health

related professionals. For an instance in 2002, a study undertaken by Waite (2004),
reported the outcome of interviews with psychiatric nurses. The interviews were
formatted to be open-ended to enable participants to fully explain their experiences.
The result showed that there were significant variances regarding the nurses
expectation, orientation process, responsibilities and supportive interventions from
colleagues. These participants identified several beneficial concepts that would
palliate negative affective states, which in turn may effectively reduce the premature

exit of new nurses from the profession. Some of the nurses admitted that they
experienced mixed feelings including fear, anger, confusion, shock, happiness and
disillusionment at the first few weeks in mental health organization. This condition
was related to inadequate process of connecting educational experiences and practice.

A study towards the perceptions of new graduates, employers and educators related to
preparedness of graduates from health professional education programs (Noseworthy
and Harnett, 2002) was done to the target audiences who were taken from
Newfoundland and Lambrador and selected programs at Dalhousie University.
According to the study, majority of new graduate respondents felt they were prepared
to meet the employers expectations except for occupational therapist new graduates
felt the least preparedness to meet employers expectation. In addition, new graduates
were satisfied with their educational programs and they planned to pursue continuing
education. The report also discussed how employers accommodate recent graduates
once they arrived in the workplace setting. Lastly, Human Resource Department
respondents felt there were inadequate numbers of health professionals being trained
in the province to meet current and future needs.

A national survey of residents completing their training in 8 specialties which were

internal medicine, paediatrics, family practice, obstetrics/gynaecology, general
surgery, orthopaedic surgery, psychiatry, and anaesthesiology at academic health
centres in the United States (Blumenthal, Gokhale, Campbell and Weissman, 2001)
was being conducted to assess residents' perceptions towards their preparedness to

provide common clinical services during their last year of graduate medical education.
Finding showed that residents in all specialties rated themselves as prepared to
manage most of the common conditions they would encounter in their clinical career.
However, more than 10% of residents in each specialty reported that they felt
unprepared to undertake one or more tasks relevant to their disciplines, such as caring
for patients with human immunodeficiency virus or acquired immunodeficiency
syndrome, substance abuse (family practice) or nursing home patients (internal
medicine), performance of spinal surgery (orthopaedic surgery) or abdominal aortic
aneurysm repair (general surgery) and management of chronic pain (anaesthesiology).
Overall, residents in their last year of training at academic health centres rated their
clinical preparedness is high.

A preliminary study in Australia attempted to capture the experience of final year

students from University of Queensland (QUT) (Blake and Connie, 2009). Some
views of students, employers and industry representative bodies had been explored
towards the preparedness of students from University of Queensland (QUT) to enter
the professional workforce. Generally, students and employers consistently perceived
that the transition out of university education to the profession was made more
seamless by an integration of academic studies and professional work experience
from the intermediate stages of the property program. The results of this study
demonstrated that some units in the program were perceived to provide direct
preparation for students commencing their professional careers while the impact of
other units was less tangible. Valuable feedback received during the study included

recognition of the need for reliable property education achieved through increased
engagement with industry participants, field work and contemporary technologies. It
is envisaged that this feedback could be applied more broadly in all similar property
educational programs in Australia.

In United States, a study was conducted to determine the percentage of residents

accepting faculty positions following completion of a community pharmacy residency
program (CPRP) and identify influences to pursue or not pursue an academic career
(Clark, Mehta, Rodis, Pruchnicki and Pedersen, 2008). Due to the outcome, after
completing their residency program, 8% (n=3) residents accepted faculty positions
and the other 8% (n=3) were awaiting offers at follow-up. The reasons for accepting a
faculty position were positive teaching experiences and the influence of a mentor or
preceptor. In other side, the reasons for not pursuing a faculty position included lack
of interest, geographic location, disliked teaching experiences, lack of preparedness,
and non-competitive salary. Finally, the study concluded that many community
pharmacy residents consider faculty positions early in their residency but few pursue
faculty positions. Therefore, community pharmacy residency program (CPRP) and
colleges of pharmacy should work together to enhance residents experiences to foster
interest in academia.

A cross-sectional study in Whitney School of Nursing, University of Wyoming (Hart

and Macnee, 2004) found that 10% of the sample perceived that they were very well
prepared for practice as nurse practitioners (NP) after completing their basic nursing

practice education. About 51% perceived that they were only somewhat or minimally
prepared. Current age, years since graduation from nursing practice program and age
when attending the nursing practice program did not differ significantly for those who
felt prepared versus those who did not. For a number of content areas, subjects did
not perceive that they were well prepared in the areas that they perceived were very
important. The results also indicate that formal nursing practice education is not
preparing new nurse practitioners (NP) to feel ready for practice and suggests several
areas where the educational programs need to be strengthened.
Members of Merritt Hawkins & Associates Research Department were conducted a
telephone survey for final year medical residents (Merritt Hawkins & Associates,
2008). According to the survey, 16% of residents said they are very prepared to
handle such matters, while the majority (66 %) said they are somewhat prepared.
18% of residents said they are unprepared for the business side of medicine.
Traditionally, medical students and residents have received little instruction in the
business of medicine as the prevalence of their education and training was focused on
clinical issues. In recent years, however, a number of medical schools and residency
programs had added at least some instructions in medical economics and practice
management. The result may be suggested by the fact that in 2003, only 53% of
residents surveyed said they were either very prepared or somewhat prepared for
the business side of medicine. By 2006 that number had increased to 84% and in 2008
it remained at the same general level (82 %). While this is a positive sign, in Merritt
Hawkins & Associates experience many residents remain unfamiliar with the basic

terms and conditions of medical employment and therefore it will be a disadvantage

when evaluating practice opportunities.

The School of Pharmacy, University Colorado Health Sciences Center (UCHSC) was
conducted an exit survey of the 2003 graduating class, the initial graduates from the
first professional pharmacy degree program (McCollum and Hansen, 2005). This
study explored the characteristics of graduating students entering and not entering
residencies along with reasons that graduates provided for what had affected their
decisions. The result showed 20% of graduates entered residencies. Non-white
students were less likely than white students to enter residencies (p < 0.01).
Motivations for entering residencies included increased clarity of professional
opportunities, improved clinical skills and enhanced job satisfaction. Lack of
willingness to train at residency salary and family obligations were cited as the
reasons for not pursuing residency training. In conclusion, pursuit of residency
training appears to be motivated by personal and career goals and it is independent of
age, sex, and level of educational debt. Continued multi-site research should focus on
overcoming perceived barriers and identifying motivations for promoting residency
training as a professional norm.

In Sydney, Australia, pharmacy students from four universities were invited to

participate in a survey that utilized the use of 42 questionnaires framed in the formed
five point Likert scale in order to seek and rate various aspects of their rural
placement (Taylor, Marriott, Dalton et al, 2006). The students were invited to explore

10

positive and negative aspects of their rural placement and to make suggestions for
future placements. As a result, about 108 students responded to the questionnaire.
Students rated most highly the role of the preceptor in making their rural placement a
success. In conclusion, students valued their placements highly when they were in a
supportive learning environment, with an organized structure and adequately
supported by the universities.

According to all literature reviews, it mostly demonstrated for other healthcare

practitioners such as medical doctors and nurses. There is no specific study has been
done towards pharmacy graduates on their preparedness to enter workforce especially
in Asian country.

1.4

Research objectives
General objective:
To assess the perception of pharmacy graduates from School of
Pharmaceutical Sciences, Universiti Sains Malaysia towards their
preparedness to enter pharmacy workforce.

Specific objectives:
1. To assess the level of preparedness of pharmacy graduates from
2.

Universiti Sains Malaysia to enter pharmacy workforce.

To determine the level of graduates satisfaction towards
pharmaceutical educational program in Universiti Sains Malaysia.

11

3.

To relate the level of graduates satisfaction towards educational

program with the level of preparedness among graduates to enter

4.

job market.
To identify the barriers that affect the preparedness among
graduates

CHAPTER 2
2.0

METHODOLOGY

2.1

Study design

A cross sectional survey was conducted on pharmacy graduates of Universiti Sains

Malaysia who had successfully completed their studies in academic session
2008/2009. They were invited to participate by answering the self administered

12

questionnaires that were distributed in August 2009. This method is beneficial to

reduce the errors and bias among the participants. Therefore, it will generalize the
outcome.

2.2

Development of questionnaire

The questionnaire was divided into three sections, which were Section A:
Demographic characteristics; Section B: Personal perception towards preparedness to
enter pharmacy workforce; and Section C: Satisfaction towards pharmacy education
received.
Section A was created to identify the characteristics of the respondent related to their
gender, age, race and final CGPA. For section B and C, it used evaluation scale
format. Five points Likert Scale ranging from 1=Strongly Disagree, 2=Disagree,
3=Neutral, 4=Agree to 5=Strongly Agree used to assess the response of
participants towards their preparedness. Section B would assess the personal
perception of the graduates towards their preparedness to enter pharmacy workforce
and run the responsibility as a pharmacist. In this section, the graduates commitment
to be a real competent pharmacist will be assessed by evaluating their answers on six
statements prepared. Section C consisted of nine statements that would be used to
assess the satisfaction of graduates on what they had learnt for four years and either
the pharmaceutical educational program in School of Pharmaceutical Sciences,
Universiti Sains Malaysia completely prepared them to enter pharmacy workforce.
The developed questionnaire was content validated (face and
content) by the supervisors. Following that, post survey analysis

13

was undertaken for the survey items and a good Cronbach value
was achieved for all the items (0.78).

2.3

Study population and sample size.

The target sample for this study is the recent graduates of School of Pharmaceutical
Science, Universiti Sains Malaysia who successfully completed their study in
academic session 2008/2009. According to the record, there are around 130 graduates.
This number was used to calculate the sample size needed for this study. By using
sample size calculator from Raosoft website (Sample Size Calculator), the minimum
effective sample size needed is 98 with a confidence interval 95% and margin of error
5%. The selected individuals must fulfil the following criterion that is pharmacy
graduates from Universiti Sains Malaysia, who successfully completed their study in
academic session 2008/2009.

2.4

Data collection procedure

The self administered questionnaires were hand distributed to all respondents (n=130)
by the researcher and were collected after they finished. Out of 130 questionnaires
distributed, a total of 102 graduates had participated in the study (response rate of
79%).

2.5

Data analysis

Both non-parametric statistical tests and appropriate descriptive statistics for

demographic characteristics were performed using SPSS for Windows version 12.
Responses to questions producing ordinal data were compared to detect differences

14

according to the demographic characteristics using either Chi-square test or Fishers

exact test wherever appropriate. The level of significance was set at p<0.05.

CHAPTER 3
3.0

RESULTS

3.1

Demographic Characteristics of Respondents

On 11th August 2009, 130 questionnaires were distributed to the recent graduates of
School of Pharmaceutical Sciences, Universiti Sains Malaysia who successfully

15

completed their study in academic session 2008/2009. Out of 130 questionnaires

distributed, a total of 102 graduates had participated in the study (response rate of
79%).

According to the summary of demographic characteristics of respondents in Table 1,

two-third of the respondents were female (69.6%; n =71) and the rest were male
(30.4%; n=31). As all the respondents came from the same batch (academic session
2008/2009), so most participants aged between 21 to 23 years old (92%; n=94).
There was almost equal distribution for most of the race groups between Malay and
Chinese (Malay: 47%; n=48; Chinese: 53%; n=54). Since there was no Indian and
other races in this batch, so there was no respondent representing both races.

More than half of respondents had final CGPA between 3.00 to 3.49 (72.5%; n=74).
Then, followed by range 2.50 to 2.99 which is 20.6% (n=21). Only 5.9% (n=6) of
respondents got final CGPA between 3.50 to 4.00. Only 1% (n=1) of respondents who
got final CGPA less than 2.50.

Table 1: Demographic characteristics of respondents (n=102)

CHARACTERISTICS NUMBER (n=102) PERCENTAGE (%)

16

GENDER
Male

31

30.4

Female
AGE

71

69.6

18-20

21-23

94

92

Malay

48

47.1

Chinese

54

52.9

Indian

Less than 2.0

2.01-2.49

1.0

2.50-2.99

21

20.6

3.00-3.49

74

72.5

3.50-4.00

5.9

24 and above
RACE

Other
FINAL CGPA

3.2

Level of preparedness according to the statements.

3.2.1

Personal perception towards preparedness to enter pharmacy workforce.

3.2.1.1

Question B (1)

According to the responses of respondents towards their preparedness, 60.8% (n=62)

agreed that overall education they received for 4 years had really prepared them to

17

practice as a competent pharmacist. Only 2.9% (n=3) of respondents strongly agreed

and 1% (n=1) of them disagreed with this statement. (Table 2.0)
Table 2.0: Responses to question B (1)

3.2.1.2

RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

Disagree

Neutral

36

35.3

Agree

62

60.8

Strongly agree

2.9

Total

102

100.0

Question B (2)

Respondents were asked whether they feel no regret with their decision of choosing
pharmacy field. The evaluation on respondents perception towards overall education
they had received then will determine that respondents feel right with their decision in
choosing pharmacy as a career. Overall respondents gave positive response towards
this statement. 54.9% (n=56) of respondents feel that the decision to choose pharmacy
as a career was right. 23.5% (n=24) of respondents strongly agreed. (Table 2.1)

Table 2.1: Responses to question B (2)

RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

18

3.2.1.3

Disagree

Neutral

22

21.6

Agree

56

54.9

Strongly agree

24

23.5

Total

102

100.0

Question B (3)

Confidence level of respondents to perform duties is also being evaluated based to

their preparedness. 12.7% (n=13) strongly believed that they can perform any duties
that will be assigned to them while 61.8% (n=63) just agreed with this statement and
the rest are neutral (25.5%; n=26). (Table 2.2)

Table 2.2: Responses to question B (3)

RESPONSE

FREQUENCY

19

PERCENT (%)

3.2.1.4

Strongly disagree

Disagree

Neutral

26

25.5

Agree

63

61.8

Strongly agree

13

12.7

Total

102

100.0

Question B (4)

Most of the respondents gave positive response towards preparedness for any selfdirected learning activities to improve their practice skills. 10.8% (n=11) strongly
agreed and 61.8% (n=63) agreed with this statement. However, there are 2.9% (n=3)
of respondents did not think they are prepared for any self directed learning activities.
(Table 2.3)

Table 2.3: Responses to question B (4)

20

3.2.1.5

RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

Disagree

2.9

Neutral

25

24.5

Agree

63

61.8

Strongly agree

11

10.8

Total

102

100.0

Question B (5)

17.6% (n=18) of respondents strongly agreed in their preparedness to work at any

places all over Malaysia, 48% (n=49) of respondents just agreed. However, 4.9%
(n=5) strongly disagreed and 6.9% (n=7)

disagreed to work at any places. (Table

2.4)

Table 2.4: Responses to question B (5)

RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

4.9

Disagree

6.9

21

Neutral

23

22.5

Agree

49

48

Strongly agree

18

17.6

Total

102

100.0

Demographic measure that has significance difference with the preparedness to work
at any workplace either at rural or urban area is race (p=0.017). Malay respondents
showed the most preparedness to work anywhere all over Malaysia compared to
Chinese respondents where 31.3% (n=15) of Malay respondents strongly agreed and
41.7 (n=20) agreed. For Chinese respondents, 53.7% (n=29) strongly agreed but only
5.6% (n=3) strongly agreed.

3.2.1.6

Question B (6)

According to Table 3.6, 48% (n=49) of respondents disagreed that they do not have
enough confidence to communicate effectively with other healthcare practitioners
especially on patients drug related problems. 35.3% (n=36) respondents just gave
neutral response. 13.7% (n=14) of respondents agreed and 2% (n=2) of them strongly
agreed that they do not have enough confidence to communicate effectively. (Table
2.5)

22

Table 2.5: Responses to question B (6)

RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

Disagree

49

48

Neutral

36

35.3

Agree

14

13.7

Strongly agree

Total

102

100.0

Statistically significant differences were noted in response to this question between

race (p=0.001) and final CGPA (p=0.021) towards confidence level in communication
skill. Chinese respondents (66.7%; n=36) showed higher confidence level to
communicate effectively compared to Malay respondents (27.1%; n=13). In aspect of
final CGPA, those respondents with final CGPA from 3.00 to 3.49 (55%; n=44)
confident to communicate effectively where 5% (n=23.8) of respondents with final
CGPA from 2.50 to 2.99 had the confidence.

3.2.2 Satisfaction towards pharmacy education received.

3.2.2.1

Question C (1)

16.7% (n=17) respondents strongly agreed and 64.7% (n=66) respondents agreed that
pharmacy program available at USM satisfies the need of this country in the effort to
produce professional pharmacists. Only 1% (n=1) respondents disagree with this

23

statement. The rest chose to be neutral in response to this statement (17.6%; n=18).
(Table 3.0)

Table 3.0: Responses to question C (1)

3.2.2.2

RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

Disagree

Neutral

18

17.6

Agree

66

64.7

Strongly agree

17

16.7

Total

102

100.0

Question C (2)

For individual satisfaction towards pharmacy curriculum at USM, the highest

percentage of respondents, 52% (n=53) chose to be neither agreed nor disagreed.
45.1% (n=46) respondents satisfied with pharmacy curriculum at USM. 2.9% (n=3)
respondents very satisfied with pharmacy curriculum at USM. (Table 3.1)
Table 3.1: Responses to question C (2)
RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

Disagree

Neutral

53

52

24

Agree

46

45.1

Strongly agree

2.9

Total

102

100.0

Race (p=0.02) showed significant difference with respondents satisfaction towards

pharmacy curriculum in USM. Malay respondents are more satisfied (60.4%; n=29)
then Chinese respondents who preferred to be neutral (64.8%; n=35).

3.2.2.3

Question C (3)

Majority of respondents, which is 58.8% (n=60) agree that practical sessions included
in pharmacy curriculum are useful for their future practice. Next, 22.5% (n=23)
respondents are strongly agreed with this statement. However, there are 2% (n=2)
respondents did not agree that practical sessions in pharmacy curriculum will help
them in future practice. (Table 3.2)

Table 3.2: Responses to question C (3)

RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

Disagree

Neutral

17

16.7

Agree

60

58.8

Strongly agree

23

22.5

Total

102

100.0

25

3.2.2.4

Question C (4)

70.6% (n=72) respondents agreed that knowledge they had gained during studying
will help them to communicate with other healthcare practitioners due to any drug
related problems. 5.9% (n=6) respondents strongly agreed with this statement and the
rest of respondents are neither agree nor disagree (23.55; n=24). (Table 3.3)

Table 3.3: Responses to question C (4)

RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

Disagree

Neutral

24

23.5

Agree

72

70.6

Strongly agree

5.9

Total

102

100.0

Gender of respondents (p=0.02) showed significant difference with this statement.

Female respondents showed higher percentage to agree compared to male
respondents (73.2%; n=52 vs 64.5%; n=20).

3.2.2.5

Question C (5)

For this statement, respondents have to choose either they want to further study or not
after completion of pre-registration requirement. The result showed less than half
respondents (42.2%; n=43) agreed to continue higher degree. Only 5.9% (n=6)

26

respondents strongly agreed to further study. There are some respondents did not wish
to continue higher degree after completion of pre-registration requirement, 11.8%
(n=12) respondents disagree and 3.9% (n=4) respondents strongly disagree with this
statement. (Table 3.4)

Table 3.4: Responses to question C (5)

RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

3.9

Disagree

12

11.8

Neutral

37

36.3

Agree

43

42.2

Strongly agree

5.9

Total

102

100.0

Final CGPA of respondents (p=0.04) showed significant difference towards their

willingness to further study after they complete pre-registration requirement.
Respondents with CGPA between 3.00-3.49 (38.8%; n=31) showed more interests to
continue higher degree compared to other respondents with less final CGPA.

27

3.2.2.6

Question C (6)

41.2% (n=42) respondents thought they could not relate the relevance of certain
courses with future practice. However, 25.5% (n=26) respondents thought of the
opposite. 7.8% (n=8) respondents strongly disagreed with this statement means that
they could relate the relevance of all courses with future practice. (Table 3.5)
Table 3.5: Responses to question C (6)
RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

7.8

Disagree

26

25.5

Neutral

26

25.5

Agree

42

41.2

Strongly agree

Total

102

100.0

Both gender (p=0.004) and race (p<0.001) showed significant difference with
question C (6). Almost male respondents (51.6%; n=16) agreed that they cannot relate
the relevance of certain courses with future practice. The same phenomenon also
happens to Chinese respondents (63%; n=34) agreed that they cannot relate the
relevance of some certain courses with future practice.

3.2.2.7

Question C (7)

Half of respondents feel that educational program is relying more on theoretical

aspect compared to practical. 8.8% (n=9) respondents strongly agree but 13.7%
(n=14) disagree and 2% (n=2) strongly disagree with this statement. (Table 3.6)

28

Table 3.6: Responses to question C (7)

RESPONSE

FREQUENCY

PERCENT (%)

Strongly disagree

Disagree

14

13.7

Neutral

26

25.5

Agree

51

50

Strongly agree

8.8

Total

102

100.0

Race (p<0.001) and final CGPA (p=0.015) of respondents showed significant

difference on satisfaction towards educational program whether it relies more on
theoretical aspect or practical. Chinese respondents (59.3%; n=32) quite agreed with
this statement compared to Malay (39.6%; n=19) who agreed. Most respondents with
final CGPA 3.00-3.49 (56.3%; n=45) also agreed with this statement.

3.2.2.8

Question C (8)

43.1% (n=44) respondents agreed and 36.3% (n=37) respondents strongly agreed that
educational program is too exam oriented. Only 1% (n=1) respondents disagreed with
this statement. (Table 3.7)

Table 3.7: Responses to question C (8)

RESPONSE

FREQUENCY

29

PERCENT (%)

Strongly disagree

Disagree

Neutral

20

19.6

Agree

44

43.1

Strongly agree

37

36.3

Total

102

100.0

Race (p=0.001) is the only demographic measure that showed significant difference.
Majority Chinese respondents (48.1%; n=26) strongly agreed that educational
programme is too exam-oriented. For Malay respondents, only 11% (n=22.9) strongly
agreed.

3.2.2.9

Question C (9)

Majority of respondents (62.7%; n=64) really feel they need more experiential
learning to prepare themselves to be a competent pharmacist. 25.5% (n=26)
respondents agreed with this statement and other respondents are neutral, neither
agree nor disagree (11.8%; n=12). (Table 3.8)

Table 3.8: Responses to question C (9)

RESPONSE

FREQUENCY

30

PERCENT (%)

Strongly disagree

Disagree

Neutral

12

11.8

Agree

26

25.5

Strongly agree

64

62.7

Total

102

100.0

Gender (p<0.001) showed significant difference with statement either respondents

need more experiential learning to improve preparedness. Majority female
respondents (73.2%; n=52) strongly agreed with this statement whereas male
respondent (35.5%; n=11) preferred to be agreed.

31

32

33

CHAPTER 4
4.0

DISCUSSION

4.1 Personal perception towards preparedness to enter pharmacy workforce.

This cross sectional study was conducted to evaluate the level of preparedness among
pharmacy graduates from Universiti Sains Malaysia (USM) in their way to enter
pharmacy workforce. All subjects were targeted to 130 pharmacy graduates of
Universiti Sains Malaysia (USM) who completed their study in academic session
2008/2009. However, only 102 respondents were responsed (response rate is 79%).
Their preparedness was evaluated based on their responses on self-administered
questionnaires. Valuable feedback received during this study showed about 61%
(n=62) of respondents agreed that overall education they had received for four years
really prepared them to practice as competent pharmacist, prepared them for any self
directed learning activities (learn according to experience) and they confident to
perform any duties which will be assigned to them in future. Although the proportion
is more than half but actually the numbers is inadequate since the expectation is
higher than this value. Preparedness was affected by a number of factors. These
included internal factors such as the graduates personality and learning style, but the
majority of references were to external factors such as undergraduate clinical
placements, shadowing, induction and the support of others, both in the workplace
and at home (Illing, Morrow, Kergon et al, 2008). Curriculum of educational program
is one of the factors that affect the preparedness too (Fisher, 1994). The level of

34

preparedness among pharmacy graduates is very important since the preparedness

will help a pharmacist to work efficiently in order to incorporate a scholarly
approach in identifying patient care problems, practicing an evidence-based manner
and ensuring safe, effective, and appropriate use of medications. Nowadays,
pharmacy field is spreading to play role in disaster condition (Pederson, Canaday,
Ellis et al, 2003), so that a competent pharmacist must have this additional disaster
preparedness.
As pharmacy graduates, they must fulfil all the qualities required. Due to study
that was undertaken using a phenomenological approach to identify student and
employer perceptions of how successfully students are transitioning to their first
professional job (Blake and Connie, 2009), they have shortlisted the soft skills
competencies of their students employees. The list included confidence, conflict
resolution, responsibility, time management, attitude and acceptance of feedbacks.
According to respondents perception towards their preparedness on various
aspects, 78% (n=80) respondents agreed that they had chosen right decision to be
a pharmacist. This proportion gave good impression as they had struggled for four
years, it really made them feel no regret to be a pharmacist and continue the
efforts of previous pharmacists and hopefully they can encourage the perceptions
of society towards pharmacists responsibility as for a long time they only thought
that pharmacists job is limited in dispensing medication. In fact, pharmacist is not
a drug dispenser only but a pharmacist hold responsibilities to promote health,
prevent disease, assess, monitor, initiate and modify medication use to assure that
drug therapy regimens are safe and effective (Joseph and Sumant Baht, 2006).

35

The evaluation on preparedness of respondents to work at any workplace either at

rural or urban areas also had been done. The result showed 56% (n=57)
respondents did not mind to work anywhere. Only 11.8% (n=12) respondents did
not agree to work at any workplace. According to a study done at School of
Pharmacy, University Colorado Health Sciences Center (UCHSC) (McCollum
and Hansen, 2005), influential factors of unwillingness to work at rural residency
cited by 2004 graduates included lack of willingness to continue training at
residency salary levels and family obligations. Several suggestions may have
contributed to increase number of students entering residencies upon graduation
from the School of Pharmacy, University Colorado Health Sciences Center
(UCHSC), including the promotion of residency training by clinical faculty
members throughout the academic program. Annual programs such as
Professional Opportunities Day and the Residency Forum conducted at the school
provide additional opportunities for faculty members and employers to discuss
with students the benefits of residency training. Finally, there is a strong schoolwide encouragement for students to participate in professional pharmacy
organizations at local and national levels, as well as support for students to attend
the national meetings of those professional organizations. As in Malaysia, an
allowance was given to those who work at rural areas in Sabah and Sarawak to
encourage the interest of graduates to work over there (SPA, 2009).
One of the main criteria that must be mastered by a competent pharmacist is
communication skill either with other healthcare practitioners or patients. In order
to have effective communication, a pharmacist must have the confidence and

36

their own effective communication styles (McDonough and Bennett, 2006). Based
on the result, 48% (n=49) of respondents disagreed that they did not have enough
confidence to communicate effectively while the rest were neutral and agreed
with this statement. This feedback was not good as for pharmacy graduates; they
should prepare themselves with communication skills. This condition occurred
because students had been guided to believe that their academic knowledges are
all they need in order to get a great job and be successful. It becomes worse when
they ignored all other aspects such as communication skills and general
knowledges during studying. Lastly, they shocked when they realized that their
qualifications are not as important as they once thought. Surely they can have
great ideas, theories, and solve complex problems, but if they cannot effectively
communicate to speak out that material in a persuasive and exciting manner by
relating to the fellow human being, then they are facing an uphill battle in
whatever challenges they encountered (Uebergang, 2007).
Some factors that caused poor communication skill included poor practice of
communicating while studying either during lectures or practicals, poor
development of self-confidence and insufficient knowledge especially related to
this field. There are numbers of method to overcome poor communication skill;
listen carefully of what your partner is saying, respond the criticism with empathy
and look for compromise or in other words, it is called win-win situation (Scott,
2009).
4.2

Satisfaction towards pharmacy education received

37

In this section, about 81% (n=82) respondents felt that pharmacy program at USM
satisfies the needs of this country in producing professional pharmacists. However
the result was slightly contrasted with respondents personal satisfaction towards
pharmacy curriculum at USM. The percentage of respondents agreed was less
than the percentage of respondents who chose neutral; 48% (n=49) vs 52%
(n=53). The satisfaction towards pharmacy education received means that the
satisfaction of respondents towards the theoretical (lectures, examinations) and
practical sessions in pharmacy educational program. Overall, 50% (n=51) of
respondents agreed educational program is relying more on theoretical aspect
compared to practical. In theoretical aspect, it is quite bad when 26% (n=26)
respondents agreed that they cannot relate the relevance of certain courses with
their future practice. About 59% (n=60) respondents agreed that practical sessions
offered in pharmacy curriculum are useful for future practice and 63% (n=64) of
them strongly agreed and they demand for more experiential learning during
studying. In addition, about 79% (n=81) respondents agreed that educational
program is too exam-oriented. The satisfaction of respondents also evaluated due
to respondents intention to further higher degree upon completion of preregistration requirement. About 48% (n=49) of respondents wished to continue
study. There were few respondents, 16% (n=16) did not wish to further study may
be due to interest, responsibility towards family and financial problems. The result
obtained was likely similar with finding from a study done on graduating PharmD
students from the School of Pharmacy at the University Colorado Health Sciences
Center (UCHSC) where it showed only 9 of 81 students (11%) indicated they

38

would be entering residencies while others planned to do higher degree

(McCollum and Hansen, 2005). However, due to overall findings, it showed that
respondents were not fully satisfied with pharmacy educational program at USM.

Each school of pharmacy around the world prescribes its unique prerequisites for
entry to the program. These requirements represent a minimum threshold and in
no way guarantee admission. It has a distinctive character and pedagogical
philosophy and utilizes different methods. Some schools tend to utilize more
traditional building blocks approach to curriculum, emphasizing foundational
subjects such as pharmaceutics, medicinal chemistry, and pharmacology in the
early years of the program, followed by more clinical coursework in later years
which is likely similar to educational program applied at Universiti Sains
Malaysia (USM). It is different with educational system at Dalhousie University
in Halifax, which have adopted more problem-based curricular design, opting for
small-group tutorial discussions and a more modularized and integrated
curriculum (Austin and Ensom, 2008). Experiential education is a common and
required feature of all curricula, and occurs in all years of the professional
program. Therefore, it is recommended for responsible department at School of
Pharmaceutical Sciences, Universiti Sains Malaysia (USM) to do deeper study to
make some modification on educational program by adding more practical
sessions and not making it to be too exam oriented, so that pharmacy students of
Universiti Sains Malaysia (USM) can really apply all the knowledge they had
gained practically rather than just apply it on examination papers.

39

4.3 Association of Demographic Characteristics with Personal Perception

towards Preparedness and Satisfaction towards Pharmacy Education
Program.
According to data analyzed by using SPSS, among various demographic
characteristics, personal perception towards preparedness was shown to be related
most frequently is race. Races of respondents showed significant different on
preparedness to work anywhere and ability to communicate effectively with other
healthcare practitioners.

In term of the preparedness to work anywhere, Malay respondents especially male

showed more prepared to work either at rural or urban areas compared to Chinese
respondents. The possible reasons are Malay; male respondents are easier to adapt
themselves with the environment wherever they go. As for Chinese respondents,
they might have difficulties to adapt themselves especially in rural areas.
However, Chinese seem to have better communication skill than Malay. It might
due to their preparedness in memorizing the theories, so that they have no
problem to apply it effectively during workforce. Furthermore, the usage of
English as primary language among Chinese respondents is an advantage for them
to have good communication especially with other healthcare practitioners.

As in satisfaction towards pharmacy education received, demographic

characteristics that related were race, gender and final CGPA. Male respondents
almost thought that knowledge they had gained is not enough to help them in

40

communication. Therefore, they demanded for more experiential learning. They

also cannot relate the relevance of certain courses with their future practice. It was
similar to response of Chinese respondents. Most Chinese respondents also agreed
that pharmacy educational program is relying more on theoretical aspect
compared to practical and it is too exam-oriented.

4.4

Barriers of preparedness

Poor communication skill

Communication skill is the main criteria that must be developed in each

pharmacist. Actually, communication skill had been trained to the students
since they were in first year at university. It is done through presentations,
answering questions in front of public and giving opinions either when
requested or not. However, some students are not using these chances to
develop communication skills. As a result, when they have to communicate
with other healthcare practitioners and patients especially on drug related
problems, they cannot do it effectively. They have great ideas, theories to
solve complex problems but due to poor communication skill, they cannot
deliver it perfectly.

Lack of exposure to real situation at hospital setting

As in pharmacy educational program at Universiti Sains Malaysia, students

will only get practical session seriously during final year. Unfortunately, the
duration is too short and students might not have enough time to learn all

41

those things related to drugs. Furthermore, there are problems to apply

everything they had learnt since first year during practical session because of
forgetfulness. Therefore, something must be done to modify educational
program by adding more practical session in the syllabus, so that students may
apply everything they learnt in the lectures practically.

Low self confidence

Self confidence is the most important criteria for all graduates to enter
workforce. It is important because it will affect the qualities of their job and
their self improvements to compete with others. If graduates have low self
confidence, surely it will influence their ability to communicate. They also not
have the ability to be out-spoken in giving opinion, so that other people
especially employers cannot see their potential to be a good pharmacist.
Therefore, educational effort and strategy should be targeted primarily at this
low self confidence group to encourage their confidence level.

4.5 Limitations of study

42

There are some limitations of the study had been identified. The questionnaires
were distributed to the graduates of School of Pharmaceutical Science, USM who
had successfully completed their study in academic session 2008/2009 during an
assembly of them in August 2009. However, not all graduates participated in this
study. The small sample size and single study site limit the generalizability of this
study. Therefore, the results obtained were unable to represent preparedness level
of all graduates.
The durations of respondents to answer the questionnaires were too short, so
respondents might not read and think deeply in answering the questions. It may
cause inaccuracy in the results.
4.6 Recommendations for future research
The method of collecting data must be improved to get more respondents, so that
the results will be more reliable. Web based survey might be applied by email the
questionnaires to all graduates and they will reply the answer. In addition,
respondents will not answer the questions in hurry.

43

CHAPTER 5
5.0

CONCLUSION

In conclusion, almost pharmacy graduates from Universiti Sains Malaysia are

prepared to enter pharmacy workforce. However, the numbers of prepared
graduates must be improved. The level of preparedness involved performing any
duties which will be assigned, preparedness for any self directed learning
activities, preparedness to work anywhere and communicate effectively with other
healthcare practitioners. Satisfaction towards pharmacy education received
influenced the level of preparedness. Mostly graduates slightly not satisfied with
pharmacy educational program they had received for four years. Two main
problems were identified in this study; lack of practical sessions and the system of
educational program is too exam oriented. Therefore, some modifications may be
done to improve learning effectiveness, enhance the preparedness of the students
to enter workforce and give the best performance as competent pharmacist. There
are few numbers of graduates who have not well prepared to enter workforce. The
barriers included poor communication skill, low self confidence and lack of
exposure in handling real situation especially regarding drug related problems.
Variables demographic characteristics also affect the preparedness of graduates.
Race and gender are the most frequent variables related to level of preparedness

44

of graduates due to reasons that had discussed before. Last but not least it is
recommended to take actions in modifying pharmacy educational program to
enhance the level of preparedness among graduates.

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