Access, Affordability, Accountability2013-2014 President-elect Address to the 2014 AACP House of Delegates
July 27, 2014 
 
We are in the midst of an exciting and yet challenging time — a period of momentous change in higher education and healthcare. The changes are so great, and they are happening so quickly, that it can be difficult to process them and to respond appropriately and swiftly. In fact, “responding swiftly” is often seen as an oxymoron in our profession. I believe we can do better. 
 
Where are the changes? I see them in three broad categories: cost, quality and access in both education and healthcare. 
 
I will refer to them as access, affordability and accountability. 
 
And what do these changes feel like? Some pessimists might liken them to a tsunami or an avalanche. But I prefer to view them optimistically — after all, I’m from the “wild and wonderful” state of West Virginia, where we don’t have tsunamis or avalanches. But we do have whitewater rafting. And that’s a powerful metaphor for navigating rapid change. 
 
Have you ever been whitewater rafting? If you have, please raise your hand. Ok, well today let’s fix that for the rest of you. 
 
This morning I’m going to take you on a whitewater rafting adventure — where the skills and commitment of everyone in the raft are necessary to make it safely to the finish. Where — like higher education and healthcare — the environment is complex and requires constant adaptation. And where things are only partially under your control! 
 
So what can we learn from a whitewater rafting trip? Let’s gear up and get ready to go down the rapids. 
 
First, you need the right equipment — a helmet, life vest and a paddle. You will also need knowledge of whitewater rafting. 
 
You need an experienced guide, and you need to follow directions. A successful rafting crew has good leaders, and good followers — which are key in higher education and health care today. 
 
You need to be agile and to demonstrate initiative in the face of unexpected difficulties. You will be dealing with fluidity, uncertainty and disorder. There will be lots of twists and turns, which will require continuous revision and realignment. 
 
You need to pace yourself. Skilled rafters know not to dive in and ride the whitewater to the end. Instead they navigate the rapids in stages. Between bursts of activity, they pull off to little pools called eddies — to catch their breath, jump in and take a swim, and prepare for the next stage. A rafting adventure can easily take all day! 
 
You need to be confident, without being reckless. You need to expect competitors on the journey; you won’t be the only rafter on the river. But if you listen to your guide and follow the river, you’ll have a great journey. And you need to anticipate and respond to unexpected changes — such as waterfalls, and your raft overturning on top of you! 
 
These are the skills we can use as we face the challenges in higher education and healthcare. Fortunately for AACP, we have excellent committees and councils to help us navigate the rapid changes. My charges to them will focus on changes in higher education (by the Academic Affairs Committee) and health care (the Professional Affairs Committee). Argus, Research & Graduate, and Advocacy will also be given charges. For structure, I have asked each committee to focus on three main areas: access, affordability and accountability. 
 
When I was asked to select members to be on these committees and councils, I found an embarrassment of riches! I had a huge list of volunteers for each one. So thank you to all who volunteered to serve. Please know, it was extremely difficult to choose from so much talent! Today I’m going to give you a sample of the challenges they will address. 
 
 
The Academic Affairs Standing Committee, chaired by Kari Franson, will identify issues and problems affecting the administrative and financial aspects of member institutions. Among the key questions they will address are: 
 
 
• Access: Why should students attend class when excellent teachers and coursework can be delivered in the comfort of their homes? 
 
 
• Affordability: How can we speed up the time spent on learning through concepts such as assessment of prior knowledge, and competency-based education (mastery vs. seat time)? I’m asking them to propose more affordable models of education. 
 
 
• Accountability: How might tools like the new Gallup/Purdue assessment instrument introduce different methods to measure the quality of education? 
 
 
 
 
 
This year, the Advocacy Committee, chaired by Bob Mangione, will examine the topics of access, affordability, and accountability in pharmacy education and their alignment with these same issues across higher education. Key questions this committee will consider include: 
 
 
• Access: With attention to, but not limited to underrepresented minorities, what are best practices at AACP member institutions that focus on individual access to professional pharmacy programs? 
 
 
• Affordability: With a primary focus on tuition and cost of attendance, describe best practices of how AACP member institutions ensure the value of a professional degree. This description should discuss the return on investment of a pharmacy degree. 
 
 
• Accountability: With attention to accreditation, describe best practices of how AACP member institutions hold themselves, their faculty and their students accountable for the creation and execution of a high-quality educational experience. 
 
 
 
 
The Argus Commission will study how access to — and use of — “big data” will influence the future of academic pharmacy from the perspectives of curriculum/education, research, clinical practice, population health, community engagement and public policy. Jeff Baldwin will chair the commission this year. 
 
The Commission will answer the question: What role should AACP play in assisting members with “big data” in the context of current efforts to employ the principles of “knowledge management” to the work of the Association? 
 
The health care environment continues its evolution with the Affordable Care Act and its focus on improving health and healthcare, and reducing costs. Both academic and professional pharmacy must ensure that new and current pharmacists are competent to meet these goals. The Professional Affairs Committee, chaired by Charles Taylor, will examine the contributions of experiential education, in the context of the emerging accreditation standards, to ensure the development of “practice-ready” graduates who are educated for current and future practice. 
 
Elements necessary for access to exemplary experiential sites will be studied. Evaluation of student pharmacist readiness for, and contributions to, IPPEs and APPEs should be considered to illustrate the value to practice sites. 
 
Accountability: What are the essential elements of successful relationships with practice sites that support student development of professional responsibilities? The committee will also review and evaluate how well the experiential education curriculum aligns with the recently approved JCPP Consensus Practice Model and what assessments might need to be developed to document accountability and improve that alignment. 
 
I believe it is time for a major reassessment of our graduate degree programs. The Research and Graduate Affairs Committee, chaired by Natalie Eddington, will examine and establish a competency-based, best-practice education model that provides guidance to colleges and schools of pharmacy offering graduate degrees and postdoctoral training. The Committee will also seek input from funding agencies who award graduate and postdoctoral fellowships and from future employers — such as academic, government and pharmaceutical industries — to ascertain that the needs of the future workforce are met. 
 
In closing, I want to say how honored and excited I am to be installed as AACP President at this time — a time of great challenge and great opportunity. When I was asked to run for the presidency, I asked my husband Jim, my Chancellor and my team what they thought, and they said “get in the boat!” To Jim and family, Dr. Colenda, and the WVU faculty and staff — thank you for your love and support. 
 
Although I belong to multiple professional organizations, AACP is my home, complete with mentors, friends and colleagues. I am truly blessed to have grown professionally, and this organization has been the key to much happiness. 
 
Today, I feel the same exhilaration that I experience during a whitewater journey. And I truly hope that we will carry the whitewater lessons through our next year together. With your support and active participation, I know we will achieve great success for the academy and for our profession. Thank you for your attention.