Attitudes and opinions of pharmacy undergraduates towards the integration of innovation and entrepreneurship programs into professional education | BMC Medical Education

Although a growing number of educators are exploring the integration of I&E elements into undergraduate pharmacy education [11, 17, 22,23,24], to date, no study has explored the actual attitudes and opinions of pharmacy undergraduates, key stakeholders in pharmacy education, towards this new educational paradigm. To the best of our knowledge, the present study is the first to examine pharmacy undergraduates’ actual I&E behaviours, attitudes, and preferred model with respect to integrating I&E into professional pharmacy education. The results revealed that the majority of the respondents were insufficiently engaged in I&E practices; however, their overall attitudes towards the integration of I&E into professional pharmacy education were very positive.

I&E behavioural gaps

To date, no well-accepted scale for I&E behaviours has been developed. For university undergraduates, who are still learning, I&E behaviour can be considered a dynamic process that puts their I&E knowledge, willingness, and new ideas into practice under certain conditions and improves team performance [27, 28]. In China, I&E training projects and competition provide a platform for students to engage in the entire process of I&E, including topic selection, competitive analysis, business or research planning, financing, implementation, product development, application and marketing, etc., and thus has become an important way for universities and colleges to implement and promote I&E education [27]. I&E training projects and competitions for Chinese college students have sprung up and are generally open to the entire country, and all enrolled undergraduates have the opportunity to participate [25, 27]. Therefore, the respondents’ experiences participating in I&E training projects and competitions were used to reflect their I&E behaviours in the present study. However, we found that although these I&E training projects and competitions were free and accessible to all the responding pharmacy undergraduates, no more than one-third of the respondents actively participated, suggesting poor I&E behaviours.

Moreover, we found that a considerable proportion of the respondents were doubtful of their own understanding of the pharmaceutical industry and pharmacy academic research and did not feel confident about their competence in I&E. One of the goals of I&E education is to help students better understand the market demand for emerging business ventures and innovative products, which is conducive to assessing I&E opportunities and forming I&E intentions, roles and mindsets [25, 29]. Therefore, pharmacy educators must provide data and information on the pharmaceutical market and the pharmacy academic environment and approaches to pharmacy undergraduates, thereby strengthening their understanding of and self-confidence in pharmacy I&E. In addition, I&E competence among students has been shown to have a significant positive effect on I&E intention [17, 27, 30]. Currently, three main dimensions—I&E knowledge, attitudes, and skills—have been highlighted as core competencies enabling students to take action on opportunities and ideas, solve problems, and turn those problems into value [17, 27, 30]; thus, they should be comprehensively addressed in undergraduate education to further develop pharmacy students’ competency in I&E practices.

I&E attitudes and barriers

For the attitude domain, encouragingly, the respondents in this study provided overwhelmingly positive support for the integration of I&E into professional pharmacy education. They particularly approved of the concept of ‘pharmapreneurism’ [17] and its importance, the necessity of I&E education and its integration into professional pharmacy education, and the close relationship between professional competence and I&E behaviours. However, their I&E attitudes at the individual level were not sufficiently positive.

As mentioned above, attitude is one of three main dimensions of college students’ I&E competence [27, 30]. The entrepreneurial attitude, which is defined as an individual response to information, events, and criticism towards existing opportunities, is considered to play a vital role in fostering a mindset for business startups [31]. The entrepreneurship constructs are mainly reflected by an entrepreneur’s attitude or orientation towards uncertainty rather than a skill or knowledge base [17]. A pharmacist entrepreneur should be a confident and proactive self-starter with a positive disposition and be willing to take risks and compete [17]. Similarly, innovative attitudes, which include the spiritual and material attitudes of an individual towards innovation, positively affect innovative behaviour [32].

A certain proportion of the respondents reported that they felt ‘undecided’ about choosing careers as entrepreneurs or academic researchers. With respect to the findings on students’ expectations for I&E education and its integration into professional pharmacy education, their tentative I&E attitudes were associated with their insufficient understanding of I&E, which can be improved through I&E education. The urgency of integrating I&E programs into professional pharmacy education was also reflected by the finding that a lack of knowledge/skills in business and the pharmacy profession was one of the greatest barriers to I&E practices. Nevertheless, the more important barriers were ‘market uncertainty and tight competition’ in entrepreneurial practices and ‘innovative idea generation’ in innovation, which should serve as the focal points of future I&E education for pharmacy undergraduates.

Preferred integration models

When asked their favourite implementation model for integrating I&E programs into professional education, the students expressed an affinity for developing their I&E competence in ‘required courses’ longitudinally distributed along the current professional pharmacy education framework, especially in the ‘professional theoretical training’ stage.

Thus far, how to integrate I&E programs with professional curricula has remained a challenge, with no standardization of “best practices” for these programs [10]. After reviewing the published literature and websites of existing I&E programs used in American and Canadian allopathic medical schools, Arias et al. [10] reported that 54% of the programs were a four-year track/concentration; 75% of the eligible curricula were based on a selective application process, suggesting that selective I&E programs of longer duration are common in medical education. American pharmacy educators have described an innovation and entrepreneurship certificate program [24] as an optional experience for pharmacy students and a cocurricular activity using the format of the television series SharkTank to introduce the concepts of I&E [11]. In addition, Lei [2] valued practical teaching based on the working process in the integration of I&E education with professional education. The present study revealed that Chinese pharmacy undergraduates favour longitudinally distributed I&E programs, which have the advantage of providing sufficient time for more meaningful and long-term I&E experiences; however, required courses are preferred over selective courses and cocurricular activities. Additionally, more students chose ‘professional theoretical training’ as the stage of pharmacy education into which I&E programs should be integrated than chose ‘professional practical training.’

In Chinese undergraduate universities, I&E education started late and is still in the exploration stage [2], especially in the pharmacy context. Teacher-centred didactic lectures are predominant in the current pharmacy education in developing countries [33]. From the perspective of students, traditional and customary theoretical training based on didactic lectures is a direct and convenient source of I&E knowledge. Theoretical learning and practical learning are two necessary paths for students, especially those who lack understanding of I&E, to acquire I&E knowledge and skills [34]. Mattingly et al. [22] conducted semistructured interviews with experienced entrepreneurs, and a mix of didactic and experiential approaches was identified through a multiround Delphi process as best for educating pharmacist entrepreneurs. For the studied university, which lacks experience in integrating regular I&E programs into professional pharmacy education, it is feasible to include key I&E topics, such as marketing, innovation idea generation, design and approaches, leadership, organizational behaviour, financial management, and human resource management, in the didactic component of professional pharmacy curricula as a starting point for the implementation of integrating I&E into professional pharmacy education.

Group comparison

Accumulating evidence has shown that demographic factors, including gender, grade, and parental entrepreneurial experience, affect students’ I&E attitudes and behaviour [7, 26, 34, 35]. Our survey suggested that female students held more positive attitudes than males did towards the integration of I&E into professional pharmacy education; however, they were less confident in their own competence in entrepreneurship and expressed less interest in starting careers as entrepreneurs and academic researchers than their male counterparts did. This finding was in line with the fact that I&E activities are generally regarded as male-dominated areas because of their high risk and high uncertainty [34]. Moreover, respondents in higher grades had a better understanding of the pharmaceutical industry, and the entrepreneurial experience of students’ relatives and friends positively influenced their attitudes towards the integration of I&E into professional education, their willingness to start a business, and their participation in I&E training projects and competitions. These findings are consistent with those of previous studies [7, 26, 34, 35]. Interestingly, our study revealed that younger undergraduates felt that they knew more about pharmacy academic research and that lower-grade and younger students were more likely to pursue careers as academic researchers. In fact, the lower-grade students at the studied university had relatively limited exposure to the knowledge and practice of pharmacy academic research compared with their higher-grade and older counterparts. There may be cognitive bias caused by these students’ idealized enthusiasm for careers as in academic research.