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Communication Apprehension in Pharmacy Students: A National.Study.

Bruce A. Berger2School of Pharmacy, Auburn University, Auburn AL 36849

H. John BaldwinSchooLof Pharmacy, West Virginia University, Morgantown WV 26506

James C. McCroskey and Virginia P. RichmondDepartment of Speech Communication. West Virginia University, Morgantowll WV 26506

In 1979 Baldwin at al. suggested a phenomen known as communication apprehension (CA) as a contributingfactor predisposing pharmacists to avoid communication. Communication apprehension is defined as "anindividual's level of fear or anxiety associated with either real or anticipated communication with another personor persons." The original study with pharmacy students reported that the rate of high communication apprehen-sion in pharmacy students was 20 percent, similar to the distribution of the trait in the general population, butlater studies reported a high CA rate of 25 percent among pharmacy students. Bulk mailings were made toparticipating pharmacy schools nationally. Students were asked to complete a questionnaire which included thePersonal Report of Communication Apprehension, three items on attitude towards communication. and threequestions on shyness. Shyness is a broader construct than CA and could be caused by a desire for solitude, CA.and/or a skills deficiency. The final report is based on responses from 10.004 pharmacy students f~om 51 (71.8percent) schools of pharmacy. Approximately 1 in 5 pharmacy students is highly communication apprehensive,similar to the general population percentage. Variability exists on a school-by-school basis. Over a third (34.4percent) of the pharmacy students classified themselves as shy, compared to a population norm of 35 percent.Sixty-three percent of the high CA students were shy, and fourteen percent of all students were both high CA andshy. Approximately 5 percent of the population were high CA, shy, and did not consider it a problem. Thesestudents apparently simply avoid communication and its resultant anxiety. The more anxiety a communicationcontext produces, the less importance a student attaches to that type of communication. An attempt is made tomatch the perceived importance of a communication context with their own cognitions. It appears that at leastone in five, and possibly as high as one in three, pharmacy students will tend to avoid communication.Systematic desensitization is the recommended treatment for the high CA student.

A communications gap exists betweenpharmacistsandpatients. Only a limited amount of pharmacist-patient com-munication takes place, although a need for, and desirability ofsuch communication is stressed in professional pharmacy jour-nals. Colleges of pharmacy have reacted to this perceiveddeficiency by instituting coursework in communication skillsand by stressing the health care and professional benefits ofcommunication. The first approach assumes deficient phar-macist communication skills. The second approach assumesknowledge.andattitude change will lead to a behavioral change.

In 1979Baldwin et aL.suggested communication apprehen-sion (CA) as a contributing factor predisposing pharmacists to

I Supponed by a Special Projects grant from the AACP Council of Sectionsthrough the American Foundation for Phannaceutical Education.

2 Corresponding author.

avoid patient communication{I). Projecting from previous re-search, these authors suggested that "a pharmacist with highCA would not only be unwilling to perform a very significantportion of her or his professional role, but that even whenattempts are made to fulfill that role, the probability of success isvery low.",

Four constructs internal to an individual, all of which resultin the avoidance of communication, are described in com-munication theory: (i) communication apprenhension; (ii) reti-cence; (iii) unwillingness to communicate; and (iv) shyness.Unwillingf.1essto communicate is viewed as a global pre-disposition, a general avoidance of communication, no matterwhat the reason for that avoidance, which could include com-munication apprehension, reticence, andlor shyness(2,3). Reti-cence is assumed to be primarily a problem of deficient com-munication skilIs(2,4). Communication apprehension, as con-

AmerIcan Journal of Pharmacautlcal Education Vol. 47, Summer 1983 95

"

ceptualized by McCroskey(5), is defined as "an individual'slevel of fear or anxiety associated with either real or anticipatedccmmunication with another person or persons.," Shyness is abroader constructthan either reticence or CA, spanning "a widebehavioral-emotional continuum"(6). At one end of this con-tinuum are shy persons who prefer solitude. "Such persons mayhave a personality problem or no problem at all(2)." Shyness isseen as the tendency to talk and engage iit communicarion withothers less than the norm which may result from high CA, lackof verbal skills, or other causal factors(7). Although causaldifferences between the constructs are posited, distinctions aredifficult to establish empirically since theconstructs overlap andresult in the same behavior, i.e., avoidance ofcommunication(2) .

Baldwin, et ai. reported that the "stable, enduring" natureof CA(I), which indicated that the high CA pharmacy studentupon graduatiot:1was likely to conform to the traditional stereo-type of the pharmacist hiding from the public in the prescriptiondepartment(8,9). This stereotype would suggest that individualswith high CA might be attracted to' the pharmacyprofession(1,10). The original West Virginia data reported thatthe number of high communicative apprehensive pharmacystudents was approximately 20 percent, similar to the dis-tribution of the trait in the adult population. Unpublished datawith subsequent classes at West Virginia and in other pharmacyschools suggested a higher rate. Later studies reported 25percent of the pharmacy students were severely communicativeapprehensive(11,12). Speculation as to the reasons for this highproportion centered on admissions policies, specificaIly pre-admission interviews and the declini..ngapplicant pool which hasled to a high accepted/applied ratio.

STUDY OBJECTIVES

This study was undertaken with four specific objectives:I. To measure communication apprehension in pharmacy stu-

dents on a national basis;2. To determine the extent of the problem in our pharmacy

students;3. To analyze the relationship between curricular and admis-

sions structures and the extent of communication apprehen-sion; and

4. To suggest methods to aIleviate the problem, if a problemexists.

METHODOLOGY

During August and September, 1981 letters were mailed to adesignated faculty member at each of the 71 schools of phar-macy in the continental United States, soliciting his or herassistance in conducting the study. This letter briefly describedthe study, indicated AACP funding, and the mode of question-naire administration. If no response was received from thedesignated individual within a month, attempts were made tocontact her or him by telephone.

During the fall of 1981, bulk mailings were made to 63schools of pharmacy which had agreed to participate. Eachmailing consisted of a cover letter, and coordinator question-naire and sufficient student questionnaires' for the school'senroHment.

The cover letter described the student questionnaire, gaveinstructions for its administration (classroom distribution, vol-untary participation, assurance of anonymity, and estimatedtime to complete), and asked the faculty member to completethe coordinator questionaire. The coordinator questionnaireasked questions regarding the existence of communication

96

courses in the curriculum, types of admissions criteria em.ployed, curricular configuration, and the number of student>who applied, were accepted, and were presently enrolled ineach current class. The student questionnaire (Appendix A)contained demographic items (age, sex, race, year of gradu-ation, degree expected), the 24 item PRCA (Personal Report 01Communication Apprehension), three items on attitude toward~communication, and three questions concerping shyness.

The PRCA is the most widely used measure of CA and ha~been demonstrated to be highly reliable and valid(l,I3 ,14)Although it is a self-report measure of cognition not a measureof actual behavior, there is a high degree of association betweenPRCA score and communication behavior.

Shyness is also measured by self-report, with individual~dichotomized as shy or not-shy(l5). In a validation study.individuals who caIled themselves shy were labeled as shy b)trained observers 67 percent of the time(l6). Self-report 01shyness appears to be effective and appropriate "since it doe~not exclude those who feel they have a problem but do nOIexhibit either inept behavior or physical signs of tension"(2)

The present study used Zimbardo's shyness identificatiorprocedure( 15), dichotomous measures which aIlowed student~to be classified into four shyness levels:

Shyness level I: Student is not shy now, andnever was.

Shyness level 2: Student is not shy now, but once was.Shyness level 3: Student is shy now, but does not

consider it a problem.Shyness level 4: Student is shy now, and considers

it a problem.Three items on the survey instrument examined the per.

ceived importance of communication. Students were asked IIrate interpersonal, group, and public speaking forms of com.munication as: (i) not important, (ii) moderately important, ami(iii) very important to the pharmacy profession. Studcnts Wl'!Ialso asked to indicate whether they had taken or were currenthtaking a public speaking course or oral communication course.

Completed questionnaires were returned in bulk by participating schools. Telephone foHow-up was attempted wit~those faculty members from whom questionnaires had not beerreceived as of January, 1982. Completed questionnaires wencomputer analyzed as they were received.

RESULTS AND DISCUSSION

Description of Final Sample. Sixty-three schools of pharmacyagreed to participate in the study, and were mailed a total of21,640 student questionnaires. Of the eight schools not sentquestionnaires, four coordinators could not be identified bytelephone follow-up, and four declined to 'participate, citingschool policies or administrative constraints.

Fifty-two schools submitted 10,233 usable completed ques-tionnaires, of which 10,004 from 51 schools were analyzed (oneschool's 229 completed questionnaires were received in lateJune, after computer analysis for this report wascompleted). Allstatistics in the tables are adjusted for missing data. Of the other11 schools not represented, one school declined to participatebecause of an administrative barrier, one set was apparently lostin the return mail, and the remainder were either not reached bytelephone follow-up and/or did not foHow through on thepromised completion.

Published enroHmentfigures( 17) indicated 24.669 student,enrolled in pharmacy schools seeking their first degree inpharmacy, and 464 students possessing a BS in Pharmaqseeking a PharmD degree. This would indicate that our final

American Journal of Pharmaceutical Education Vol. 47, Summer 1983

/trudY',f!"""'"1,1..:H'I"I'I)C/J'"1'.1i pcu;clIlul phanna~y schoolsalld approximately 40 percent of the pharmacy studentpopulation.

This percentage may be an undercslimatc of the number ofpotcmial studenl respondems. Typically, a large percentage ofstudents in their tinal professional year are involved in extern-ships or clerkships, and thus not accessible for questionnaire

administration through regular classroom procedure~.,-

Nonresponse Bias. A number of techniques are used to mea-sure the possibility of nonresponse errors(l8-20). The mostpopular method is based upon demographic characterislics ofrespondents and nonrespondents. However, current demo-graphic data on the nation's pharmacy students simply are notavailable. The most current data are for 19HO(17). Even over thepast year, the male-female ratio has changed considerably.Therefore, demographic methods are not usable. Since thesurvey instrument was made available to literally every phar-macy student, not simply a random sample, one is fairly safe inassuming that, unless regions of the country are not represented,the respondents are representative of the population. The finaldata include respondents from all geographical regions.

To determine if nonresponse error is a problem, a thirdmethodological approach is possible. "A. . .way by which the

. adjustment is sometimes made involves keeping track of thoseresponding to the initial contact, the first follow-up, the secondfollow-up, and so on. The mean of a variable (or variables, orother appropriate statistics) is then calculated, and each sub-group is compared to determine if any statistically significantdifferences emerge as a function of the difficulty experienced inmaking contact. If not, the variable mean from the respondentsis assumed equal to the mean for those responding. This infer-ential method is particularly valuable in mail surveys, where it isan easy task 10 identify those responding to the first mail-ing. . .and so on"(l8).

t\fter 5,000 responses were received, telephone follow-upto nonresponding schools began. Respondents were dividedinto prefollow-up and postfollow-up groups. Table I sum-marizes the statistical comparisons between the groups. Nostatistical differences were found. Although this approach totest for nonresponse error is not absolutely conclusive, it may beinferred that the characteristics of nonrespondents appear to bereasonably similar to those of the respondents.

Because of the manner in which the survey instrument wasadministered, nonresponse was more a function of the schooland coordinator than of pharmacy students. Finally, it should bereiterated that this was a population survey.

Communication Apprehension. For pharmacy students thePRCA mean score and standard deviation was 65.15 and 16.28,respectively (N =9,830). These numbers compare favorably togeneral population figures (N 2. 40,000) of 65.6 and 14.1.Pharmacy students appear to be "normal" relative to the popu-

TABLEI.Several characteristics of respondents overtime.

Approximate PRCA ScoreN Mean S.D.

MeanAge22.2922.3122.29

Shyb

1.661.661.66

Sex.

5,0008,500

10,000

65.3765.0665.15

16.0816.2416.29

1.511.501.50

81 = Male; 2 = Femalebl = Yes; 2 = No

lation in general in terms of communication apprehensionHowever, there is greater variability in the pharmacy studendata.

Mean PRCA scores from the participating schools rangecfrom 57.24 to 69.14 (Table II). One of tive individuals (2Cpercent) in the general population is highly communicationapprehensive (PRCA score ~ 79)( 14).The present data indicate19.5 percent of the pharmacy students studied would be classi-fied as high communication apprehensives (PRCA score L 79).

TABLEII. Summary data on communication appre-hension and shyness by school

Proportion ofstudents inshy level 4

17.4519.2916.5617.6221.8117.6012.4318.4016.3816.9012.9()15.0417.2224.3920.4111.2318.4120.6911.7921.3121.5721.7717.2414.4016.4422.1815.0418.1317.7418.7213.7513.8318.0022.2618.2817.8018.9018.1122.2219.1122.4724.8323.3312.9021.1315.1325.5321.3219.4022.6216.33

Mean Proportion ProportionPRCA of high of shy

School score CA students students

I23456789

101\121314151617181920212223242526272829303132333435363738~9404142434445464748495051

64.7067.4966.4664.4566.8766.5562.6364.3465.5264.4664.7663.4463.0264.0257.2463.3767.4767.2065.1767.5166.0066.8166.9264.5063.2968.6465.4863.9266.9661.9464.5462.3065.6267.0463.8766.5263.6861.2962.3564.4163.6169.1063.5264.9569.1469.0167.8863.8865.0866.2367.80

American Journal of Pharmaceutical Education

Ayerage 65.15

Vol. 47, Summer 1983

34.40

20.5321.2122.3919.2724.0922.8410.9815.3218.8518.8718.9219.2615.4716.674.08

13.3024.5220.5918.5821.3120.9222.2221.1314.6015.5828.1519.7014.9422.4913.3714.8214.4018.3725.8320.5722.3615.9512.3520.4317.4713.3328.9120.0018.7525.3527.5026.0417.5321.2120.3223.53

19.50

39.3339.9032.8332.8138.3535.4328.6636.8038.5634.112!U432.0929.4427.7136.0031.7531.5140.2935.9736.0738.3141.7334.2536.0328.1941.8532.0931.2136.1729.9041.4630.2033.0038.8130:9336.6731.5232.8640.2428.7633.8937.8438.1026.9838.0336.9843.6235.1436.0333.9839.22

18.31

97

Although this figure appears nonnal, the proportion of high CAstudents at p:u1icipating schools ranged from 4 percent to 29percent.

Differences in PRCA scores were examined in ferms of Hex,

race, and rural-urban background (Tables III, IV AND V).Although there are statistically significant differences for allthree variables, caution in interpretation of the results is neces-sary. It is quite easy to demonstrate statisticaily significantdifferences with such large sample sizes. The important ques-tion is: are these differences "clinically" or pragmaticallyuseful? In regard to sex, both male and female respondentPRCA scores are certainly in the nonnal range even thoughmales have significantly lower PRCA scores than females.TABLE III. PRCA scores of male and femalerespondents

TABLE IV. Race/ethnic group PRCA scores ofrespondentsRace/ethnicgroup

WhiteBlackOrientalNativeAmericanHispanic

N

8437393467

53189

PRCAscore F

65.0259.8771.1867.3267.62

28.13"

.p <0.000I

TABLEV.Townsize of respondentsand PRCAscoresPRCA

.PiO.0002

TABLE VI. Shyness level and mean PRCAscoresShyness PRCAlevel N score F

2

3

4

.p<0.000I

Analysis of variance (ANOVA) showed statistically sig-nificant differences in race/ethnic group. Blacks were the lowestapprehensives; orientals were the highest. It is possible thatblacks in phannacy schools may come from middle class orupper middle class backgrounds, and are not necessarily rep-

resentative or typical of black students in general. Since orientalcultures do not value "talk" as much as does American culture,it is not surprising that orientals had the highest PRCA meanIIcore 1111II JlrnllJ1. In Iht' hClIllt', Iht' 11I'1t'","1!IIIII11'11I i~ tlill

encouraged10behighlyverhalundvocul,yetlIut!lldrIhr homcthese b.ehaviorsare valued. Communication apprehension mayresult from conflicting cultural values.

Although ANOVA demonstrated statistically significantdifferences in PRCA scores based on town size, the mean PRCAscores are all within two units of the general population mean.For all practical purposes, there are no real differences in thesescores. The statistical significance is more an artifact of thelarge sample size.

Communication Apprehension and Shyness. Over a third(34.4 percent) of the respondents said they were currently shy(Table II). This compares to a general population nonn of 35-40percent. Forty-six percent of those who considered themselvesshy now said it wasn't a problem. This result is particularlydisturbing since these people will not actively engage in com-munication with others. They seek to enter a profession whichprofesses high value given to a patient counseling role, yet theseindividuals don't perceive their shyness as a problem.

Table VI illustrates the strong relationship between shynesslevel and PRCA score. Those students in Shyness level 4(currently shy, problem) have PRCA scores (on the average)that classify them as high apprehensives. Students in Shynesslevel 3 (currently shy, but not a problem) have CA scores thatare considerably higher than general population norms.

Table VII examines the relationship between com-munication apprehension and shyness in a somewhat differentmanner. Three levels of communication apprehension werecross-tabulated with the four shyness levels. Seventy percent ofthe high CA students were shy. A total of 1350 students (14percent) were both highly communication appi'ehensive andshy. However, 442 of these students did not consider theirshyness to be a problem. This finding is especially curious sinc~their PRCA score classifies them as individuals who are highlyanxious about communicating. It is quite possible that theseindividualsdon't consider their shyness (or CA) a problem sincethey simply avoid communication situations and hence theresultant anxiety.

The Spearman correlation coefficient (0.458) for the data inTable VII indicates a positive relationship between shyness andcommunication apprehension. Since shyness may result frompersonal preference, anxiety and/or a skills problem, all of thevariability in the data will not be explained. To reiterate,shyness and communication apprehension are two differentconstructs, even though the resultant behavioral manifestations(avoidance of communication situations) may be the same(2).

Communication Apprehension and Perceived Importanceor Communication.TablesVIII, IX andX present the relation-ship between PRCA scores and perceived importance of varioustypes of communication. A consistent observation is that tho.seindividuals who valued each type of oral communication as"very important" had the lowest meanPRCA scores. The morethreatening or anxiety producing the communication situation(interpersonal is less threatening than group which is lessthreatening than public speaking), the lower the PRCAscore forthe "very important" category. With the exception of onecategory of interpersonal communication, the lower the impor-tance assigned, the higher the PRCA scores. The interpretationis that the higher the amount of anxiety produced by a com-

. munication context for an individual, the less that type of

98 American Journal of Pharmaceutical Education Vol. 47, Summer 1983

PRCASex N. score Student t

Male 4894 63.907.70"-

Female 4910 66.42

.P<O.OOOI

Town size N score F

Farm 642 67.28Under5,000 1725 65.66

6.88"5,000-50.000 3631 65.42Largecity or suburb 3600 64.43

1879 55.45

4436 60.92

1230.60"

1516 72.24

1756 79.81

TABLE VIII. Importance of Interpersonal com-munication and communication apprehension

MeanImportance N PRCAscore F

Not important 152Moderately important 715Very important 8742

67.5869.0967.74

25.45"

'P<O.OOOl

TABLE IX. Importance of group communication andcommunication apprehension

MeanPRCAscore FImportance N

Not important 544Moderately important 5667Very important 3387

73.8167.1860.22

291.70"

'P<O.OOOI

TABLEX. Importance of public speaking and com-munication apprehension

Importance N

Not important 2043Moderately important 5277Very important 2275

"P<O.OOOI

MeanPRCA score

71.5465.1059.31

F

322.94"

comm"nication will be valued. Both high apprehensives andshy peoplewill value all communication situations less than lowapprehensives becauseof that anxiety. The result makes it easierto understand why over 40 percent of those who considerthemselves shy don't consider it a problem. Psychologically,their values and behavior are congruent. Since they don'theavily value communication in various contexts, they don't

Total

193220.15

579660.44

186119.41

9589"100.00

engage in those contexts (or vice versa). Therefore, theirshyness does not present a problem for them.

Communication Apprehension, Communication Courses,Curricular Structure, and Admissions Procedures. Table Xlrelates communication apprehension to communicationcoursework. Students who had taken or were currently takingcommunication courses (oral or public speaking) had sig-nificantly lower communication apprehension levels than thosewho had not. Either these courses lowered the student's CAlevel or students with higher CA levels don't seek out thesecourses. The latter explanation seems more plausible.

Table XII examines the relationship between dominantprogram arrangement and communication apprehension. Thedegree of communication apprehension was not related toprogram configuration, although PharmD program students hadlower than average PRCA scores. Also, the self-reportedPharmD degree seeking students had lower than average PRCAscores (Table XIII). This wasespecially true of students seekingpostgraduate PharmD degrees. It is reasonable to assume thatstudents entering BS degree programs in pharmacy view theprofession much as does the lay public. Indeed, some students

TABLEXI.Communication courses and com-munication apprehension

MeanPRCA score Student t

62.0813.22"

66.66

62.6610.12"

66.25

American Journal of Pharmaceutical Education Yol.47, Summer 1983..

99

TABLE.VII.Communication apprehension level and shyness levelShyness level

Frequency Not shy now Shy now, Shy now,Percent Not shy now, used to be not a isaRow Percent never was shy problem problemColumn Percent

1 2 3 4

739 1075 83 35I 7.71 11.21 0.87 0.37

PRCA<52 38.25 55.64 4.30 1.8139.33 24.23 5.47 1.99

2 1046 2944 993 813PRCA<51 & 10.91 30.70 10.36 8.48

PRCA<80 18.05 50.79 17.13 14.0355.67 66.37 65.42 46.30

94 417 442 9083 0.98 4.35 4.61 9.47

PRCA<79 5.05 22.41 23.75 48.795.00 9.40 29.12 51.71

1879 4436 1518 1756Total 19.60 46.26 15.83 18.31

"adjusted for missing data.Spearman Correlation = 0.458.

Course N

Public SpeakingYes 3236

No 6587Oral Communication

Yes 3017

No 6803

'P<O.OOOt

TABLEXII.Program arrangement and communicationapprehension

may be initially attracted to pharmacy because of a perceivedlack of communication. Students pursuing a postgraduatePharmD program could be expected to be more knowledgeable

about curriculum components and practice expectations in-volving communications such as patient counseling. in-serviceeducation, hospital rounds with physicians, etc. It is logical thatthese communication expectations might screen out high CApeople and that consequently only those students who had lowerlevels of anxiety about communicating would be attracted to thepostgraduate PharmD.

The coordinator questionnaire sought information on thedegree to which various factors were weighted in the admissionsdecision. Unfortunately, few coordinators were able to supplysuch information in a quantitative form. For purposes of thisresearch. therefore, this analysis has been eliminated. Anyconclusions would have been tenuous, at hest due to insufficientdata.

CONCLUSIONS

Approximately I in 5 pharmacy students(similar to the generalpopuhltion) has high communication apprehension. There iswide variability within and between schools. The proportion ofhigh CA individuals in different schools ranged from 4 percentto nearly 30 percent. Thesepeople are likely to becomehigh CApharmacists who will not actively engage in communicationwith patients or may be ineffective if they do so.

In addition, over one-third of pharmacy students considerthemselves shy. The proportion varies from 25 percent to 42percent at different schools. Approximately 40 percent of theseshy individuals don't consider their shyness a problem eventhough many of them are highly communication apprehensive.These shy individuals are also likely to avoid communicationsituations much of the time.

The more anxiety a communication context causes.the lessimportance a student attaches to that type of communication. Itappearsanattempt is being madeto make the importance of oralcommunication consistent with the person's cognitions: ineffect, to rationalize the avoidance of communication.

Interviews as a part of the admissions process may bepartially successful in screening out the extremely high CAapplicants. but further investigation is necessaryon this aspect.

At leastone out of five pharmacy students. and possihly ashigh as one in three, will avoid communication as far aspossible.

SUGGESTED APPROACHES TO SOLUTION OF THEPROBLEM

Three treatment modes for those who avoid communicationhave been suggestedin the literature. "When the nature of theproblem is assumed to stem from inadequate communicationskills, an intensive skilIs training program is advocated. Sec-ond, when the problem is viewed as anxiety based, relaxation

TABLE XIII.Anticipated degree and communicationapprehension

therapy is the proposed solution. Finally, cognition therapy isadvocated for those whose problem is presumed to stem frominappropriate cognition about self and communication"(2).

For the one in five pharmacy students who avoid com-munication, the preferred treatment is systematic de-sensitization(21). Systematic desensitization is a behaviormodification technique involving progressive relaxation juxta-posed with hierarchial anxiety-provoking stimuli. The indi-vidual is trained to relax in increasinglydifficultsituations.

A word of caution. For thosewho havehigh CA, systematicdesensitization should be provided. and it should be providedbefore any other component for maximum success. For studentswithout high CA. this component is not relevant.

The following list of references is recommended for thmcseeking to implement a systematic desensitization prol-'ramtoovercome high CA.

I. Paul. Gordon L.. Illsight I'S. V('.H'nsitization in PI.\"cho-therapy: All EXl'aime/lf ill Anxh.ty Reduction, StanfordUniversity Press. Stanford CA. 1966.

2. Paul, Gordon L.. "Two Year Follow-Upof SystematicDesensitizationin TherapyGroups." J. AhnormalP.IH-Ir..73, 199-230(1968).

3. McCroskey, Jamesc. Ralph. David C, and Barrick.James E., "The Effect of SystematicDesensitizationonSpeech Anxiety," Speech Teacher, 19, 32-36 (1970).

4. McCroskey. James C. "The Implementation of a Large-Scale Program of Systematic Desensitization for Com-munication Apprehension," Spe('ch T('(leher, 21, 255-2M( 1972).

5. Nichols, Jack Goo "An Investigation of the Effects ofVaried Ratesof Training on Systematic Desensitization forInterpersonal Communication Apprehension." Un-published dissertation. Michigan State University. 1969.

6. Ertle. Charles D., ..A Study of the Effect of HomogeneousGrouping on Systematic Desensitization for the Reductionof Interpersonal Communication Apprehension," Un-published dissertation. Michigan State University, 1969.

7. Sheehan, Angela Moo "The Effects of Systematic De-sensitization and Communication Exposure on SpeechAnxious Students," Unpuhlished thesis, Illinois Slate Uni-versity, 1971.

8. Berger, Bruce A., Baldwin, H. John, McCroskey. JamesC, and Richmond, Virginia P., "Implementation of aSystematic Desensitization Program and Classroom In-struction to Reduce Communication Apprehension inPharmacyStudents," Am..I. Pharm. Educ., 46,227-234( 1(82).

9. McCroskey, James C, Richmond, Virginia P., Berger,Bruce A., and Baldwin, H. John, "How to Make A GoodThing Worse: A Comparison of Approaches to HelpingStudents Overcome Communication Apprehension,"Communications, in press.

100 American Journal of Pharmaceutical Education Vol. 47, Summer 1983

MeanProgram N PRCA score F

1-4:BS degree 2058 65.190-5: BS degree 1243 65.30

2.14"2-3: BS degree 4951 65.39PharmD (first degree) 551 63.55

'P<O.092.

Mean

Degree N PRCA F

BS Pharmacy X723 65.29PharmD 643 63.XO

4.yO"

PharmD (postgraduate) 132 61.12

'P<O.OO23.

~o. .McCroskey, James C., "On Communication Competenceand Communication Apprehension: A Response to Page."Commun. Educ., 29,109-111 (19HO).

II. McCroskey, James C., "Oral Communication Apprehen-sion: A Summary of Recent Theory and Research, " HumallCommun. Res., 4, 78-96 (1977).

Am. J. Plwrm. Edu,'" 47, 95-102(1983); reccivctl 8lIM!2. acccptctl 2/7l83..'

References

(I) Baldwin, H.1., McCroskey, J.C. and Knutson, 1'.1., Am. J. Pllarm.Educ., 43, 91(1979).

(2) Kelly, L., Hum. Commul/. Res., 8, 99(982).(3) Burgoon, J., Commul/. MOl/og., 43, 60(976).(4) Sokoloff, K.A., amI Phillips, G.M. J. COmml4ll.Oi.."rtl., 9, 331(1976).(5) McCroskey, J.C., Hum. Commul/. Res., 4,78(1977).(6) Zimbardo, P.G., Pilkonis, P.A., and Norwood, R.M., Psycll. Today, 8,

68(1975). .(7) McCroskey, J.C., and Richmond, V.P., Central Stales Speech J.. (in

press).~ -

>=,,~

APPENDIX A: PHARMACY STUDENT QUESTIONNAIRE

(8) Smith, D.L., Can. Plwrm. J., 11,336(1977).(9) The Dichter Institute fOf Motivational Research Inc., Communicating the

Vallie o/CoI/Il,n'ht'llsi\-e Plwrmucelllical 5en'il'e.\ /tJIIII'COII.mmer, Amer-ican Pharmaceutkal Association, Washington DC (1973), p. 14.

(10) Daly, LA. and McCroskey, J.e., J. Counsel. Psych., 22, 309(1975).(I I) Berger, B.A. and McCroskey, J.C.,Am.J. Pharm. Edlll'., 46,132(1982).(12) Berger. B.A., Baldwin, H.1., McCroskey, J.C. and Richmond, V.P.,

ibid., 46, 227(1982).(13) McCroskey, J.C., Speech Monog., 37, 269(1970).(14) McCroskey, J.c., Commun. Monog., 45, 192(1978).(IS) Zimbardo, P.G.. Shynes.\, Atldison-Wesley, Reading MA, 1977.(16) Pilkonis, P.A., J. Persollal.. 45, 596(1977).

(11) Speedie, S.M., Am. J. Pharm. Educ., 45, 399(11)81).(18) Churchill, G.A., Markelil/g Research Melhodological Foundalions, Dry-

den Press, Hinsdale IL (1976).(II) Kish, L., Sun-ey Sampling, John Wiley and Sons, New York NY (1978).(20) Nunnally, T.C., Psychometric Theory, McGraw-Hili, New York NY

(1978).

(21) McCroskey, J.C., Richmond, V.P., Berger, B.A., Baldwin, H.J., Com-munications, in press.

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This is an anonymous questionnaire. Please do not indicate your name on this fonn. Please complete all the questions.

1-2. Your age3, Your sex (circle one) (I) Male, (2) Female4, Race/Ethnic group (circle one) (I) White (2) Black (3) Oriental (4) Native American (5) Hispanic (6) Other5. For most of my life I have lived (circle one):

(I) On a fann(2) In a small town (under 5,000 population)(3) In a medium sized town (5,000-50,000 population)(4) In a urban area (large city or suburb of a large city)(5) Other (please specify)

Directions:Thisinstrumentis composedof 24statementsconcerningyourfeelingsaboutcommunicationwithotherpeople.Pleaseindicatein thespaceprovidedthedegreeto whicheachstatementappliesto youby markingwhetheryou(I) StronglyAgree,(2) Agree,(3) AreUndecided,(4)Disagree, or (5) Strongly Disagree with each statement. There are no right or wrong answers. Many of the statements are similar to other statements.Do not be concernedaboutthis. Workquickly,just recordyour first impression.

6. I dislikeparticipatingin groupdiscussions.7. Generally,I am comfonablewhile participatingin groupdiscussions.8. I am tenseand nervouswhileparticipatingin groupdiscussions.9. I like to get involvedin groupdiscussions.

- 10. Engagingin a groupdiscussionwith newpeoplemakesme tenseand nervous.- I I. I am calmand relaxedwhileparticipatingin groupdiscussions.- 12. Generally,I am nervouswhenI haveto participatein a meeting.- 13. UsuallyI amcalmand relaxedwhileparticipat.ingin meetings.- 14. I am verycalmand relaxedwhenI amcalleduponto expressan opinionat a meeting.- 15. I am afraidto expressmyselfat meetings.- 16. Communicatingat meetingsusuallymakesme uncomfortable.- 17. I am veryrelaxedwhenansweringquestionsat a meeting.- 18. Whileparticipatingin a conversationwitha newacquaintance,I feel verynervous.- 19. I haveno fearof speakingup in conversations.- 20. OrdinarilyI am very tenseand nervousin conversations.- 21. OrdinarilyI am verycalmand relaxedin conversations.- 22, Whileconversingwitha newacquaintance,I feel very relaxed.- 23. I'm afmidto speakup in conversations.- 24. I have no fear of givinga speech. .- 25. Certainpartsof my bodyfeel verytenseand rigid whilegivinga speech.- 26. I feel relaxedwhilegivinga speech.- 27. My thoughtsbecomeconfusedandjumbledwhenI am givinga speech.- 28..1 face theprospectof givinga speechwithconfidence.- 29. Whilegivinga speechI get so nervous,I forgetfacts I reallyknow.

30. Do you presentlyconsideryourselfto be a shy person'?(I) - Yes (2) - No

31. If you answered "no" to number 30, was there ever a period in your life during which you considered yourself to be a shy person?(I) - Yes (2) - No

AmerIcan Journal of Pharmaceutical Education Vol. 47, Summer 1983 101

32. If you al'!~wered"yes" to number 30, do you consider your shyness to be a problem? In other words, would you rather not be shy?(I) - Yes (2) -- No

Immediate behaviors are those communication behaviors that reduce distance between people. Immediate behaviors may actually decrease thephysical distance, or they may decrease the psychological distance. The more immediate a person is the more likely he/she is to communicate at closedistances. smile, engage in eye contact, use direct body orientations. use overall body movement and gestures. touch others, relax. and be vocallyexpressive. In other words, we might say that an immediate person is perceived as friendly and warm.

On the scales helow please circle the ",,,nlwr j;'/r (.(It'llflair (It ;/(/j('("(il'('.\'which best describes your n'aclion 10Ihe followi,,!(slalelllcnl:I am a very immediate person when I am communicating with olhers.33. Agree I 2 3 4 5 6 7 Disagree34. True I 2 3 4 5 6 7 False35. Correct I 2 3 4 5 6 7 Incorrect36. Right I 2 3 4 5 6 7 Wrong37. Yes I 2 3 4 5 6 7 No

How important are the following forms of communication in your profession? Please rate using the following: (I) Not important; (2) Moderatelyimportant; (3) Very Important.38. One-to-one interpersonal communication.39. Group communication.40. Public speaking.

Please check the course(s) below which you have taken or are currently taking:41. Public speaking42. Oral communication

43-44. What year do you anticipate graduation (circle one) 81828384858687.

45. What degree will you receive? (circle one)(I) BS Pharmacy (2) PharmD (1st degree) (3) PharmD (postgraduate)(4) Olher- _0-- ~~ -~- ~ -- ~ ~ ---~ -'>0- ~ ~ ""'-- c::

A Planned Program for Evaluation and Development of ClinicalPharmacy Faculty

Robert E. Martin, Donald Perrier and Carl E. Trinca1,2

College of Pharmacy. Univer.fityof Arizona. Tucson AZ 8572/

Institutions facing severe financial retrenchment and demands for accountability and cost effectiveness areconcerned with faculty evaluation for promotion and tenure. Faculty evaluation typically falls short as ademonstrated accomplishment, but consistently heads the list of intended purposes at most colleges anduniversities. The intent is to provide faculty members with information regarding their performance in the areasof: (i) teaching; (ii) service to the institution, community and patient; and (iii) research and scholarly publication.Hopefully, faculty will be motivated and capable of improvement when feedback is received. Occasionally,institutions provide programs and resources to help faculty members improve. This paper describes evaluationand development programs for clinical faculty in the Department of Pharmacy Practice, College of Pharmacy,University of Arizona.

INTRODUCTION

Faculty evaluation occurs in order to make decisions regarding.promotion and/or reward and to improve perfom1ance-twopurposes which should not be mutually exclusive( I). The intentof faculty evaluation is to provide faculty members with infor-mation regarding their performance in the areas of: (i) teaching;(ii) service to the institution. community. and patient; and Wi)research and scholarly publication. Hopefully. faculty will be

motivated and capable of improvement when fcedbat:k i\received.

I Corresponding author: Present addrcss: Amcrican Association of Collcl!cs01PhaOllacy. 4630 Monlgomcry Avcnue. Suitc 20I. Bethesda MD 20XI~.

2 The authors would like 10 acknowledge the assistance of Ronen [)orr andKeith E. Likcs for suhmilling oril!inal drafts of thc rescarch and scrviceportions of the Guidelines for Prnmotion and Conlinuing Appointmcnldocumcnt.

102 American Journal of Pharmaceutical Education Vol. 47, Summer 1983