The Pursuit of Pharmacy Residency Training and the Theory of Planned Behavior
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Objectives: The primary objective is to examine the motivating factors and barriers to pursuing residency training using the Theory of Planned Behavior (TPB) framework to determine the contribution of the constructs attitude (A), subjective norm (SN), and perceived behavioral control (PBC) on the intention to apply for a pharmacy residency. The secondary objective will be to identify the past behaviors and specific behavioral beliefs that indirectly predict pharmacy students’ intention to apply for a postgraduate residency program. Methods: A cross-sectional, 26-item, online questionnaire was developed from a literature review of factors found to influence the decision to pursue residency training. A total of 983 second and third-year pharmacy students from four Texas pharmacy schools were surveyed. Descriptive statistics and multiple linear regression analyses were utilized to assess the study objectives. Results: The response rate was 25.5% (251/983). The TPB model was found to explain 50% of the variance in intention to apply for a residency (R2 = 0.50, p < 0.001). Attitude, SN, and PBC were significant predictors of intention (β = 0.32, 0.58, and 0.36, respectively, p < 0.001). The results of past behavior show that attending ASHP’s Midyear meeting or other residency showcase is a significant predictor of intention (β = 0.71, p = 0.006). Significant predictors of A were the beliefs a residency would increase confidence in practicing pharmacy (β = 0.36, p < 0.001) and help achieve career goals (β = 0.16, p < 0.02). Significant predictors of SN were the social influence of faculty members (β = 0.10, p = 0.003) and family (β = 0.08, p = 0.02). Significant predictors of PBC were the beliefs that financial obligations (β = 0.20, p = 0.006), feeling afraid of the competition and/or not matching (β = 0.24, p < 0.001), needing to relocate (β = 0.09, p = 0.04), and the lengthy application and/or interview process (β = 0.12, p = 0.04) would make it more difficult to apply for a residency. Conclusions: The TPB model among our study sample was useful in predicting pharmacy students’ intention to apply for a residency. All TPB constructs were significant predictors of intention, with SN being the strongest predictor. Therefore, interventions that target students’ A, SN, and PBC may be valuable to increase their intention, especially the specific beliefs found to indirectly influence intention. Future research into ways in which these motivating factors can be encouraged and perceived barriers can be addressed will increase interest and participation in postgraduate residencies, and thus promote the completion of residency training as the professional norm for pharmacists. Additionally, future studies assessing whether intention translates into students completing the residency application process are needed to strengthen these findings.