Pharmacy students’ perceptions of a transition to a virtual curriculum and their mental health implications


  • Katherine Muilenburg University of North Texas Health Science Center College of Pharmacy, Texas, United States
  • Crystal K Howell University of North Texas Health Science Center College of Pharmacy & University of Texas Southwestern Medical Center, Texas, United States
  • Annesha White University of North Texas Health Science Center College of Pharmacy, Texas, United States



Mental health, Pharmacy school, Student, Virtual


Objective: The purpose of this study was to assess pharmacy students' satisfaction with a transition to a remote pharmacy curriculum in the pandemic setting.  

Methods: This was a cross-sectional study conducted in Autumn 2020. Participating pharmacy schools distributed an anonymous survey link to their pharmacy students. The survey evaluated student perceptions of virtual learning, barriers to success, solutions, mental health, and the validated Perceived Stress Scale (PSS-10). Descriptive and inferential statistics were used to analyse the data.   

Results: A total of 488 students responded to the survey. The majority of participating students were female (78%), 25-30 years old (68%), and racially diverse. Feelings of isolation were reported by 62% of students. Three-quarters of students disagreed or strongly disagreed that their motivation to study increased during quarantine. During quarantine, the PSS-10 revealed a statistically significant decline in mental health.    

Conclusion: This study identified barriers and solutions to student success in a virtual curriculum. The results also highlighted the need for support for pharmacy students' mental health resources and advocacy.

Author Biographies

Katherine Muilenburg, University of North Texas Health Science Center College of Pharmacy, Texas, United States

Department of Pharmacotherapy

Crystal K Howell, University of North Texas Health Science Center College of Pharmacy & University of Texas Southwestern Medical Center, Texas, United States

Assistant Professor, Department of Pharmacotherapy & Department of Pharmacy

Annesha White, University of North Texas Health Science Center College of Pharmacy, Texas, United States

Department of Pharmacotherapy

References n.d. Commitment to Clinician Well-Being and Resilience | AACP. [online] Available at:

Abarghouie, M. H. G., Omid, A., & Ghadami, A. (2020). Effects of virtual and lecture-based instruction on learning, content retention, and satisfaction from these instruction methods among surgical technology students: A comparative study. J Educ Health Promot, 9, 296.

APhA, A., AACP, NABP, NASPA. (2019). Enhancing Well-Being and Resilience Among the Pharmacist Workforce: A National Consensus Conference. Paper presented at the National Consensus Conference, Chicago, IL.

Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27-45.

Beall, J. W., DeHart, R. M., Riggs, R. M., & Hensley, J. (2015). Perceived Stress, Stressors, and Coping Mechanisms among Doctor of Pharmacy Students. Pharmacy (Basel), 3(4), 344-354.

Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet, 395(10227), 912-920.

Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med, 15(5), 593-600.

Chisholm-Burns, M. A., Spivey, C. A., Jaeger, M. C., & Williams, J. (2017). Associations Between Pharmacy Students' Attitudes Toward Debt, Stress, and Student Loans. Am J Pharm Educ, 81(7), 5918.

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A Global Measure of Perceived Stress. Journal of Health and Social Behavior, 24(4), 385-396.

Demeke HB, M. S., Marks S, et al. (2021). Trends in Use of Telehealth Among Health Centers During the COVID-19 Pandemic — United States, June 26–November 6, 2020. MMWR Morb Mortal Wkly Rep, 70, 240-244.

Dresser, J. D., Whitfield, K. M., Kremer, L. J., & Wilby, K. J. (2021). Exploring How Postmillennial Pharmacy Students Balance Life Priorities and Avoid Situations Known to Deplete Resilience. American Journal of Pharmaceutical Education, 85(4), 8369.

Engle, J. P. (2020). Assuring Quality in Pharmacy Education During a Time of Crisis. Am J Pharm Educ, 84(6), ajpe8135.

Falk G, R. P., Carter JA, Nicchitta IA, Nyhot EC. (2021). Unemployment Rates During the COVID-19 Pandemic: In Brief. Congressional Research Service Retrieved from

Fischbein, R., & Bonfine, N. (2019). Pharmacy and Medical Students' Mental Health Symptoms, Experiences, Attitudes and Help-Seeking Behaviors. Am J Pharm Educ, 83(10), 7558.

Folkman, S., & Moskowitz, J. T. (2000). Stress, Positive Emotion, and Coping. Current Directions in Psychological Science, 9(4), 115-118.

Garber, M. C., Huston, S. A., & Breese, C. R. (2019). Sources of stress in a pharmacy student population. Curr Pharm Teach Learn, 11(4), 329-337.

Garland, E. L., Gaylord, S. A., & Fredrickson, B. L. (2011). Positive Reappraisal Mediates the Stress-Reductive Effects of Mindfulness: An Upward Spiral Process. Mindfulness, 2(1), 59-67.

Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. J Psychosom Res, 57(1), 35-43.

Hagemeier, N. E., & Dowling-McClay, K. (2021). The Impact of Transitions Related to COVID-19 on Pharmacy Student Well-being. American Journal of Pharmaceutical Education, 85(4), 8291.

Hamilton, L. A., Suda, K. J., Heidel, R. E., McDonough, S. L. K., Hunt, M. E., & Franks, A. S. (2020). The role of online learning in pharmacy education: A nationwide survey of student pharmacists. Curr Pharm Teach Learn, 12(6), 614-625.

Ibrahim, M. B., & Abdelreheem, M. H. (2015). Prevalence of anxiety and depression among medical and pharmaceutical students in Alexandria University. Alexandria Journal of Medicine, 51(2), 167-173.

Liu, I., Buige, A., Bulfin, M. P., Osae, L., Wingo, B., Frick, A., & Harris, S. C. (2020). Assessment of mental health needs and barriers to care in students enrolled in doctor of pharmacy and pharmaceutical sciences programs. Curr Pharm Teach Learn, 12(6), 641-647.

Liu, X., Kakade, M., Fuller, C. J., Fan, B., Fang, Y., Kong, J., . . . Wu, P. (2012). Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic. Compr Psychiatry, 53(1), 15-23.

Marshall, L. L., Allison, A., Nykamp, D., & Lanke, S. (2008). Perceived stress and quality of life among doctor of pharmacy students. Am J Pharm Educ, 72(6), 137.

McKnight-Eily LR, O. C., Strine TW, et al. (2021). Racial and Ethnic Disparities in the Prevalence of Stress and Worry, Mental Health Conditions, and Increased Substance Use Among Adults During the COVID-19 Pandemic — United States, April and May 2020. MMWR Morb Mortal Wkly Rep, 70, 162-166.

Moreland A, H. C., Tynan MA, et al. . (2020). Timing of State and Territorial COVID-19 Stay-at-Home Orders and Changes in Population Movement — United States, March 1–May 31, 2020. MMWR Morb Mortal Wkly Rep, 69, 1198-1203.

Pan, J. D., Chang, S.-H., & Yu, Y.-Y. (2005). A Support Group for Home-Quarantined College Students Exposed to SARS: Learning from Practice. THE JOURNAL FOR SPECIALISTS IN GROUP WORK, 30, 363-374.

Prunuske, A. J., Henn, L., Brearley, A. M., & Prunuske, J. (2016). A Randomized Crossover Design to Assess Learning Impact and Student Preference for Active and Passive Online Learning Modules. Med Sci Educ, 26, 135-141.

Registry, A. f. T. S. a. D. (2021, April 16, 2020). Retrieved from

Roberts, L. W., Warner, T. D., Lyketsos, C., Frank, E., Ganzini, L., & Carter, D. (2001). Perceptions of academic vulnerability associated with personal illness: a study of 1,027 students at nine medical schools. Collaborative Research Group on Medical Student Health. Compr Psychiatry, 42(1), 1-15.

Rotenstein, L. S., Ramos, M. A., Torre, M., Segal, J. B., Peluso, M. J., Guille, C., . . . Mata, D. A. (2016). Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. Jama, 316(21), 2214-2236.

Schimming, L. M. (2008). Measuring medical student preference: a comparison of classroom versus online instruction for teaching PubMed. J Med Libr Assoc, 96(3), 217-222.

Silva, R. G., & Figueiredo-Braga, M. (2018). Evaluation of the relationships among happiness, stress, anxiety, and depression in pharmacy students. Curr Pharm Teach Learn, 10(7), 903-910.

Song S, W. A., Kucik JE. (2021). Use of Selected Recommended Clinical Preventive Services — Behavioral Risk Factor Surveillance System, United States, 2018. MMWR Morb Mortal Wkly Rep, 70, 461-466.

Sprang, G., & Silman, M. (2013). Posttraumatic stress disorder in parents and youth after health-related disasters. Disaster Med Public Health Prep, 7(1), 105-110.

Staff, A. (2021, January 1, 2021). A Timeline of COVID-19 Developments in 2020. Retrieved from

Tak, C., Henchey, C., Feehan, M., & Munger, M. A. (2019). Modeling Doctor of Pharmacy Students' Stress, Satisfaction, and Professionalism Over Time. Am J Pharm Educ, 83(9), 7432.

Vahratian A, B. S., Terlizzi EP, Schiller JS. (2021). Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic — United States, August 2020–February 2021. MMWR Morb Mortal Wkly Rep, 70, 490-494.




How to Cite

Muilenburg, K., Howell, C. K., & White, A. (2022). Pharmacy students’ perceptions of a transition to a virtual curriculum and their mental health implications. Pharmacy Education, 22(1), p. 696–705.



Research Article