Report of the 2014-2015 Academic Affairs Standing Committee: Addressing Affordability, Accessibility, and Accountability.

Background and Charges According to the Bylaws of the American Association of Colleges of Pharmacy (AACP), the Academic Affairs Committee shall consider "... the intellectual, social, and personal aspects of pharmaceutical education. It is expected to identify practices, procedures, and guidelines that will aid faculties in developing students to their maximum potential. It will also be concerned with curriculum analysis, development, and evaluation beginning with the preprofessional level and extending through professional and graduate education. The Committee shall seek to identify issues and problems affecting the administrative and financial aspects of member institutions. The Academic Affairs Committee shall extend its attention beyond intra-institutional matters of colleges of pharmacy to include interdisciplinary concerns with the communities of higher education and especially with those elements concerned with health education." Consistent with identifying issues and problems affecting the administrative and financial aspects of member institutions, President Patricia Chase charged the 2014-15 Academic Affairs Standing Committee to examine access, affordability, and accountability in health professions education, specifically implications and expected outcomes for academic pharmacy from the perspective of the learner and faculty. One must take on a systems approach when discussing the three pressures on college education: affordability; access and accountability. Coined the "Iron Triangle" by John Immerwahr et al., these pressures must be kept in balance as an intervention in one area affects one or both of the other areas. (1) For example, a drop in the numbers of applicants and intense competition from increasing numbers of pharmacy programs over recent years has forced colleges of pharmacy to consider a broader and more varied applicant pool. For some colleges, efforts to market to and recruit this wider audience has resulted in increased costs. Additional programming is often needed to better prepare the diverse matriculating student population for the challenges of professional graduate education. Finally, greater demands for accountability and assessment of the diverse student population from Accreditation Council for Pharmacy Education (ACPE) will also require reallocation of funds to staff assessment activities. Given all these factors influencing the "Iron Triangle", it can be a difficult balance to achieve in pharmacy education. The purpose of this report is to examine affordability, accessibility, and accountability from both higher education and pharmacy education perspectives and propose considerations for the key stakeholders, mainly colleges/ schools, students, and faculty to deliver a pharmacy education that is desirable, attainable and of high quality. The balance between affordability, accessibility, and accountability will also be considered along with considerations of what may be perceived as the inevitable arrival of disruptive innovation to higher education that creates a simpler, more affordable educational product for a new group of students who, in most cases, were not buying (or succeeding in) the current system of higher education. (2) Affordability Higher education may have become too expensive and too cumbersome to maintain balance of the "Iron Triangle" and to successfully achieve its academic mission. The increased price of higher education with a much slower increase in family incomes has led to increased indebtedness; and, for some students, pressures to work while in school or even to defer school entry. (3) Is higher education unaffordable? Affordability has been defined as . .the degree to which an institution or program provides a combination of tuition, fees, grants, loans, and time-to-completion that make worthwhile a student's investment in his/her education." (4) Before the financial crisis of 2008, enrollments increased rather than declined despite increases in tuition over the years. …