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JAOA/AACOM Medical Education  |   March 2019
Just Say Know to Drugs! A High School Pharmacology Enrichment Program for a Rural Population
Author Notes
  • From the West Virginia University in Morgantown (Dr Hamrick); West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg (Dr Carrier and Student Doctors Fox and Dhir); and Marshall University in Huntington, West Virginia (Dr Harter). 
  • Financial Disclosures: None reported. 
  • Support: This study was supported by the WVSOM Rural Health Initiative, the West Virginia Governor's STEM Initiative, and in-kind institutional support. 
  •  *Address correspondence to Raeann L. Carrier, PhD, WVSOM, 400 Lee St N, Lewisburg, WV 24901-1128. Email: rcarrier@osteo.wvsom.edu
     
Article Information
Medical Education
JAOA/AACOM Medical Education   |   March 2019
Just Say Know to Drugs! A High School Pharmacology Enrichment Program for a Rural Population
The Journal of the American Osteopathic Association, March 2019, Vol. 119, 199-207. doi:https://doi.org/10.7556/jaoa.2019.031
The Journal of the American Osteopathic Association, March 2019, Vol. 119, 199-207. doi:https://doi.org/10.7556/jaoa.2019.031
Web of Science® Times Cited: 1
Abstract

Context: Just Say Know to Drugs! is a summer pharmacology enrichment program for high school students. First-year osteopathic medical students serve as teachers, introducing students to pharmacology while acquiring teaching skills.

Objective: To assess the effects of a pharmacology program on high school students and to understand the effects of teaching this program on first-year osteopathic medical students.

Methods: The influence of a pharmacology STEM (science, technology, engineering, and mathematics) enrichment program on high school students’ career interests and student teacher preparedness was determined by a pre- and posttest, as well as a postprogram survey.

Results: Data from all 37 participating high school students and 10 of 16 student teachers (medical students and undergraduate assistants) were evaluated in the study. Survey findings suggested that this STEM program increased student awareness and knowledge of pharmacology, osteopathic medicine, and scientific research. Furthermore, student teachers thought that they developed the necessary skills to communicate and educate populations with diverse science backgrounds and comprehension levels. The immersion of high school students in the scientific content significantly increased student awareness of pharmacology (paired t test, P<.0001).

Conclusion: The Just Say Know to Drugs! program delivered benefits for both high school students and student teachers.

High school pipeline programs promoting STEM (science, technology, education, and mathematics) have become conventional mechanisms to introduce these fields as possible careers. Although STEM content can be integrated into the regular curriculum, many of these pipeline, or enrichment, activities take place outside school time.1 These activities include after school programs, summer camps, college immersion programs, and teacher training activities. A supportive home environment may help interested students remain engaged with STEM-related coursework while they are still in high school; however, significant STEM attrition occurs during postbaccalaureate studies, suggesting that early parental support may not lead to long-term student interest in these fields.2-4 Despite the growing need for employees in STEM fields, the current number of US high school pipeline programs struggle to meet the demand.5,6 Consequently, the demand for successful STEM programming is still relevant. 
Many of these STEM enrichment programs have focused on general sciences, but some have provided more specific, discipline-based opportunities. For example, Duke University used pharmacology as a mechanism to enhance science literacy and science career awareness for high school students.7-9 The results of this program suggest that the integration of a novel topic improves understanding of general sciences and increases student STEM understanding both after the immersion into the discipline and when tested 9 months later.7-9 Furthermore, Goldsmith et al10 teamed with a local middle school to investigate early exposure to health careers and help develop interest in pharmacy and physician assistant programs. Their work indicated that hands-on experiences increase interest in and awareness of these fields. Thus, incorporation of pharmacology into STEM enrichment programs engages students with the material and encourages them to explore these opportunities. 
Many STEM programs flourish in urban cities, owing to the broad infrastructure of larger university systems11-15; however, the impact in a rural community can be just as beneficial. The Louisiana State University High School Science Initiative was created in 1985 to support rural underrepresented minority (URM) students with an interest in health and science.16 In 1997, the 773 URM students who had participated in the program were surveyed, and more than 90% were attending Louisiana colleges.16 Similarly, West Virginia University (WVU) created the Health Sciences and Technology Academy in 1994 to help West Virginia high school students overcome educational and economic barriers to STEM careers.17 As of 2014, 96% of the students had matriculated to college, and 65% graduated with a degree in a STEM-related field.18 Furthermore, the programs OKStars and Native OKStars, STEM enrichment camps, were developed at Oklahoma State University Center for Health Sciences for local high school students, with an emphasis on the recruitment of Native American high school students.19 High school students who have participated in the program rated their experiences highly, especially their exposure to medical students.19 These programs highlight the importance and overall success of STEM activities focusing on a rural population. 
Pharmacology STEM programs broaden awareness of a novel field, and programs in rural populations have shown positive correlations to college matriculation. However, data are lacking on whether the impact of a pharmacology-focused STEM program for rural high school students would increase their knowledge of general sciences and pharmacology, enhance their awareness of osteopathic medicine, and introduce them to careers in the health and science fields. 
The Just Say Know to Drugs! program at the West Virginia School of Osteopathic Medicine (WVSOM) has trained medical students and undergraduates to engage and educate high school students, and it offers high school students early exposure to pharmacology, as well as osteopathic medicine, health science careers, and research. 
The purpose of this study was to assess the effects of a pharmacology program on high school students and to understand the effects of teaching this program on first-year osteopathic medical students and undergraduates. We hypothesized that participation in Just Say Know to Drugs! would increase high school student interest in pharmacology and the health sciences. 
Methods
The Just Say Know to Drugs! summer program has been held annually at WVSOM. Data for the study were collected over a 5-year period (2013-2017). The survey was approved by the WVSOM institutional review board, and parental/guardian consent for high school participants was obtained before survey distribution. 
This program ran from 8:30 am to 4:30 pm each day for 1 week. The student teachers developed daily lectures followed by applied group activities. Lectures included pharmacology topics, osteopathic medicine, careers in the health sciences, and research. An overriding theme woven into the lectures was the interrelationship of structure and function of the body. 
Participants
High school students were recruited through social media, newspaper advertisements, emails to local high school affiliates, and flyers distributed at local high school events. Interested students in the ninth to twelfth grades and recent graduates applied to the program by submitting a 1-page interest essay and recommendation letter. 
First-year osteopathic medical students were informed of the program and encouraged to apply to be teachers. The application process included both an interview and presentation. Medical students were selected by a faculty/staff panel, one of whom was a member of the institution's Rural Health Initiative, a program focused on training medical students to practice in rural primary care. Medical students collaborated to implement the curriculum with feedback and training from the program creator and director (R.L.C.). An undergraduate student working toward a bachelor's degree in the health care or other STEM field was recruited each year for assistance. 
Pre- and Posttests
On the first and last day of the program, students were administered the same comprehensive test that assessed their knowledge of biology, chemistry, and pharmacology. The 35-question test was modified from the work of Kwiek et al8 and Sikes and Schwartz-Bloom,21 and additional questions were created specific to this program's curriculum. Test performance was analyzed with a paired t test in GraphPad Prism Software (version 7.01). 
Surveys
All high school students were asked to complete a survey after completing the posttest. The survey was anonymous and voluntary. After completion of the fifth year of camp, all medical students and undergraduate assistants who had participated in the camp were sent a voluntary and anonymous survey to complete through Survey Monkey. One-follow-up email was sent to the medical students and undergraduate assistants. Surveys used a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5). The survey data for the student teachers were a component of quality of assessment for the program. Raw data or mean scores and SDs are presented. 
Results
During the 5-year study period, 37 high school students, 10 medical students, and 6 undergraduate assistants participated in the program. All 37 high school students completed the survey (100% response rate), and 10 student teachers or undergraduate assistants returned the survey (62.5% response rate). 
High School Students
The majority of students were female (23 [62%]), from West Virginia (27 [73%]; Table 1), and in the 10th and 12th grades (data not shown). Furthermore, students were interested in jobs primarily in the health sciences or STEM career areas. 
Table 1.
Demographics of High School Student Participants in the Just Say Know to Drugs! Program (N=37)
Characteristic Survey Responses, No. (%)
Gender
 Male 14 (38.0)
 Female 23 (62.0)
State of Residence
 Virginia 7 (19.0)
 West Virginia 27 (73.0)
 Other 3 (8.0)
After high school, I plan on doing the following (you may select more than 1)a
 Applying for a job in my career pathway 16 (43.2)
 Obtaining a certificate from a college/technical school 7 (18.9)
 Obtaining an associate's degree from a community college 2 (5.4)
 Obtaining a bachelor's degree from a 4-year college 19 (51.3)
 Obtaining a master's degree 14 (37.8)
 Obtaining a doctorate degree
  PhD 24 (64.9)
  DO 8 (21.6)
  MD 5 (13.5)
  PharmD 1 (2.7)
  Unsure 4 (10.8)
After high school, I plan on working at a job in the following career areas (select up to 3)a
 Health sciences 26 (70.3)
 Science, technology, engineering, and math 22 (59.5)
 Education and training 7 (18.9)
 Science research 6 (16.2)
 Architecture and construction 3 (8.1)
 Business management and administration 3 (8.1)
 Agriculture, food, and natural resources 2 (5.4)
 Human services 2 (5.4)
 Law, public safety, corrections, and security 2 (5.4)
 Marketing 2 (5.4)
 Arts, audiovisual technology, and communications 1 (2.7)
 Government and public administration 1 (2.7)
 Information technology 1 (2.7)
 Liberal arts and sciences 1 (2.7)

a Post–high school plans and career areas with zero responses were excluded from the data.

Table 1.
Demographics of High School Student Participants in the Just Say Know to Drugs! Program (N=37)
Characteristic Survey Responses, No. (%)
Gender
 Male 14 (38.0)
 Female 23 (62.0)
State of Residence
 Virginia 7 (19.0)
 West Virginia 27 (73.0)
 Other 3 (8.0)
After high school, I plan on doing the following (you may select more than 1)a
 Applying for a job in my career pathway 16 (43.2)
 Obtaining a certificate from a college/technical school 7 (18.9)
 Obtaining an associate's degree from a community college 2 (5.4)
 Obtaining a bachelor's degree from a 4-year college 19 (51.3)
 Obtaining a master's degree 14 (37.8)
 Obtaining a doctorate degree
  PhD 24 (64.9)
  DO 8 (21.6)
  MD 5 (13.5)
  PharmD 1 (2.7)
  Unsure 4 (10.8)
After high school, I plan on working at a job in the following career areas (select up to 3)a
 Health sciences 26 (70.3)
 Science, technology, engineering, and math 22 (59.5)
 Education and training 7 (18.9)
 Science research 6 (16.2)
 Architecture and construction 3 (8.1)
 Business management and administration 3 (8.1)
 Agriculture, food, and natural resources 2 (5.4)
 Human services 2 (5.4)
 Law, public safety, corrections, and security 2 (5.4)
 Marketing 2 (5.4)
 Arts, audiovisual technology, and communications 1 (2.7)
 Government and public administration 1 (2.7)
 Information technology 1 (2.7)
 Liberal arts and sciences 1 (2.7)

a Post–high school plans and career areas with zero responses were excluded from the data.

×
A paired t test was conducted to compare the high school students’ test scores before and after the program. A significant difference was found (t37=9.55; P<.0001) between the mean (SD) pretest scores and posttest scores (45.4 [9.3] vs 63.5 [10.4], respectively). All students enjoyed learning and talking about science. Furthermore, students stated that the program increased their knowledge of pharmacology, osteopathic medicine, treatment of patients, and scientific research. The program also increased participant knowledge of how substances of abuse work and how addictions develop (Table 2). 
Table 2.
High School Student Responses to the Just Say Know to Drugs! Program Likert Scale Survey Questions (N=37)
Survey Question Responses, Mean (SD)a
I enjoy learning science. 4.70 (0.5)
I like talking about science. 4.63 (0.5)
I'll need science for my career/future job. 4.59 (0.8)
I would like to study more science than I do now.  4.59 (0.6)
Science is useful in everyday life. 4.54 (0.6)
I plan on studying science or engineering in college. 4.43 (0.9)
I expect to do as well or better than other students in my science class. 4.19 (0.8)
Being a scientist might be fun. 4.16 (0.8)
The science I learned has practical value to me. 4.16 (0.7)
I usually understand what we are doing in science. 4.16 (0.7)
I like to do science experiments. 4.04 (1.0)
I think I could do more difficult science work. 3.89 (0.8)
I think designing and conducting experiments would be challenging. 3.54 (0.8)
I enjoy recording and analyzing data. 3.50 (1.0)
I want to work in a hospital for my career. 3.32 (1.2)
Being a pharmacist would be exciting. 3.22 (1.2)
I worry about failing science tests. 2.57 (1.2)
Being in science class makes me feel stressed or nervous. 2.32 (1.2)
Before this program, I didn't know what pharmacology was. 2.58 (1.0)
The Just Say Know to Drugs! program taught me about pharmacology. 4.49 (0.5)
Before the program, I knew about osteopathic medicine and osteopathic manipulation.  2.84 (1.28)
The Just Say Know to Drugs! program provided a good understanding of what an osteopathic physician does.  4.38 (0.59)
During the Just Say Know to Drugs! program, I learned a lot about different types of scientific research. 4.54 (0.61)
Before the program, I thought drugs were the only way to treat illness and disease. 2.08 (0.93)
The Just Say Know to Drugs! program explained other treatments for illness and disease. 4.42 (0.50)
Before this program, I did not feel confident about my knowledge of drugs people abused (like alcohol, nicotine, and methamphetamine). 3.65 (1.03)
The Just Say Know to Drugs! program explained how drugs of abuse work and why people become addicted to them.  4.65 (0.48)
Before this program, I knew what type of career/future job I wanted. 3.78 (1.03)
The Just say Know to Drugs! program helped me decide on my career/future job. 3.62 (0.79)

a A 5-point Likert scale was used, from strongly disagree (1) to strongly agree (5).

Table 2.
High School Student Responses to the Just Say Know to Drugs! Program Likert Scale Survey Questions (N=37)
Survey Question Responses, Mean (SD)a
I enjoy learning science. 4.70 (0.5)
I like talking about science. 4.63 (0.5)
I'll need science for my career/future job. 4.59 (0.8)
I would like to study more science than I do now.  4.59 (0.6)
Science is useful in everyday life. 4.54 (0.6)
I plan on studying science or engineering in college. 4.43 (0.9)
I expect to do as well or better than other students in my science class. 4.19 (0.8)
Being a scientist might be fun. 4.16 (0.8)
The science I learned has practical value to me. 4.16 (0.7)
I usually understand what we are doing in science. 4.16 (0.7)
I like to do science experiments. 4.04 (1.0)
I think I could do more difficult science work. 3.89 (0.8)
I think designing and conducting experiments would be challenging. 3.54 (0.8)
I enjoy recording and analyzing data. 3.50 (1.0)
I want to work in a hospital for my career. 3.32 (1.2)
Being a pharmacist would be exciting. 3.22 (1.2)
I worry about failing science tests. 2.57 (1.2)
Being in science class makes me feel stressed or nervous. 2.32 (1.2)
Before this program, I didn't know what pharmacology was. 2.58 (1.0)
The Just Say Know to Drugs! program taught me about pharmacology. 4.49 (0.5)
Before the program, I knew about osteopathic medicine and osteopathic manipulation.  2.84 (1.28)
The Just Say Know to Drugs! program provided a good understanding of what an osteopathic physician does.  4.38 (0.59)
During the Just Say Know to Drugs! program, I learned a lot about different types of scientific research. 4.54 (0.61)
Before the program, I thought drugs were the only way to treat illness and disease. 2.08 (0.93)
The Just Say Know to Drugs! program explained other treatments for illness and disease. 4.42 (0.50)
Before this program, I did not feel confident about my knowledge of drugs people abused (like alcohol, nicotine, and methamphetamine). 3.65 (1.03)
The Just Say Know to Drugs! program explained how drugs of abuse work and why people become addicted to them.  4.65 (0.48)
Before this program, I knew what type of career/future job I wanted. 3.78 (1.03)
The Just say Know to Drugs! program helped me decide on my career/future job. 3.62 (0.79)

a A 5-point Likert scale was used, from strongly disagree (1) to strongly agree (5).

×
Student Teachers
Raw data for the student teacher survey responses are presented in Table 3. The number of responses for “strongly agree” and “agree” are combined in this paragraph to summarize results. Before the program, 6 respondents felt comfortable with their understanding of pharmacology, 8 wanted to pursue teaching as part of their career, and, although they thought they knew the expectations required to teach in a course (9 respondents), they were somewhat nervous about creating lectures (6 respondents). During the program, respondents felt challenged (6), but that did not increase their stress levels (2). Most noteworthy, they acknowledged feeling more comfortable with public speaking (8), and they had used skills developed during the program in their rotations/residencies (8). 
Table 3.
Student Teacher Responses to the Just Say Know to Drugs! Likert Scale Survey Questionsa Survey Response
Survey Question Strongly Agree Agree Neutral Disagree Strongly Disagree
Before participating in the Just Say Know to Drugs! Program (n=9)…
I felt comfortable in my understanding of pharmacology. 2 4 3 0 0
I knew the expectations and requirements necessary to teach a course. 3 6 0 0 0
I wanted to pursue teaching as part of my career. 5 3 1 0 0
I had prior experience with teaching. 2 5 2 0 0
I thought teaching would be easy. 0 3 5 1 0
I was most nervous about creating lectures. 2 4 2 0 1
I was able to explain challenging concepts in science to those with limited foundational knowledge. 3 3 2 1 0
I was most excited about how much I would learn. 3 4 1 1 0
I was most excited about sharing my knowledge with campers. 5 3 1 0 0
I was most excited about the opportunity to experience teaching. 5 4 0 0 0
I was most nervous about speaking in front of a group. 1 2 1 3 2
I was most nervous about explaining difficult concepts. 1 5 1 2 0
During the Just Say Know to Drugs! Program (n=10) …
I felt invigorated each day. 2 6 2 0 0
I felt stressed each day. 0 2 2 4 2
I felt challenged each day. 2 4 4 0 0
I felt prepared each day. 4 6 0 0 0
I learned about pharmacology. 9 0 1 0 0
I learned how to modify my approach based on camper interactions. 7 3 0 0 0
I improved my teaching style. 6 3 1 0 0
I discovered some of my own academic strengths and weaknesses. 6 4 0 0 0
I discovered some of my own interpersonal strengths and weaknesses. 4 4 2 0 0
I was motivated by the campers’ response to the material. 5 5 0 0 0
I was motivated by the desire for the campers to perform well on the post-test. 4 5 0 1 0
I struggled with some aspect of my job as an intern.  2 2 1 4 0
After participating in the Just Say Know to Drugs! Programb
I plan to pursue teaching as a component of my career. 4 4 2 0 0
My perception of teaching changed. 4 4 1 1 0
I felt that my teaching skills improved. 5 3 2 0 0
I felt more comfortable with pharmacology. 4 5 1 0 0
I was more interested in pharmacology. 3 6 1 0 0
I felt satisfaction and rewarded. 7 3 0 0 0
I am pursuing/have pursued teaching as a component of my career. 1 5 3 1 0
Participating in camp changed my career path. 0 2 2 4 2
I am using/have used skills I learned as a camp intern during rotations/residency. 4 4 1 0 0
[The program] played a role in my choice of specialty. 2 0 6 1 0
I felt more comfortable with public speaking because of my experience as an intern. 4 4 1 0 0

a Student teacher respondents were medical students and undergraduate assistants.

b Either 9 or 10 medical students/undergraduate assistants responded to these items.

Table 3.
Student Teacher Responses to the Just Say Know to Drugs! Likert Scale Survey Questionsa Survey Response
Survey Question Strongly Agree Agree Neutral Disagree Strongly Disagree
Before participating in the Just Say Know to Drugs! Program (n=9)…
I felt comfortable in my understanding of pharmacology. 2 4 3 0 0
I knew the expectations and requirements necessary to teach a course. 3 6 0 0 0
I wanted to pursue teaching as part of my career. 5 3 1 0 0
I had prior experience with teaching. 2 5 2 0 0
I thought teaching would be easy. 0 3 5 1 0
I was most nervous about creating lectures. 2 4 2 0 1
I was able to explain challenging concepts in science to those with limited foundational knowledge. 3 3 2 1 0
I was most excited about how much I would learn. 3 4 1 1 0
I was most excited about sharing my knowledge with campers. 5 3 1 0 0
I was most excited about the opportunity to experience teaching. 5 4 0 0 0
I was most nervous about speaking in front of a group. 1 2 1 3 2
I was most nervous about explaining difficult concepts. 1 5 1 2 0
During the Just Say Know to Drugs! Program (n=10) …
I felt invigorated each day. 2 6 2 0 0
I felt stressed each day. 0 2 2 4 2
I felt challenged each day. 2 4 4 0 0
I felt prepared each day. 4 6 0 0 0
I learned about pharmacology. 9 0 1 0 0
I learned how to modify my approach based on camper interactions. 7 3 0 0 0
I improved my teaching style. 6 3 1 0 0
I discovered some of my own academic strengths and weaknesses. 6 4 0 0 0
I discovered some of my own interpersonal strengths and weaknesses. 4 4 2 0 0
I was motivated by the campers’ response to the material. 5 5 0 0 0
I was motivated by the desire for the campers to perform well on the post-test. 4 5 0 1 0
I struggled with some aspect of my job as an intern.  2 2 1 4 0
After participating in the Just Say Know to Drugs! Programb
I plan to pursue teaching as a component of my career. 4 4 2 0 0
My perception of teaching changed. 4 4 1 1 0
I felt that my teaching skills improved. 5 3 2 0 0
I felt more comfortable with pharmacology. 4 5 1 0 0
I was more interested in pharmacology. 3 6 1 0 0
I felt satisfaction and rewarded. 7 3 0 0 0
I am pursuing/have pursued teaching as a component of my career. 1 5 3 1 0
Participating in camp changed my career path. 0 2 2 4 2
I am using/have used skills I learned as a camp intern during rotations/residency. 4 4 1 0 0
[The program] played a role in my choice of specialty. 2 0 6 1 0
I felt more comfortable with public speaking because of my experience as an intern. 4 4 1 0 0

a Student teacher respondents were medical students and undergraduate assistants.

b Either 9 or 10 medical students/undergraduate assistants responded to these items.

×
Discussion
The Just Say Know to Drugs! program is one of several high school STEM enrichment programs available to high school students nationally, and most of the camps encourage the incorporation of URM,11,14,16,21,22 with one of the goals being to fill the need for URM physicians and other health care professionals.23-25 However, the program was created with the philosophy of osteopathic medicine in mind. In addition to pharmacology, high school students were exposed to the tenets of osteopathic medicine and a career in medicine. Through this holistic approach, students were given a well-rounded exposure to how different aspects of pharmacology would benefit or harm a patient. Furthermore, students spent 1 day learning about nonpharmacologic mechanisms of chronic disease management, with an emphasis on methods such as manipulation. Students were also taught the history of osteopathic medicine, its guiding principles, and basic manipulative techniques. Interactive research laboratory tours further facilitated the students’ understanding of careers in the health sciences, as many of the students had never seen a scientific research laboratory. The faculty investigators and individuals working in the laboratory often gave the students the opportunity to be hands on during the tours. These findings highlight the uniqueness of the Just Say Know to Drugs! program and its important focus on rural initiatives. 
In addition to the impact on the high school students, participation in the program provided the opportunity for medical student teachers and undergraduate assistants to develop tools to become better educators. To our knowledge, the current study is the first to document the impact of learning how to teach pharmacology on future physicians. Medical students rarely have the time or opportunity to develop teaching skills, though more schools have integrated student-as-teacher programs and peer- and near-teaching opportunities.26-28 Formal training for medical students in teaching and education theory has multiple benefits, including improved teaching and communication skills and improved learning.28,29 The ability of physicians to communicate with patients and help educate them is an important aspect of a physician's professional obligation as identified by undergraduate and graduate medical education.30-32 Through working closely with the program director to develop clear and cohesive lectures and activities and receiving ongoing formative feedback from the program director regarding their performance, medical students could develop the skills necessary to communicate effectively with high school students with varying science backgrounds. 
Limitations to this program included recruitment method, biased results of the postprogram survey, and teaching interest. We struggled to obtain our maximum high school student group of 15 students each year, possibly because of the rural location. Also, potential high school students were told that they had to attend at least 3 of the 5 days of the program, which may have affected their commitment. Furthermore, high school students may be unlikely to sign up for a program that focuses on an unfamiliar topic. The postprogram survey included items that may have provided a more accurate preprogram assessment if administered to the high school students before the program started instead of during the posttest. For instance, responses to survey questions that began with “Before the camp, I…” may not have been accurate because the program itself likely skewed the students’ perspective. Similarly, students may have signed up for the program because of a strong interest in science and medicine, and the impact of the program itself may not have been as profound in these students. Finally, student teachers are asked to dedicate 2 weeks to the program during the summer between their first and second year of medical school. Medical students who want to participate in other opportunities or have other committments during this time may be unlikely to apply to teach in this program. 
We intend to transition the program into a Just Say Know Scholars Program, which will immerse high school students in other sciences, such as virology and anatomy. Further development of the teaching immersion program for medical students is also in the works, including a focus on instructional design and public speaking. We anticipate a more formalized program evaluation process to measure the long-term career and study interests of high school students, as well as the impact of this teaching immersion program on the medical students’ careers. Specific measures would include following up with the high school students regarding educational choices and professional goals. With new Just Say Know program options, we will be able to refine our understanding of program impact by providing a preprogram survey before the program week to establish baseline interests without the influence of program experience. 
Conclusion
The study findings indicate that a 1-week pharmacology day program for rural high school students increased their knowledge of the topics covered in the program and influenced their career and academic intentions. Furthermore, the medical students who participated in teaching the program reported that their most important experience was the opportunity to improve their public speaking skills. The Just Say Know to Drugs! pharmacology program fulfills a need for rural high school students to be encouraged to pursue education and careers in the STEM fields and provides osteopathic medical students lifelong skills for teaching and communicating effectively with their future patients, colleagues, and trainees. 
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Table 1.
Demographics of High School Student Participants in the Just Say Know to Drugs! Program (N=37)
Characteristic Survey Responses, No. (%)
Gender
 Male 14 (38.0)
 Female 23 (62.0)
State of Residence
 Virginia 7 (19.0)
 West Virginia 27 (73.0)
 Other 3 (8.0)
After high school, I plan on doing the following (you may select more than 1)a
 Applying for a job in my career pathway 16 (43.2)
 Obtaining a certificate from a college/technical school 7 (18.9)
 Obtaining an associate's degree from a community college 2 (5.4)
 Obtaining a bachelor's degree from a 4-year college 19 (51.3)
 Obtaining a master's degree 14 (37.8)
 Obtaining a doctorate degree
  PhD 24 (64.9)
  DO 8 (21.6)
  MD 5 (13.5)
  PharmD 1 (2.7)
  Unsure 4 (10.8)
After high school, I plan on working at a job in the following career areas (select up to 3)a
 Health sciences 26 (70.3)
 Science, technology, engineering, and math 22 (59.5)
 Education and training 7 (18.9)
 Science research 6 (16.2)
 Architecture and construction 3 (8.1)
 Business management and administration 3 (8.1)
 Agriculture, food, and natural resources 2 (5.4)
 Human services 2 (5.4)
 Law, public safety, corrections, and security 2 (5.4)
 Marketing 2 (5.4)
 Arts, audiovisual technology, and communications 1 (2.7)
 Government and public administration 1 (2.7)
 Information technology 1 (2.7)
 Liberal arts and sciences 1 (2.7)

a Post–high school plans and career areas with zero responses were excluded from the data.

Table 1.
Demographics of High School Student Participants in the Just Say Know to Drugs! Program (N=37)
Characteristic Survey Responses, No. (%)
Gender
 Male 14 (38.0)
 Female 23 (62.0)
State of Residence
 Virginia 7 (19.0)
 West Virginia 27 (73.0)
 Other 3 (8.0)
After high school, I plan on doing the following (you may select more than 1)a
 Applying for a job in my career pathway 16 (43.2)
 Obtaining a certificate from a college/technical school 7 (18.9)
 Obtaining an associate's degree from a community college 2 (5.4)
 Obtaining a bachelor's degree from a 4-year college 19 (51.3)
 Obtaining a master's degree 14 (37.8)
 Obtaining a doctorate degree
  PhD 24 (64.9)
  DO 8 (21.6)
  MD 5 (13.5)
  PharmD 1 (2.7)
  Unsure 4 (10.8)
After high school, I plan on working at a job in the following career areas (select up to 3)a
 Health sciences 26 (70.3)
 Science, technology, engineering, and math 22 (59.5)
 Education and training 7 (18.9)
 Science research 6 (16.2)
 Architecture and construction 3 (8.1)
 Business management and administration 3 (8.1)
 Agriculture, food, and natural resources 2 (5.4)
 Human services 2 (5.4)
 Law, public safety, corrections, and security 2 (5.4)
 Marketing 2 (5.4)
 Arts, audiovisual technology, and communications 1 (2.7)
 Government and public administration 1 (2.7)
 Information technology 1 (2.7)
 Liberal arts and sciences 1 (2.7)

a Post–high school plans and career areas with zero responses were excluded from the data.

×
Table 2.
High School Student Responses to the Just Say Know to Drugs! Program Likert Scale Survey Questions (N=37)
Survey Question Responses, Mean (SD)a
I enjoy learning science. 4.70 (0.5)
I like talking about science. 4.63 (0.5)
I'll need science for my career/future job. 4.59 (0.8)
I would like to study more science than I do now.  4.59 (0.6)
Science is useful in everyday life. 4.54 (0.6)
I plan on studying science or engineering in college. 4.43 (0.9)
I expect to do as well or better than other students in my science class. 4.19 (0.8)
Being a scientist might be fun. 4.16 (0.8)
The science I learned has practical value to me. 4.16 (0.7)
I usually understand what we are doing in science. 4.16 (0.7)
I like to do science experiments. 4.04 (1.0)
I think I could do more difficult science work. 3.89 (0.8)
I think designing and conducting experiments would be challenging. 3.54 (0.8)
I enjoy recording and analyzing data. 3.50 (1.0)
I want to work in a hospital for my career. 3.32 (1.2)
Being a pharmacist would be exciting. 3.22 (1.2)
I worry about failing science tests. 2.57 (1.2)
Being in science class makes me feel stressed or nervous. 2.32 (1.2)
Before this program, I didn't know what pharmacology was. 2.58 (1.0)
The Just Say Know to Drugs! program taught me about pharmacology. 4.49 (0.5)
Before the program, I knew about osteopathic medicine and osteopathic manipulation.  2.84 (1.28)
The Just Say Know to Drugs! program provided a good understanding of what an osteopathic physician does.  4.38 (0.59)
During the Just Say Know to Drugs! program, I learned a lot about different types of scientific research. 4.54 (0.61)
Before the program, I thought drugs were the only way to treat illness and disease. 2.08 (0.93)
The Just Say Know to Drugs! program explained other treatments for illness and disease. 4.42 (0.50)
Before this program, I did not feel confident about my knowledge of drugs people abused (like alcohol, nicotine, and methamphetamine). 3.65 (1.03)
The Just Say Know to Drugs! program explained how drugs of abuse work and why people become addicted to them.  4.65 (0.48)
Before this program, I knew what type of career/future job I wanted. 3.78 (1.03)
The Just say Know to Drugs! program helped me decide on my career/future job. 3.62 (0.79)

a A 5-point Likert scale was used, from strongly disagree (1) to strongly agree (5).

Table 2.
High School Student Responses to the Just Say Know to Drugs! Program Likert Scale Survey Questions (N=37)
Survey Question Responses, Mean (SD)a
I enjoy learning science. 4.70 (0.5)
I like talking about science. 4.63 (0.5)
I'll need science for my career/future job. 4.59 (0.8)
I would like to study more science than I do now.  4.59 (0.6)
Science is useful in everyday life. 4.54 (0.6)
I plan on studying science or engineering in college. 4.43 (0.9)
I expect to do as well or better than other students in my science class. 4.19 (0.8)
Being a scientist might be fun. 4.16 (0.8)
The science I learned has practical value to me. 4.16 (0.7)
I usually understand what we are doing in science. 4.16 (0.7)
I like to do science experiments. 4.04 (1.0)
I think I could do more difficult science work. 3.89 (0.8)
I think designing and conducting experiments would be challenging. 3.54 (0.8)
I enjoy recording and analyzing data. 3.50 (1.0)
I want to work in a hospital for my career. 3.32 (1.2)
Being a pharmacist would be exciting. 3.22 (1.2)
I worry about failing science tests. 2.57 (1.2)
Being in science class makes me feel stressed or nervous. 2.32 (1.2)
Before this program, I didn't know what pharmacology was. 2.58 (1.0)
The Just Say Know to Drugs! program taught me about pharmacology. 4.49 (0.5)
Before the program, I knew about osteopathic medicine and osteopathic manipulation.  2.84 (1.28)
The Just Say Know to Drugs! program provided a good understanding of what an osteopathic physician does.  4.38 (0.59)
During the Just Say Know to Drugs! program, I learned a lot about different types of scientific research. 4.54 (0.61)
Before the program, I thought drugs were the only way to treat illness and disease. 2.08 (0.93)
The Just Say Know to Drugs! program explained other treatments for illness and disease. 4.42 (0.50)
Before this program, I did not feel confident about my knowledge of drugs people abused (like alcohol, nicotine, and methamphetamine). 3.65 (1.03)
The Just Say Know to Drugs! program explained how drugs of abuse work and why people become addicted to them.  4.65 (0.48)
Before this program, I knew what type of career/future job I wanted. 3.78 (1.03)
The Just say Know to Drugs! program helped me decide on my career/future job. 3.62 (0.79)

a A 5-point Likert scale was used, from strongly disagree (1) to strongly agree (5).

×
Table 3.
Student Teacher Responses to the Just Say Know to Drugs! Likert Scale Survey Questionsa Survey Response
Survey Question Strongly Agree Agree Neutral Disagree Strongly Disagree
Before participating in the Just Say Know to Drugs! Program (n=9)…
I felt comfortable in my understanding of pharmacology. 2 4 3 0 0
I knew the expectations and requirements necessary to teach a course. 3 6 0 0 0
I wanted to pursue teaching as part of my career. 5 3 1 0 0
I had prior experience with teaching. 2 5 2 0 0
I thought teaching would be easy. 0 3 5 1 0
I was most nervous about creating lectures. 2 4 2 0 1
I was able to explain challenging concepts in science to those with limited foundational knowledge. 3 3 2 1 0
I was most excited about how much I would learn. 3 4 1 1 0
I was most excited about sharing my knowledge with campers. 5 3 1 0 0
I was most excited about the opportunity to experience teaching. 5 4 0 0 0
I was most nervous about speaking in front of a group. 1 2 1 3 2
I was most nervous about explaining difficult concepts. 1 5 1 2 0
During the Just Say Know to Drugs! Program (n=10) …
I felt invigorated each day. 2 6 2 0 0
I felt stressed each day. 0 2 2 4 2
I felt challenged each day. 2 4 4 0 0
I felt prepared each day. 4 6 0 0 0
I learned about pharmacology. 9 0 1 0 0
I learned how to modify my approach based on camper interactions. 7 3 0 0 0
I improved my teaching style. 6 3 1 0 0
I discovered some of my own academic strengths and weaknesses. 6 4 0 0 0
I discovered some of my own interpersonal strengths and weaknesses. 4 4 2 0 0
I was motivated by the campers’ response to the material. 5 5 0 0 0
I was motivated by the desire for the campers to perform well on the post-test. 4 5 0 1 0
I struggled with some aspect of my job as an intern.  2 2 1 4 0
After participating in the Just Say Know to Drugs! Programb
I plan to pursue teaching as a component of my career. 4 4 2 0 0
My perception of teaching changed. 4 4 1 1 0
I felt that my teaching skills improved. 5 3 2 0 0
I felt more comfortable with pharmacology. 4 5 1 0 0
I was more interested in pharmacology. 3 6 1 0 0
I felt satisfaction and rewarded. 7 3 0 0 0
I am pursuing/have pursued teaching as a component of my career. 1 5 3 1 0
Participating in camp changed my career path. 0 2 2 4 2
I am using/have used skills I learned as a camp intern during rotations/residency. 4 4 1 0 0
[The program] played a role in my choice of specialty. 2 0 6 1 0
I felt more comfortable with public speaking because of my experience as an intern. 4 4 1 0 0

a Student teacher respondents were medical students and undergraduate assistants.

b Either 9 or 10 medical students/undergraduate assistants responded to these items.

Table 3.
Student Teacher Responses to the Just Say Know to Drugs! Likert Scale Survey Questionsa Survey Response
Survey Question Strongly Agree Agree Neutral Disagree Strongly Disagree
Before participating in the Just Say Know to Drugs! Program (n=9)…
I felt comfortable in my understanding of pharmacology. 2 4 3 0 0
I knew the expectations and requirements necessary to teach a course. 3 6 0 0 0
I wanted to pursue teaching as part of my career. 5 3 1 0 0
I had prior experience with teaching. 2 5 2 0 0
I thought teaching would be easy. 0 3 5 1 0
I was most nervous about creating lectures. 2 4 2 0 1
I was able to explain challenging concepts in science to those with limited foundational knowledge. 3 3 2 1 0
I was most excited about how much I would learn. 3 4 1 1 0
I was most excited about sharing my knowledge with campers. 5 3 1 0 0
I was most excited about the opportunity to experience teaching. 5 4 0 0 0
I was most nervous about speaking in front of a group. 1 2 1 3 2
I was most nervous about explaining difficult concepts. 1 5 1 2 0
During the Just Say Know to Drugs! Program (n=10) …
I felt invigorated each day. 2 6 2 0 0
I felt stressed each day. 0 2 2 4 2
I felt challenged each day. 2 4 4 0 0
I felt prepared each day. 4 6 0 0 0
I learned about pharmacology. 9 0 1 0 0
I learned how to modify my approach based on camper interactions. 7 3 0 0 0
I improved my teaching style. 6 3 1 0 0
I discovered some of my own academic strengths and weaknesses. 6 4 0 0 0
I discovered some of my own interpersonal strengths and weaknesses. 4 4 2 0 0
I was motivated by the campers’ response to the material. 5 5 0 0 0
I was motivated by the desire for the campers to perform well on the post-test. 4 5 0 1 0
I struggled with some aspect of my job as an intern.  2 2 1 4 0
After participating in the Just Say Know to Drugs! Programb
I plan to pursue teaching as a component of my career. 4 4 2 0 0
My perception of teaching changed. 4 4 1 1 0
I felt that my teaching skills improved. 5 3 2 0 0
I felt more comfortable with pharmacology. 4 5 1 0 0
I was more interested in pharmacology. 3 6 1 0 0
I felt satisfaction and rewarded. 7 3 0 0 0
I am pursuing/have pursued teaching as a component of my career. 1 5 3 1 0
Participating in camp changed my career path. 0 2 2 4 2
I am using/have used skills I learned as a camp intern during rotations/residency. 4 4 1 0 0
[The program] played a role in my choice of specialty. 2 0 6 1 0
I felt more comfortable with public speaking because of my experience as an intern. 4 4 1 0 0

a Student teacher respondents were medical students and undergraduate assistants.

b Either 9 or 10 medical students/undergraduate assistants responded to these items.

×