Fostering Student Commitment through I/R

Compliance or commitment:  What’s better for students?

Pharmacy curricula, perhaps now more than ever, must be continually evaluated and updated, based on what appears to be a never-ending deluge of new information, scientific breakthroughs, updated practice standards, etc. Amidst these exciting (and sometimes daunting) changes in pharmacy education, it can be tempting to focus on delivering information to students for them to absorb and remember.  Unfortunately, this older model of education – which assumes the teacher has all the information and bears the responsibility of providing it to students – is not terribly helpful when students need to critically interpret, think creatively, and collaborate with peers.  After all, these are the skills cited by professionals as most important in almost every field, particularly health care.  

The older model of education is also based on behaviorist principles, in which students are rewarded with grades by memorizing information for a test. Contrast this with a constructivist environment, in which students are actively engaged in pursuing information by working through problems.  The difference in these two environments is similar to the difference between compliance and commitment – one requires a minimum standard of performance, and one inspires learning through the process of inquiry and discovery.

What is I/R?

With this in mind, Drs. Kerry Fierke and Gardner Lepp developed a simple educational practice called Intention/Reflection (I/R).  The goal is to help students engage in the content of an educational activity, by encouraging them to identify and articulate why that content is important, and how it might help them in the future. (An “educational activity” can include almost any learning experience, from something as small as a one-hour class session to a semester-long course.)  

This activity asks students to explore and identify their Intention through several questions prior to the educational activity, such as:

  1. What do you hope to gain from this educational activity?  
  2. Why is this important to you?
  3. What will do to make sure you achieve these gains, especially considering possible obstacles you may encounter?
  4. How will this opportunity affect your future profession?

These questions, based on principles espoused by Piaget, Habermas, Knowles, Mezirow, Brookfield and others, helps students develop a personal connection to the content of the activity.

In order to prompt Reflection on their Intention, toward the end of the educational activity, another similar set of questions is asked of the student:

  1. To what degree did you achieve your learning intention?
  2. How has this learning experience changed your perspective?
  3. Considering what you gained, how will this affect your future as a professional?


IR Diagram
Diagram of Intention/Reflection

What have we learned about I/R so far?

This educational practice has been piloted with students in a variety of learning environments: 4th year pharmacy rotations (APPEs), courses involving international travel, a leadership course, and a children’s health fair (extra-curricular).  Certainly, not all students respond favorably to this activity.  However, preliminary evaluations indicate that the majority of students benefit from this practice because it helps them connect their individual interests and priorities to the educational activity.  

Because of its ease and simplicity, the researchers continue to apply the I/R practice in a variety of settings.  This practice will be highlighted in a special session at the upcoming AACP meeting in July.  Of course, all attendees at that session will take a few minutes to go through the I/R practice!


This post was guest authored by Dr. Gardner Lepp, Adjunct Faculty for the Department of Pharmacy Practice and Pharmaceutical Sciences and Education Specialist for UMN-COP. Contact Dr. Lepp to learn more about I/R at