healthcare Article Pharmacy Student Challenges and Strategies towards Initial COVID-19 Curriculum Changes Luyao Liu, Suzanne Caliph , Claire Simpson, Ruohern Zoe Khoo, Geenath Neviles, Sithira Muthumuni and Kayley M. Lyons *   Citation: Liu, L.; Caliph, S.; Simpson, C.; Khoo, R.Z.; Neviles, G.; Muthumuni, S.; Lyons, K.M. Pharmacy Student Challenges and Strategies towards Initial COVID-19 Curriculum Changes. Healthcare 2021, 9, 1322. https://doi.org/10.3390/ healthcare9101322 Academic Editors: José João Mendes, Vanessa Machado, João Botelho and Luís Proença Received: 18 August 2021 Accepted: 28 September 2021 Published: 4 October 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia; lliu0007@student.monash.edu (L.L.); Suzanne.Caliph@monash.edu (S.C.); csim0005@student.monash.edu (C.S.); rkho0002@student.monash.edu (R.Z.K.); gnev0001@student.monash.edu (G.N.); smut0004@student.monash.edu (S.M.) * Correspondence: Kayley.lyons@monash.edu Abstract: Due to COVID-19, tertiary institutions were forced to deliver knowledge virtually, which proposed challenges for both institutions and students. In this study, we aimed to characterize pharmacy students’ challenges and strategies during COVID-19 curriculum changes, therefore developing a comprehensive understanding of students’ learning, wellbeing, and resilience in the ever-changing situation. Data were collected from student written reflections across four year levels at one school of pharmacy from March–May 2020. In addition, data were collected from written responses of second-year pharmacy students responding to prompted questions. The data were qualitatively analyzed inductively by five coders using NVivo 12. For each piece of data, two coders independently coded the data, calculated the inter-rater agreement, and resolved discrepancies. The most coded challenges were ‘negative emotional response’ and ‘communication barrier during virtual learning’. The most coded strategies were ‘using new technology’ and ‘time management’. This study allows researchers and education institutions to gain an overview of pharmacy students’ experiences during COVID-19, therefore helping universities to provide students with necessary support and techniques on how to self-cope with COVID-19 as well as stressful events in the future. Keywords: e-learning; healthcare education; clinical teaching 1. Introduction At the beginning of the COVID-19 global crisis, healthcare education institutions and their students underwent transformative change. Overnight, institutions cut place- ments, moved small-group learning to Zoom ® , and delivered education virtually. The self-isolation and new virtual learning systems influenced students’ study and daily life, potentially resulting in negative impacts on some students’ well-being [1,2]. For example, a recent study in China reported that 24.9% of their medical student cohort experienced anxiety to some degree due to social distancing and a lack of interpersonal communication during the COVID-19 pandemic [3]. Students have reported several challenges and low satisfaction with engaging in virtual learning during COVID-19 [1,4]. In contrast, other authors have reported that health professions students have adapted well from the chal- lenges and virtual learning has resulted in better attendance, engagement, and feedback as both teaching staff and students have created various ways to cope [5,6]. Due to these varied responses to online learning, scholars have been interested in exploring the factors that influence student satisfaction during COVID-19. Chen and colleagues have found that student satisfaction with online learning during COVID-19 was explained by the quality of the online platform, emotional changes, and communication with students [4]. Chiu proposes that self-determination theory can help explain student engagement during COVID-19 [7]. Self-determination theory encourages educators to support student autonomy, competence, and relatedness in online learning. Satisfaction of Healthcare 2021, 9, 1322. https://doi.org/10.3390/healthcare9101322 https://www.mdpi.com/journal/healthcare