# Addressing Pharmacy Admissions Declines Through a Student-Led Pre-Health Advising and Leadership System (PAALS): An Implementation Evaluation

## TL;DR

A student-led program called PAALS was created to improve pharmacy student leadership and increase admissions by mentoring pre-health students and expanding community partnerships.

## Contribution

PAALS is a novel student-led pre-health advising system that addresses gaps in pharmacy admissions and leadership training.

## Key findings

- PAALS reached 42 PharmD students and expanded partnerships to 8 regional high schools and community programs.
- Student mentors successfully led sustained leadership and advocacy roles, resulting in over 25 mentees matriculating into the PharmD program.
- PAALS maintained operations for five academic years with leadership succession and institutional embedding.

## Abstract

To enhance PharmD student leadership and advocacy skills, combat the paucity of trained pre-health advisors for pharmacy admissions, augment community relationships, and increase pharmacy admissions volume, we designed, implemented, and assessed PAALS, a Pre-health Academic Advising and Leadership System. PAALS was grounded in Astin’s Theory of Student Involvement and evaluated using the RE-AIM implementation science framework. RE-AIM measured outcomes across Reach, Effectiveness, Adoption, Implementation, and Maintenance as indicators of PAALS’s scale, fidelity, sustainability, and institutional embedding. Analysis of PAALS using the RE-AIM framework demonstrated the following outcomes: (1) Reach: 42 P1-P3 PharmD students participated as mentors; external partnerships expanded from 2 to 8 regional high schools and community programs; and more than 25 mentored learners successfully matriculated into the PharmD program. (2) Effectiveness: students enacted sustained leadership, advocacy, and mentoring roles. (3) Adoption: voluntary uptake of mentoring and governance roles by PharmD students occurred with repeated engagement by external partner institutions. (4) Implementation: Core program components were delivered consistently using existing institutional resources. (5) Maintenance: PAALS remained operational across five academic years despite student turnover, with leadership succession and institutional embedding sustained across cohorts. Our findings demonstrate that student-led advising and advocacy ecosystems address critical gaps in pharmacy-specific pre-health advising models.