Using The Business Model Canvas To Guide Students in Building Business Plans
Using The Business Model Canvas To Guide Students in Building Business Plans
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Using the Business Model Canvas to Guide Students in Building Business Plans
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Tyler D. Wagner
Virginia Commonwealth University
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REVIEW
Using the Business Model Canvas to Guide Students in Building Business Plans
David A. Holdford, PhD, Vasco M. Pontinha, MPharm, MA, Tyler D. Wagner, PharmD
Corresponding Author: David A. Holdford, Virginia Commonwealth University, School of Pharmacy, 410 North 12th Str.,
Box 980581, Richmond, VA, 23298. Tel: 804-828-6103. Email: [email protected]
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Submitted May 6, 2021; accepted July 26, 2021; ePublished August 2021
Objective. To review the use of the business model canvas, a one-page visual description of a business initiative, as a tool
for teaching pharmacy students about entrepreneurship and business planning in pharmacy practice settings.
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Findings. Students often struggle to develop the mindset, skillset, and toolset to effectively apply business modeling and
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planning processes to pharmacy practice settings. Over years of experimentation and various iterations in a pharmacy
practice management class, a new business model canvas was developed and refined. The canvas contains thirteen
sections which emphasize key terms, concepts, and ideas crucial for achieving entrepreneurial competencies. Using the
Zone of Proximal Development as a framework, the course structure offered a range of supportive activities that guided
students to independent competence. The business model canvas formed a framework around which assigned course
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readings, exercises, and group assignments helped pharmacy students build confidence and competence in completing a
capstone business plan assignment.
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Summary. This paper provides recommendations and examples of how to structure a course in the Doctor of Pharmacy
(PharmD) curricula using an entrepreneurial tool, the business model canvas, to help students master business
competencies. Recommendations and lessons-learned are provided.
Keywords: entrepreneurship, curriculum development, course development, pharmacy management, community pharmacy
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INTRODUCTION
The modern, practicing pharmacist must be prepared to meet many challenges on a daily basis. While some will be
related to the clinical aspects of patient care and the management of patients with complex medical conditions, other
significant challenges arise while managing pharmacy practice. Indeed, the failure of pharmacists to serve patients’ needs
is rarely the result of clinical matters such as not knowing the chemical structure of a drug or its pharmacokinetic profile.
Rather, failure is more often the result of unsustainable business models and poor practice management.
This reality is why standards have been set in pharmacy education for achieving competencies in business and
entrepreneurship.1,2 The Accreditation Council for Pharmacy Education (ACPE) considers business management
competencies such as “the ability to develop a sound business plan for clinical service programs” as important for an entry
level pharmacist.1 American Association of Colleges of Pharmacy CAPE Outcome 4.3 specifically relates to innovation
and entrepreneurship associated with envisioning better ways of accomplishing professional goals. 2
There are numerous strategies for achieving competencies in business management and entrepreneurship. These
competences can be acquired through required didactic courses,3–8 electives,9–11 co-curricular activities,12 workshops,13
experiential rotations,14 or a combination of strategies. Courses can focus on initiatives in ambulatory care,9 mass
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merchandise pharmacy,3 community pharmacy,6,10,15,16 clinical pharmacy,5,7 or students can have the freedom to choose
from an array of business ideas.4,15 Competency is commonly demonstrated with the presentation of an innovative service,
product, or program via a written business plan, an oral pitch of a business plan, or both.
The purpose of any business plan, including one in pharmacy practice, is to describe the business model of an
initiative. A business model, in contrast to a business plan, is a general depiction of how a business or institution serves or
intends to serve customers over time.17,18 All business initiatives have business models, although the model may not be
summarized in a formal, detailed document like a business plan. Sometimes businesses do not have business plans
because the process of crafting one can be time consuming and difficult. For other initiatives, a business plan is more
detailed than necessary. Some have suggested replacing the business plan with a new instrument, the business model
canvas, especially for innovative initiatives with high levels uncertainty about what business model to pursue. 19
A business model canvas is a strategic management tool that provides a comprehensive framework for describing and
understanding the crucial elements of any business enterprise, including innovative pharmacist services.20,21 It differs from
initial assumptions about a real life pharmacy initiative at the beginning of the semester, and each week they complete
exercises that test their assumptions about the model. At the end of the semester, they use what they learn to complete a
final business plan for a grade. Experiences and thoughts about choices made in designing the course are presented in this
paper to help others interested in assisting students in learning how to develop sustainable innovations.
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Course Description
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The course “Community Pharmacy Practice Management II” is a required 2 credit hour course in the first semester of
students’ third year of pharmacy school at Virginia Commonwealth University. The course is taught simultaneously at
three locations: in-person on the Richmond campus and virtually at the University of Virginia and INOVA campuses. The
class size averages 100 students with approximately 70% of students being taught on the Richmond campus. The
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objective of the course is for students to develop the necessary competencies to design and manage pharmacist services in
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community pharmacy practice settings, although the course competencies are equally applicable to other practice settings
including health systems and ambulatory care. Entrepreneurship competencies22 attained in the class include strategic
planning, decision-making, creativity, innovation, divergent thinking, risk management, service design, practice
management, communication, teamwork, and marketing.
Learning outcomes are achieved through assigned course readings, quizzes and tests of reading material, exercises to
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analyze and apply concepts from assigned readings, and group assignments associated with the development of a business
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plan. A flipped classroom approach to teaching is used where students are assigned readings or videos and quizzed prior
to class. Class sessions accompany active learning exercises and provide an opportunity for live educator facilitation and
feedback (Table 1). The flipped classroom approach allows students to work at their own speed and on their own time to
learn content. Class time is used to master skills through group collaborative projects and discussions for the purpose of
better and deeper learning. It provides the educator with more flexibility in adapting the material to the needs of students,
with more class time spent on unscheduled topics or student questions. The professor’s role in the class is primarily as a
guide and a coach. Each week, the general structure of the class consists of before class, in class, and after class activities
(Table 2).
The capstone of the course is a business plan project for an advanced practice pharmacy service or program. The
overarching goal of the project is for students to develop the mindsets and skill sets to change pharmacy practice, one
innovative project at a time. By the end of the course, the goal is to have students think like pharmacists whose careers
and livelihoods depend on the success of their employers and practice setting.
The design and delivery of “Community Pharmacy Practice Management II” has evolved over the years through trial-
and-error. Earlier iterations of the course utilized a lecture-based format in which students submitted a completed business
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plan at the end of the semester. This format yielded business plans of uneven quality based upon assessments by faculty
members and practicing pharmacists involved in the course. Some were quite good, meeting the standard of work
expected of a professional (See Table 3). Others were disappointing, suffering from reoccurring problems that were
summarized in a handout given annually to students titled, “The Most Common Problems to Avoid”. This list included
issues such as poorly written and vague descriptions of business plan elements, ignoring or inadequately addressing major
sections of the plan (e.g., stakeholders), communicating in generalities instead of specifics, inconsistencies between
sections of the plan including contradictory information and different fonts and writing styles, not getting out of the
classroom to see the actual location where a program is to be offered, failing to find simple details that can be easily
collected with a phone call or internet search (e.g., local competitors for the program, costs of radio, TV, newspaper ads),
magical thinking in which students made unrealistic assumptions about how the world works (e.g., people will throw
money at a poorly thought-out pharmacy idea), and boring the reader with a plan that is neither persuasive nor compelling.
Sharing this list every semester helped students to avoid these problems and made them a less common occurrence.
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Other pharmacy educators identified similar challenges in teaching students about business.16,23 They highlighted the
fact that most pharmacy students have little background or training in business which makes it more difficult to grasp
basic terminology and concepts without significant remediation. Indeed, their understanding of pharmacy practice and life
in general is also limited. Student inexperience frequently hinders appreciation of the need to learn the topic or the
complexity of businesses centered on patient care. Teaching the topic is further complicated when it is not adequately
integrated with other parts of the curriculum [e.g., advanced pharmacy practice experiences (APPEs)] and when class size
makes it difficult for faculty to provide extensive personal feedback. Consequently, a significant gap must be traversed by
faculty members tasked with teaching business and entrepreneurship.
Vygotsky’s Zone of Proximal Development (ZPD) framework describes an educator’s role in teaching topics that a
student is unable to learn without assistance. According to Vygotsky, individuals acquire new knowledge and skills either
on their own or through the assistance of others. Learning without help is sufficient for some things, but for more complex
tasks and topics, individuals need help to traverse the ZPD. According to the ZPD framework, the educator’s role is to
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guide learners as they move through the zone of proximal development by providing supportive activities, also known as
scaffolding, with the goal of achieving independent competence.
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The ZPD emphasizes three key components which aid the learning process.24 The first is an educator or guide whose
knowledge and skills exceed that of the learner. The educator does not need to be an expert – just more knowledgeable
than the learner. The second component is for opportunities be built into the process that allow interactions between
people. Interactions can be with the professor, teaching assistants, outside mentors, and peers. These interactions provide
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opportunities for active learning by students. The final key component in the ZPD framework is the provision of
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scaffolding, or supportive activities, to aid the student through the zone to competency. Scaffolding consists of the various
pedagogy provided by the educator to facilitate learning.
The ZPD framework was used in “Community Pharmacy Practice Management II” to guide students to develop their
business plans. The task of competing a business plan fits the framework because it is an assignment that students cannot
do on their own without assistance, yet it is not too difficult to complete given the right amount and type of guidance.
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Opportunities for interaction between people were built into the learning process through class assignments that
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encouraged conversations between peers. Other opportunities built into the course design included the assignment of a
practice faculty mentor to answer questions about real-life pharmacy practice and hold periodic team conferences to talk
through issues and problems. To help students achieve competency by working through the ZPD framework, they were
guided using the business model canvas, thoughtfully selected real-life innovations around which students could build
business models, and in-class exercises, all of which are described in the following section.
2. Value proposition
3. Revenue streams
4. Channels
5. Customer relationships
6. Key activities
7. Key resources
8. Key partners
9. Cost structure
A variation of Osterwalder’s canvas was developed for this course over time for the purpose of teaching pharmacy
students (Figure 1). Although Osterwalder’s model is a widely adopted framework, experience in teaching pharmacy
students revealed that many had difficulty understanding fundamental ideas relating to building a business plan. Over
years of experimentation and various iterations, the number of business building blocks was increased to thirteen to better
emphasize key learning objectives and to address ideas that students struggled to grasp. The new business model canvas
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for pharmacists was also developed to match the major sections of the assigned written business plan, allowing it to be
used as a scaffold to complete the plan.
The components of the business model canvas for pharmacy differ significantly from those in Osterwalder’s canvas.
Only four components were similar between the two; value proposition, revenues, costs, and stakeholders (key partners).
All other components of Osterwalder’s canvas were either replaced by new sections on the canvas (strengths and
weaknesses, opportunities and threats, organization’s operation, and implementation) or were modifications of
Osterwalder’s components (primary and secondary customers, service/product, communication plan, key activities, key
resources, and channels). Despite their differences, both canvases cover all major elements of business models. The
distinctions exist primarily in how the elements are named and presented to students.
The business model canvas for pharmacy has the following notable features. It contains all the elements of a business
model in a one-page summary, which allows for a quick understanding of the plan’s business model at a glance. The
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canvas presents the building blocks of a business in separate boxes, which ensures that no building blocks are ignored or
insufficiently considered. The value proposition is placed at the center of the model to highlight the fact that all elements
of the business revolve around the value delivered to customers. Use of the canvas mimics the scientific process by
providing a well-structured process for testing the assumptions or hypotheses of a business model. It follows a problem-
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based approach to building business models with each discrete element consisting of a problem to be solved (e.g., Who is
our customer? What is our value proposition to the customer?). Finally, it encourages continuous iterations of the business
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model through customer interviews, prototyping, and small pilot tests based upon the assumption that the development of
sustainable business ideas is a non-linear process.
In “Community Pharmacy Practice Management II”, each business model canvas developed by students evolves over
the semester through a series of group exercises that test initial drafts of the canvas and while clarifying details about the
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business idea (Table 4). The exercises allow students to build their plans in stages with numerous opportunities for
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experimentation and educator feedback. Ideas are played with and refined in preparation for the final formal business plan
document.
National Community Pharmacist Association (NCPA) business plan competition. Business ideas can be real (i.e.,
intending to solve an actual business problem) or a simulation (i.e., based upon a made-up scenario). The choice requires
balancing projects that are interesting to students, challenging but not too challenging, realistic but not without some
structure, achievable given the students’ often limited knowledge and experience, and not too time-intensive for the
professor.
Allowing students to come up with their own idea helps them develop the important skills of idea generation, but it
can lead to several problems. For many, this task falls into the Zone of Proximal Development and requires a lot of
assistance from faculty members. Without significant help, students tend to default to their limited personal and
professional experiences and often generate trivial ideas (e.g., a new pill counting tray), minor improvements in
convenience (e.g., an additional pharmacy drive-thru window), or innovations outside of the pharmacy profession (e.g.,
combination health food store and gym). Others suggest complex technology solutions that exceed their expertise to build
and implement (e.g., Siri-like voice-controlled personal assistant for medication adherence) causing them to be quickly
overwhelmed and frustrated. Indecision grips other students leading to procrastination or not offering any ideas at all.
For projects in which there is a short timeline between the generation of an idea and the deadline for submitting a
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business plan, it is important for students to start with an established idea early in the semester. In “Community Pharmacy
Practice Management II,” students are provided with a structured choice in which they can choose from a list of business
ideas which are generated by faculty members who also offer to act as mentors. Students are given an alternative option to
propose their own ideas to be vetted by the professor, but this option has never been selected. This structured choice
method of identifying projects avoids the problem of students getting too far into the semester without a viable business
plan idea, and it provides an opportunity for advanced practice faculty members to tackle, real-life problems faced in
practice. Example projects completed in the course include pharmacogenetic testing services at a local independent
pharmacy, expansion of medical center services to local college students, creation of a financially sustainable position for
a pharmacist within a local physician practice, drive-thru INR monitoring, CKD screening in a local community
pharmacy, retinal screening service for underserved patients with diabetes, home blood pressure monitoring at a clinic for
underserved patients, telemedicine in a family medicine practice with a collaborative practice agreement, a new faculty
oncology clinic, a student-led flu immunization initiative, and contract tracing services for businesses and government
entities.
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Proponents of the business model canvas recommend developing an initial draft of the entire canvas instead of
building it piece-by-piece.19,20 The purpose is to describe an initial, big picture view of the business model which will go
through numerous drafts. The initial draft is seen as a series of hypotheses about the business model that need to be tested.
For example, the primary customer for a diabetes management program might be hypothesized to be individuals from
underserved communities with type II diabetes, but conversations with patients, payers, and providers might result in a
new hypothesis that the primary customers are prescribing physicians.
The initial draft of the business model canvas of the proposed patient care service should be completed early in the
semester because class activities will revolve around testing and improving the initial canvas. Over the course of the
semester, exercises for each element of the canvas will be completed, allowing students to reconsider their hypothesized
business models and pivot to other hypotheses as needed.
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Class Exercises
The actual learning from the course occurs when students test their hypotheses with in-class exercises. These
exercises help students deeply consider their initial ideas for the model. The exercises also require students to provide
more details for each element of the canvas, which can be used later in the final business plan. Table 4 lists the class
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exercises used by student groups to build their final business plan.
Using the business model canvas and class exercises throughout the semester makes the final writing of the business
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plan much easier. Rather than franticly writing the plan at the last minute, students compile what they learned from the
exercises and edit these findings into a document. Students are provided with the rubric shown in Table 3 and examples of
business plans from previous years to further communicate what is expected of them. Students adopt some ideas from
previous year’s plans and add their own personal touches, typically resulting in incremental improvements in plans from
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year-to-year. This has made grading the plans more enjoyable because good plans are a pleasure to read. Although some
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groups still submit disappointing work, the level of disappointment has diminished in comparison to past years. The
overall quality of submissions is such that students are encouraged to list the completed business plans on their resume so
potential employers are aware of this accomplishment.
CONCLUSION
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The pharmacy business model canvas in this paper has been built through trial and error using ideas from the business
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literature. Most of the ideas and techniques described above have been tested and promoted by experienced entrepreneurs
who recommend an experiential approach to teaching and continuous qualitative feedback throughout the process.19,20 A
similar approach was described in this paper where assessment of business plans was limited to qualitative assessments by
the authors using the rubric provided in Appendix A. Therefore, recommendations about the course design, tools, and
delivery are not supported by data-driven evidence (e.g. plan scoring comparisons) and should be viewed with caution. In
the future, research should attempt to validate the rubric used to evaluate plans to allow quantitative assessment of the
recommendations described in this paper. Still, the recommendations in this paper may be useful to pharmacy educators
who are considering other approaches to teaching about business and business planning.
The pharmacy business model canvas can form a portion of the scaffolding needed for pharmacy students to cross the
Zone of Proximal Development to independent competency. All tasks within the business plan can be completed at a high
level by students with appropriate assistance. When provided with the right ideas, directions, guidance, and feedback,
students can generate professional work. Experience with the use of the business model canvas and accompanying in-class
exercises show that students can complete professional business plans designed to solve real-world problems in clinical
practice. By the end of the semester, students have the skillset to submit business plans that they would be proud to show
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a potential employer.
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Table 1. Flipped Classroom Design
Asynchronous (Outside of Class) Synchronous (In-class, Zoom)
Practicing the principles on real Teams work together on: Assigned exercises
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Table 2. Typical Student Activities for Each Topic (50 min class)
Before Class During class After class (in groups)
Student Read Take quiz over Engage with Breakout into Discuss Insert Discuss
activities Assignment reading mini-lecture groups for exercise in exercise changes in
(comprehension) exercise class into business model
business
model
Time <30 min. <10 min. 10 min. 30 min. 10 min. 1 min. Variable
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breakout
Note: In this class the online course management program was Canvas, the video conference software was Zoom, and the shared word
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processing program was Google Docs.
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Table 3. Rubric for Assessing Student Business Plans
1 2 3
Level expected of a
pharmacist who is trying
Level expected of a team of
to change the practice of
Not up to expectations good students completing Points
pharmacy, quality and
an academic exercise
presentation is very
professional
Executive Executive summary does Executive summary Executive summary is clear,
Summary not present a clear provides a satisfactory concise, and effective;
overview of the plan; overview of the plan; summary provides a 0 to
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main points are not summary is missing a few thorough overview of the 10
outlined or not clear minor points but meets plan and fully outlines and
expectations describes main points
Description of Plan is missing a The service/ product idea is Presents the service/ product
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Service/ product description of the service/ clearly presented; with a few idea thoroughly and
product or the description minor omissions, acceptable effectively; uses detailed
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is vague or inadequately visual presentation if visual presentation if 0 to
developed; few if any appropriate, provides appropriate, provides 15
details are provided. No support for the design using support for the design using
visual illustrations appropriate citations. Visual appropriate citations. Good
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provided. illustrations provided. visuals provided.
Value
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Plan does not make a Value proposition is clearly Value proposition is
Proposition clear and/or compelling presented; with a few minor presented in a clear and
case for why customers omissions, benefits and compelling way; benefits
should use the service/ impact on customer needs and impact on customer
product; benefits and are clearly presented needs are clear and 0 to 5
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impact on customer needs although some reasons may supported by proof points
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Primary and The primary and The primary and secondary The primary and secondary
secondary secondary customers are customers are identified, customers are identified,
customers not identified, differentiated, and/or differentiated, and/or
differentiated, and/or described; some details are described; details are clear
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superficial detail.
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Partners and Key partners and Key partners and Key partners and
Competitors competitors are not competitors are identified, competitors are identified,
identified, differentiated, differentiated, and/or differentiated, and/or
and/or described; details described; some details are described; specific details
about their potential missing or vague, their are provided, specific 0 to 5
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impact on success of the potential impact on success individuals are contacted
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service/ product are not of the service/ product is and their insights about the
explained or vague explained or vague but plan are presented
needs greater insight
Costs Costs are not adequately Costs are adequately Costs are adequately
identified, differentiated, identified, differentiated, identified, differentiated,
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and/or described; and/or described with only and/or described with no 0 to
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necessary cost documents minor errors; necessary cost errors; necessary cost 10
are missing, inadequate, documents are present with documents are present with
or incorrect only some errors no errors
Revenues Sources of revenue are Sources of revenue are Sources of revenue are
not adequately described described but lack of detail described and detailed, a
or insufficient to sustain makes it unclear that they case is made for financial
the service/ product over will be sufficient to sustain sustainability, documents 0 to
time, documents are the service/ product over are presented with only 10
missing, inadequate, or time, documents are minor errors
incorrect presented with only minor
errors
Marketing The objective of the plan The objective of the plan is The objective of the plan is
Communications is missing or not clear; present and clear; the present and clear; the
Plan the message and strategy message and strategy are message and strategy uses
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are vague or confusing, acceptable but does not use best practices and the mix is
0 to
the communication mix is best practice from the integrated, a measure for
10
not integrated, no textbook, the success is presented
measure for success is communication mix is
presented integrated, a measure for
success is presented
Implementation Implementation of the Implementation of the plan Implementation of the plan
plan is not provided, is provided and only missing is detailed and complete
inadequate, not fully some details, some issue without need for further
developed, or incomplete; overlooked but what is explanation 0 to 5
description of major presented is minimally
issues is missing or acceptable
lacking detail; no plan is
10
presented for assessing
success
Overall Business plan looks like Well written and easy to Presents a clear overview of
Presentation it is written by students read; no misspellings or the business plan; is well
who are in a hurry to grammar errors; quality of written and easy to read; no
0 to
complete a distasteful presentation is acceptable misspellings or grammar
10
task. Is poorly written, but not what is expected of a errors
difficult to read, and full professional.
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of errors.
0 to
Total Possible Points
100
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Table 4. Class Exercises Relating To The Building Blocks Of A Business Model
Business Model Building Description of class exercise Learning objective of the exercise
Block
Organization’s Operation Students complete a description of the Consider the consistency of an innovation
organization behind the pharmacy enterprise with the mission, values, product
portfolio, and resources of the
organization
Strengths/ Weaknesses Students conduct a SWOT analysis of their Investigate the relative competitive
Opportunities/ Threats innovation advantage of the initiative within
identified markets
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Service/ Product Students describe the innovation being offered Provide a detailed but brief description of
to customers the innovation and its main features
Students develop a service blueprint about the Visually map out and explain the
service or program being offered touchpoints between the customer and
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Value Proposition Students explain why the value to be delivered Write a compelling and clear statement
by an innovation differentiates it from about how the proposed innovation is
competing options better than any other choice available to
customers
Primary Customers/ Students build customer personas for key Prioritize customers and learn to visualize
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Secondary Customers customer groups customer groups as individuals instead of
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Competitors Students complete a perceptual map of an Identify how competitors’ offerings differ
innovation and a competitor analysis table from the proposed innovation
Partners Students develop a stakeholder map and a Recognize various stakeholders and
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power/interest matrix identify strategies for managing them
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Costs Students fill in the revenue portion of the pro Identify all startup and ongoing operations
forma income statement for the business costs for an initiative
initiative
Revenues and other Students fill in the revenue portion of the pro Identify all potential sources of revenue
benefits forma income statement for the business generated by an initiative and the point at
initiative and complete a break-even analysis which revenues exceed costs
Communication Plan Students craft the messaging for an integrated Develop precise messaging that can be
marketing communications plan for a target used across different channels and
audience audiences
Students develop key elements of a marketing Apply a step-by-step process for
communications plan including touchpoints, developing a communications plan
channels, and budget
Implementation Students identify the most likely causes for an Learn to realistically assess potential
initiative's failure in the future and describe flaws in a business plan
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