Science or practice? UK undergraduate experiences and attitudes to the MPharm degree

A scoping review of health professional curricula: Implications for developing integration in pharmacy

BACKGROUND

Integrated health professions curricula aim to produce graduates who are capable of meeting current and future healthcare needs. This is reflected in pharmacy education where integration is increasingly advocated by pharmacy regulators as the perceived optimal way of preparing students for registration as pharmacists. There is, however, no definition of integration. Integration can be described according to a model of horizontal, vertical or spiral integration. It can also be described by the themes used to integrate, such as a systems-based approach or by integrative teaching and learning approaches. The level of integration can also be described.

OBJECTIVE

This scoping review aimed to explore health professions education literature to inform the optimal design of integrated pharmacy curricula. This review asks: what is meant by integration in health professions curricula?

METHODS

The Arksey and O'Malley scoping review framework was utilised. Ovid MEDLINE, EMBASE, Scopus, Web of Science and ERIC were searched. Models of integration, themes for integration, integrative teaching and learning approaches, and level of integration were defined and supported data extraction.

RESULTS

There were 9696 records screened and of these 137 were included. The majority of studies (n = 88) described horizontal integration. Systems-based teaching (n = 56) was the most common theme reported. Various integrative teaching and learning approaches were described, including experiential (n = 43), case-based (n = 42) and problem-based (n = 38) learning. The majority of the curricula could be classified as levels 5-7 on Harden's ladder (n = 102). Perception outcomes were reported for 81 studies, and only 3 reported outcomes beyond perception. Reported outcomes were generally positive and included knowledge gains and increased motivation.

CONCLUSIONS

There is a need for integration to be explicitly defined by curriculum developers and researchers. Attention should be given to describing the model, theme, teaching and learning approach and level of integration. There remains a lack of evidence for integration.

An Integrated Dyspepsia Module for First-year Pharmacy Students

Objective. To design an integrated dyspepsia module for first year pharmacy students that combines clinical and professional practice with fundamental sciences in five different science subject areas. Methods. The approaches used in designing this module are described with emphasis on strategies adopted to integrate science and practice, and the new ways of working adopted by the design team. Students' views and experiences of the module and its integration were explored using questionnaires. Results. A high proportion of students reported positive views and experiences of the module, the integration and its impact (as self-reported) on their learning and practice. The assessment of student performance indicated learning and attainment was at an appropriate level for a first-year module. Both the student grades and research results indicate a positive student learning experience. Conclusion. The dyspepsia module provides a flexible and effective template for the integration of science and practice in theme-based modules, with students reporting positively about the integration, including their perception of its contribution to improving their learning and understanding. New and more collaborative ways of working are required when designing integrated modules.

Exploring an integrated curriculum in pharmacy: Educators' perspectives

BACKGROUND AND PURPOSE

Lack of consensus regarding the benefits of an integrated curriculum, and ambiguity concerning what is being integrated within a pharmacy curriculum exists, but how an integrated curriculum is viewed, epistemologically, and subsequently incorporated into teaching practice has not been investigated. This study explores how educators conceptualize, experience and enact curricula integration both pedagogically and organizationally.

EDUCATIONAL ACTIVITY AND SETTING

In-depth qualitative interviews with faculty members purposively sampled for maximum variation in disciplinary background and teaching experience were undertaken at a single site. Interviews addressed two research questions: how pharmacy educators understand an integrated curriculum and educators' experiences of it.

FINDINGS AND DISCUSSION

Analysis of the interview data suggests four essential meanings of integration: integration as a method for organizing teaching and learning; integration as enacted by self and others; integration as tension between conflicting knowledge domains; and integration as an impossible concept to apply to teaching practice. Analysis suggests that integration is an abstract rather than enacted concept and although integration is viewed as learner-centered, integration is complex and associated with a loss of in-depth learning.

SUMMARY

Differences in how faculty members conceptualize the purpose and effects of integration mean that the level and type of integration reported varied. A clearer understanding of the rationale for change, and methods for better applying theory of integration to teaching practice, may be needed to achieve curriculum standards required by bodies accrediting undergraduate pharmacy programs.

An International Perspective on Pharmacy Student Selection Policies and Processes

Objective. To reflect on selection policies and procedures for programs at pharmacy schools that are members of an international alliance of universities (Universitas 21). Methods. A questionnaire on selection policies and procedures was distributed to admissions directors at participating schools. Results. Completed questionnaires were received from 7 schools in 6 countries. Although marked differences were noted in the programs in different countries, there were commonalities in the selection processes. There was an emphasis on previous academic performance, especially in science subjects. With one exception, all schools had some form of interview, with several having moved to multiple mini-interviews in recent years. Conclusion. The majority of pharmacy schools in this survey relied on traditional selection processes. While there was increasing use of multiple mini-interviews, the authors suggest that additional new approaches may be required in light of the changing nature of the profession.

Pharmacists in pharmacovigilance: can increased diagnostic opportunity in community settings translate to better vigilance?

The pharmacy profession has undergone substantial change over the last two to three decades. Whilst medicine supply still remains a central function, pharmacist's roles and responsibilities have become more clinic and patient focused. In the community (primary care), pharmacists have become important providers of healthcare as Western healthcare policy advocates patient self-care. This has resulted in pharmacists taking on greater responsibility in managing minor illness and the delivery of public health interventions. These roles require pharmacists to more fully use their clinical skills, and often involve diagnosis and therapeutic management. Community pharmacists are now, more than ever before, in a position to identify, record and report medication safety incidents. However, current research suggests that diagnostic ability of community pharmacists is questionable and they infrequently report to local or national schemes. The aim of this paper is to highlight current practice and suggest ways in which community pharmacy can more fully contribute to patient safety.

Integrating science and practice in pharmacy curricula

An integrated curriculum is one where the summation of different academic disciplines forms a coherent whole and, importantly, where the relationships between the different disciplines have been carefully and strategically considered when forming the composite. Within pharmacy curriculum integration is important in order to produce graduates who have the capacity to apply their knowledge to a range of complex problems where available information is often incomplete. This paper discusses the development of an integrated curriculum in which students are presented with an organized, logical sequence of material, but still challenged to make their own integrations and develop as integrative thinkers. An evidence-based model upon which an interdisciplinary undergraduate pharmacy curriculum can be built is presented.

The inclusion of a business management module within the master of pharmacy degree: a route to asset enrichment?

BACKGROUND

Over the past decade the profession of pharmacy has steadily evolved. The New Pharmacy Contract exposed pharmacists to a fundamental change in traditional pharmacy business models.

OBJECTIVE

This study will consider whether community pharmacists, pharmacy undergraduates and academic staff within the United Kingdom believe it would be beneficial to incorporate a business management module within the Master of Pharmacy (MPharm) undergraduate degree along with potential mechanisms of delivery.

METHODS

Further to ethical approval, the questionnaire was distributed to UK registered pharmacists (n=600), MPharm undergraduates (n=441) and academic staff at Liverpool John Moores University (n=44). The questions were formatted as multiple choice questions, Likert scales or the open answer type. On questionnaire completion and return, data were analysed using simple frequencies, cross tabulations and non-parametric techniques in the SPSS (v18).

RESULTS

The majority of pharmacists (84.9%) confirmed that business skills affect their everyday responsibilities to a considerable extent. A high proportion of undergraduate students (92.8%) believed that business management skills will impact on their future role. In total, 64.3% of this cohort declared that if a module were introduced they would study it. The majority of staff (79%) agreed that business skills are gaining increased importance within the field of pharmacy.

CONCLUSIONS

Data suggest that business skills are of relevance to the practice of pharmacy. Appropriate staff to deliver the taught material would include business owners / lecturers and teaching practitioners covering topics including management, leadership, interpersonal skills and regulation. We suggest the inclusion of a business module with the MPharm degree would be of great value in preparing individuals for practice within a modern day healthcare setting.

Pharmacy professionalism and the digital age

OBJECTIVES

To explore how the use of digital media could affect how people view professional behaviour.

KEY FINDINGS

The growth in social networking sites has been phenomenal and they are now an extremely popular medium for interacting with others both commercially and privately. This as-yet-uncontrolled digital media provides ample opportunities for public and professional scrutiny for the unwary. Instances of employer screening and employee dismissal are already documented. All pharmacists who use digital media now need to be conscious that their virtual presence could be subject to regulator investigation.

CONCLUSIONS

It is important that individuals are aware of the risks associated with using digital media and that pharmacy organisations begin to provide clear leadership to help pharmacists know what is and is not acceptable.

Concept mapping to evaluate an undergraduate pharmacy curriculum

OBJECTIVES

To explore a pharmacy school curriculum for opportunities for student engagement and to determine how these might shape student identity as pharmacists.

METHODS

The learning aims and objectives and methods of assessment from the curriculum of a bachelor of pharmacy (BPharm) program were collected and a concept map was generated. The concept map was interpreted using Barnett and Coates' curricular domains of knowing, acting and being.

RESULTS

The key concepts within the intended curriculum that were identified from the concept map were drugs, pharmacy, understanding, practice, and skills. Concepts such as patient and consumer, which would indicate a patient-centered approach to the curriculum, were limited. The main form of assessment used in the curriculum was multiple-choice and short-answer examinations.

CONCLUSION

There was an emphasis in the curriculum on student acquisition of knowledge and this was reinforced by the use of theoretical examinations. The content of the curriculum was drug-centered rather than patient-centered and the emergence of students' identity as pharmacists may be fragmented as a result.

New fitness-to-practice requirements for pharmacists in Ireland: implications for undergraduate pharmacy education

Internationally, there is tighter monitoring and enforcement of fitness-to-practice requirements in healthcare, which are being specified within legislation and guidelines. In Ireland, the Pharmacy Act 2007, that was recently published and is being gradually implemented, includes a provision for monitoring fitness-to-practice of pharmacists practicing here. This will mean that upon initial and continued registration by the Council of the Pharmaceutical Society of Ireland, pharmacists must satisfy a fitness-to-practice committee. Two routes by which a pharmacist can be deemed unfit to practice are specified within the Act - on the basis of ill health and through technical incompetence/malice. However, the exact nature of professional, cultural, and technical competencies required to satisfy these new fitness-to-practice requirements remain undecided and a further consultation with all stakeholders is required. Importantly, this consultative process must consider current practice standards and raise awareness of these issues among pharmacists while also considering the current and future undergraduate pharmacy students, i.e. the future pharmacists of Ireland. Radical cultural shifts in monitoring fitness-to-practice, with full professional accountability, must inform changes in the undergraduate curriculum and in assessing students, such that when they graduate, they are thoroughly prepared for ongoing fitness-to-practice scrutiny. Here, different approaches to international pharmacy education that may help pharmacy educators in Ireland prepare their students for the new fitness-to-practice requirements are reviewed and discussed.

Different development of general beliefs about medicines during undergraduate studies in medicine, nursing and pharmacy

OBJECTIVE

To analyze differences in general beliefs about medicines between healthcare students and to see if health education was of importance to general beliefs about medicines.

METHOD

The participants were students of medicine, pharmacy, pharmaceutical bioscience, dispensing pharmacy, nursing and economics (comparison group) at the University of Gothenburg. Data were collected twice in 2003 and 2005. A questionnaire was used comprising background questions and the general part of Beliefs about Medicines Questionnaire.

RESULTS

The questionnaire was completed by 460 of 642 (71.7%) first-year and 293 of 398 (73.6%) third-year students. Over 70% were women and two-thirds were under 25 years of age. Medical and pharmacy students saw medicines as less harmful than nursing students did. Stage of education was also important: third-year medical and pharmacy students saw medicines as more beneficial and less harmful than first-year students did. Experience of medicine use was relevant to general beliefs about medicines.

CONCLUSION

Different beliefs exist between healthcare professions owing to different types and stages of education, which could result in different messages being given to the patient.

PRACTICE IMPLICATIONS

It is important to educate future healthcare professionals about the potential effect of beliefs on communication.