How do pharmacy students learn professionalism?

Relevance of the community pharmacy policy environment to pharmacists' performance, as reflected in stakeholders' perspectives on professionalism and standards

Background

A complex array of legislation, regulation, policies and aspirational statements by governments, statutory agencies and pharmacy organisations constitutes the policy environment that influences Australian community pharmacy, including pharmacists' performance.

Objective

The objective was to assess the relevance of the policy environment to Australian community pharmacists' performance by examining stakeholders' perspectives on their professionalism and standards.

Methods

Inductive thematic analysis was undertaken on 38 semi-structured interviews of purposively selected individuals including pharmacists and other key stakeholders, from 4 socio-ecological strata (societal, community, organisational, and individual) that have influence on the person to person interaction that a consumer may have with a pharmacist in a community pharmacy.

Results

As indicators of their performance, pharmacists' professionalism and compliance with standards can no longer be assumed; they must be demonstrated. However, the current dispensing funding model compromises their ability to demonstrate professionalism and policy is lacking in relation to monitoring and rewarding standards. These shortcomings are further compromised by a growth in commercialism in community pharmacy which impacts the delivery of professional services.

Conclusion

The findings of this study have implications for pharmacy as an autonomously regulated profession in Australia. Dispensing funding policy could better support and reward quality in pharmacists' performance, and there is strong support for compulsory monitoring of standards. Compliance with a nation-wide quality framework, and provision of a minimum set of professional services should be an obligatory requirement of all community pharmacies.

Performance, interpersonal relationships and professional satisfaction: determinants to support pharmaceutical reengineering

Professionalism represents the ethical contract that binds professionals and society. Its technical aspects, such as the professional practice model, form the foundation for attitudinal and behavioral characteristics, including the fiduciary relationship between pharmacists and patients. Despite significant interest in the topic, contextualizing professionalism proves to be a challenging endeavor, relying on collaboration among formal leaders, academics, and practitioners in the field. Consequently, defining, understanding, teaching, and evaluating pharmaceutical professionalism contribute to shape societal perceptions and the understanding of pharmacists and students, who may occasionally struggle to grasp the underlying rationale behind professional practices. Moreover, contextualizing professionalism entails addressing various challenges, such as fostering support for professionalism and its adaptation, which encompasses pharmacists' performance across diverse clinical services, their interpersonal interactions with patients, families, communities, and fellow healthcare professionals, as well as personal job satisfaction amidst obstacles as job insecurity, ethical dilemmas, and compromised autonomy.

Assessment of Professionalism in Pharmacists and Pharmacy Students: Scoping Review of Instruments and Validity Evidence

OBJECTIVE

To characterize which instruments have been developed to assess professionalism in the field of pharmacy.

FINDINGS

A scoping review was conducted to answer which instruments have been developed to assess professionalism in the field of Pharmacy. The databases consulted were EMBASE, ERIC, PUBMED/Medline, Scopus, and Web of Science. No restrictions on language or year of publication were made. Only studies about development or translation of instruments for professionalism assessment were included. The methodological quality of studies was verified by the Questionnaire Cross-Cultural Adaptation Guideline and the COnsensus-based Standards for the selection of health Measurement INstruments. Seven studies met the eligibility criteria and were included in this scoping review. In general, the instruments were developed from ideological elements assigned to professionalism by pharmaceutical and medical entities, in addition to theoretical references that came from social sciences. Regarding the evaluation of validation and psychometric property evidence, the studies generally adopted distinct procedures which highlights some destandardization, although the methodological quality was accepted.

SUMMARY

More studies on the professionalism field should be conducted to characterize professionalism and develop pharmaceutical practices in line with societal demands and expectations.

Exploring the Impact of a Vicarious Learning Approach on Student Pharmacists' Professional Identity Formation Using a Simulated Pharmacist-Patient Encounter

Purposefully developed professional identity formation (PIF) learning activities within the didactic curriculum provide crucial groundwork to complement PIF within authentic settings. The aim of this didactic exercise was to explore the impact upon student pharmacists' PIF after viewing, analyzing, and reflecting upon a simulated pharmacist-patient encounter (PPE). A 12 min role-play video was created, featuring a pharmacist counseling a standardized patient on a new medication regimen; foundational principles of medication safety, health literacy, social determinants of health, empathic communication, and motivational interviewing were included in the counseling, with some aspects intentionally performed well, others in need of improvement. Also included were the patient's varied reactions to the counseling. Students assumed the observer role and learned vicariously through viewing the PPE. Postactivity debriefs included justifying a foundational principle performed well by the pharmacist, and another in need of improvement, and a self-reflection essay expressing the impact of viewing the PPE on their PIF, from which extracts were thematically analyzed for impact. The main themes of the impact included increased awareness of counseling techniques, patient-friendly medical jargon, patient perspectives/empathy, positive and negative pharmacist role-modeling, and the value of the observer role. This PPE exercise enhanced PIF in terms of students thinking, acting, and feeling like a pharmacist, based on students' self-reflections, which most often referenced effective pharmacist-patient communication and enacting optimal patient care.

Emotional intelligence and professional identity formation in pharmacy education

INTRODUCTION

Considering the various professional roles of pharmacists, pharmacy students and pharmacists have had difficulty identifying with a clear professional identity. Thereby there is a need for a professional identity formation (PIF) that conveys a consistent message about the role and value of pharmacists. Having a clear professional identity may also be a driver to advance the pharmacy profession. While achieving PIF is a challenging path, one element that conceivably contributes to PIF is emotional intelligence (EI). EI is acquired through life experiences and relates to personal and social awareness and the management of emotions and relationships. EI is critical for personal and professional success.

PERSPECTIVE

Pharmacy students are exposed to different pharmacists' professional identities. This faces them with challenges as they try to incorporate their roles and expectations into practice. Integrating the core elements of EI into pharmacy education through a variety of teaching and learning methods is essential in the PIF of pharmacy students. PIF will enable pharmacy students to better associate with the profession by "thinking, acting, and feeling like a pharmacist."

IMPLICATIONS

Both EI and PIF need to be integrated in pharmacy curricula. However, there is paucity of literature on how to best develop, integrate and assess EI and PIF. Therefore, a collaborative comprehensive approach by the pharmacy profession is necessary to that end.

The Impact of Cocurricular Engagement on Doctor of Pharmacy Students' Personal and Professional Development

OBJECTIVE

To explore how third-year students in 4-year Doctor of Pharmacy programs make meaning of their participation in cocurricular activities relative to their personal and professional development, and to determine the extent to which any perceived learning outcomes identified by the students align with the personal and professional development skills required for new Doctor of Pharmacy graduates, as identified in Standard 4 of the Accreditation Council for Pharmacy Education Standard 4.

METHODS

Seventy third-year Doctor of Pharmacy students across 4 schools/colleges of pharmacy were interviewed and completed a preinterview survey to gather demographic data. Data were analyzed through an inductive, iterative process, which was completed multiple times until theoretical ideas were formulated through a deductive process.

RESULTS

Eight themes were identified through the interview process, each intersecting with 1 or more of the Key Elements identified in Standard 4 as desired learning outcomes (self-awareness, leadership, innovation, and professionalism), suggesting a strong connection between students' perception of their cocurricular engagement and their personal and professional development.

CONCLUSION

This study broadens the scope of knowledge relative to students' perceived learning outcomes resulting from their cocurricular involvement beyond the prior scope of related literature. Results point to multiple action items for educators to better support students in their personal and professional development through cocurricular engagement.

Behaviours that contribute to pharmacist professionalism: a scoping review

OBJECTIVES

Clearly understanding and describing professional behaviours of pharmacists allows the profession, researchers and policy-makers to observe and monitor the professionalism of pharmacists, and design interventions to improve it where needed. The primary objective of this review was to identify which behaviours are discussed to contribute to professionalism in registered pharmacists in peer-reviewed literature. The secondary objective was to review the identified behaviours using a behavioural specification framework to understand how they are expressed.

DESIGN

A scoping literature review was conducted.

DATA SOURCES

An electronic database search of Scopus, Embase, PsycINFO, PsychArticles, Emcare and Medline limited to articles published in English from 1 January 2000 to 21 October 2022 was conducted.

ELIGIBILITY CRITERIA

Eligible articles contributed behaviourally relevant content with reference to registered pharmacists' professionalism.

DATA EXTRACTION AND SYNTHESIS

Extracted behaviourally relevant content was subject to researcher's familiarisation, then deductive coding to one of two overarching definitions of technical or non-technical behaviour. Data were then inductively coded through assignment of a descriptive code to identify categories of professional behaviour within these two overarching types of behaviour.

RESULTS

Seven articles were identified and included in the final analysis. From the extracted behaviourally relevant content, 18 categories of behaviours were identified. All articles identified behaviours in categories titled 'establishes effective relationships' and 'complies with regulations codes and operating procedures'. Identified behaviours were often broadly described and merged with descriptions of influences on them and broader outcomes that they contribute to.

CONCLUSIONS

Behaviours described to contribute to pharmacists' professionalism in the literature are broad and non-specific.

Exploration of changes in pharmacy students' perceptions of and attitudes towards professionalism: outcome of a community pharmacy experiential learning programme in Taiwan

BACKGROUND

A powerful way to nurture and strengthen professionalism is by accruing practice-based experiences. However, few studies in Taiwan have evaluated the impacts of experiential learning programmes on pharmacy students' views on professionalism - the core of quality healthcare practices and services. This study aimed to measure changes in perceptions of and attitudes towards professionalism among third-year pharmacy students following an introductory-intermediate experiential learning course.

METHODS

A single-group pre- and postcourse comparative study using a self-administered survey was conducted in 2017. Pharmacy students in their third year of a six-year programme were eligible to participate in this study. We used a 28-item questionnaire with a 10-point Likert-type scale to assess students' professionalism. Among them, 10 items were employed to assess students' perceived importance of professionalism in pharmacy practice, and another 18 items adapted from the Pharmacy Professionalism Instrument were used to evaluate students' attitudes towards pharmacy professionalism. An independent t test was performed to compare the differences in students' anonymous survey responses before and after the course, with an a priori level of statistical significance of 0.05.

RESULTS

Fifty-two pharmacy students participated in the study. They showed significant improvement in three tenets of professionalism, namely, altruism (p = 0.035), accountability (p = 0.026), and duty (p = 0.002), after completing the 5-week experiential course.

CONCLUSIONS

Pharmacy students' attitudes towards professionalism were modifiable by purposely designed experiential learning programme in the community setting. Such experiences may help socialize students with positive attitudes towards altruism, accountability, and duty.

Professionalism development through the curriculum: Developing a new system for identifying and tracking professional behavior lapses

INTRODUCTION

Pharmacy education has evolved from focusing on knowledge alone to highlighting personal and professional growth. Providing a standardized process for tracking, mentoring, and guiding students in professionalism and other soft skills may help achieve compliance with the current Center for the Advancement of Pharmacy Education Educational Outcomes and Accreditation Council for Pharmacy Education Standards 2016.

COMMENTARY

Becoming a pharmacist requires more than demonstrating proficiency in tasks and responsibilities associated with pharmacy practice. Exhibiting strong professional behavior and soft skills are important for the clinical practice environment. These behaviors are more difficult to measure due to the broad definition of professionalism. In the academic setting, it is important to identify students struggling in this area.

IMPLICATIONS

Promotion of professional behavior and soft skills development is a responsibility of higher education; however, it is difficult to assess. Development and implementation of an effective tracking and monitoring system for professionalism lapses will aid in identifying students struggling with professional behavior and offer mentoring opportunities for student personal growth and professional development.

Development of a Structured Communication and Counseling Skills Course for Pharmacy Students: A Simulation-based Approach

Objectives

We aimed to develop a structured communication and counseling education program to improve pharmacy students' skills. Then, we objectively assessed this program by using simulated patients. The program aims to improve pharmacy students' communication and counseling skills by using a patient-centered approach.

Materials and Methods

The study was conducted in three stages. First, a "Pharmacist-Patient Communication and Counseling Skills" education program was developed. Second, this program was implemented for pharmacy students. Third, the program was tested on volunteer students and evaluated for its effectiveness.

Results

The education program had a very large effect (Cohen's d_z: 6.074) on improving students' communication and counseling skills, especially their empathy skills.

Conclusion

The education program achieved its goals. After demonstrating the program's success, a course was added to the pharmacy curriculum, and a communication skills laboratory was established in the school.

Comparing perceptions of professionalism by pharmacy students, faculty, and staff during didactic education

INTRODUCTION

The objectives were to describe pharmacy students' perceptions of professionalism and to compare students and faculty/staff perceptions of professionalism during the didactic years at Touro University California College of Pharmacy in California (TUC COP).

METHODS

A two-part online survey was administered to the TUC COP faculty/staff and first-year (P1) and second-professional year (P2) students in May 2016. The first part of the survey collected demographic information, assessment of faculty/staff and students' overall opinions on behavior and conduct displayed by P1 and P2 students, students' responses about the average of missed lectures per month, and the average number of days of late arrival to lecture per week. The second part assessed professionalism perceptions responses to 20 scenarios using a 4-point Likert rating.

RESULTS

The study included 37 (88.4%) faculty/staff and 181 (96.4%) P1 and P2 students, for a 98% response rate. Of the faculty/staff, 59.5% perceived the students' overall behaviors and conduct as acceptable whereas 35.3% of students perceived the overall behavior of P1 and P2 students as acceptable, with the majority of students self-reporting missing on average fewer than five lectures per month (65.2%) and arriving late to lecture fewer than one day each week (71.8%). There were statistically significant differences between faculty/staff and students' responses in 9 of the 20 scenarios.

CONCLUSIONS

Differences in responses between faculty/staff and students regarding what is considered professional suggest that there is a gap in professionalism perceptions that should be addressed during didactic years.

The Impact of Pharmacy Student Participation in the White Coat Ceremony on Professionalization

Objective. To assess the impact of participation in a formal white coat ceremony on Doctor of Pharmacy (PharmD) students' professionalization by analyzing students' reflective writing. Methods. First-year PharmD students participated in the college's white coat ceremony following orientation. During the Foundations of Pharmacy course in the first semester, students were instructed to reflect on and write about the impact the white coat ceremony had on them as a graded assignment. A grading rubric was developed to standardize assessment of the reflections and to differentiate critical reflection (which cites future behavioral change) from other forms of reflection that are less impactful, such as non-critical reflection, general understanding, and non-reflection. Thematic analysis was conducted and prevalent themes were identified. Each reflection was then reviewed to identify up to three themes. Results. Of the 225 students in the incoming class of 2020, 218 submitted valid reflection assignments. Of these, 92% met critical reflection criteria. Four percent offered "negative connotation," while 75% described an eye-opening experience or realization. Of 483 thematic classifications, six student professionalization themes were identified, as follows: personal achievement (26%), professionalism (21%), welcome to pharmacy (18%), patient care (16.8%), life-long learning (12.8%), and code of ethics (5.2%). Conclusion. For the majority of PharmD students, the white coat ceremony held during first-year orientation had a positive impact on their professionalization. All pharmacy schools should conduct a white coat ceremony that includes recitation of the Pledge of Professionalism as an impactful first step toward student professionalization.

Characteristics of significant events identified by pharmacy students while on early immersion pharmacy practice experiences

Objective:

The purpose of this study was to characterize and classify significant events of pharmacy students who completed an early practice experience.

Methods:

Significant event analyses (SEAs) were reflections submitted by students about events that they found impactful during their early practice experiences. An online repository has stored 287 SEAs submitted by first year pharmacy students for later use in a pharmacy course. For this study, all significant events were read and coded according to the pre-specified themes and tones (positive, negative, neutral, hybrids) of the event. Themes used were derived from prior literature characterizing major themes from other health professional students’ experiences. Additional themes were added by authors for those that did not fit into the pre-set categories. All themes of the narratives were subsequently categorized. To assure confirmability, the investigators conferred to discuss new themes that emerged and events that were ambiguous. To assure credibility, an external audit of a sample of the coded SEAs was completed. Upon reaching consensus between primary reviewer and secondary reviewers, data were reported as frequencies and percentages. This study received ethics clearance from the Office of the University Registrar and was deemed exempt by the University Institutional Review Board.

Results:

A total of 1,055 coded responses were analyzed. The majority of SEAs were positive in tone (n=190, 66.2%) and many were hybrids of negative-turned-positive emotions (n=62, 21.6%). The most common major content theme was “patients and the provision of patient care” (n=412, 39.1%), followed by “pharmacy students and their behavior” (n=260, 24.6%). The most prevalent subthemes were “learning by doing” (n=134, 12.7%) and “feelings of usefulness or uselessness” (n=111, 10.5%).

Conclusions:

The majority of students framed significant events in their pharmacy practice experiences in a positive light, even from challenging interactions. The events that resonated most frequently with these students centered around patient interactions and providing patient care. These results will be useful for pharmacy educators developing pharmacy school curriculums to better prepare students to excel and feel more comfortable in direct patient care experiences.

Design and Evaluation of a Professional Identity Development Program for Pharmacy Students

Objective. To design and evaluate a professional identity program (PIP) based on self-determination theory (SDT) for entering Bachelor of Pharmacy (BPharm) students. Methods. The PIP, which featured autonomy-supportive teaching approaches, was delivered as 10 workshops that were integrated into existing pharmacy courses over the first four semesters (2 years) of the BPharm program. The program was evaluated using a student satisfaction survey and two previously validated tools for measuring professional identity (MCPIS-9) and motivation to study pharmacy (Pharm-S). Nonparametric statistical techniques were used to compare students' scores before and after introducing the PIP. Results. Students responded positively to the introduction of the PIP in the pharmacy program. Based on survey responses, the students valued opportunities to engage in activities and discussions related to professional development and identity formation. Student scores on the motivation-based tool (Pharm-S) increased by the end of the first year of participation in the PIP, indicating an increase in student autonomy levels. There was no change in students' scores on the professional identity measure (MCPIS-9) after the first year. Conclusion. The use of SDT-based instruction in professional identity education resulted in increased levels of autonomy in pharmacy students, indicating a transition to more intrinsic levels of motivation. This has the potential to positively impact student professional identity and future professional practice.

Pharmacy student professional identity formation: a scoping review

PURPOSE

Transitioning from being pharmacy students to pharmacists is challenging. Students need to reconcile their professional aspirations and what they have learnt with the realities of practice. A smooth transition can be hampered when they are unable to enact the role they have envisaged or if their expectations are not met. These challenges relate to professional identity. A key challenge for pharmacy educators is how best to support the professional identity formation (PIF) of pharmacy students. To assist with this challenge, we conducted a scoping review to identify factors influencing pharmacy students' PIF and pedagogical strategies to support PIF.

METHODS

In September 2018, we undertook a scoping review of all contemporary research investigating pharmacy student PIF including all relevant qualitative, quantitative, theoretical, and gray literature. We searched eight databases for the review: MEDLINE, CINAHL, PsycINFO, Embase, Australian Education Index, PubMed, Scopus, and Web of Science. Literature published between January 2008 and September 2018 was reviewed and screened using inclusion/exclusion criteria. The selected articles were charted and thematically analyzed.

RESULTS

We included 22 articles in the review. Studies generally concurred about the importance of attending to PIF throughout the whole pharmacy curriculum. Yet, those studies reporting on pharmacy students' professional identities found that students experienced challenges forming their identities. While several curriculum interventions supporting PIF have been implemented, these tended to be one-offs and there was an absence of interventions engaging key stakeholders including placement preceptors, other health professionals, and patients/consumers.

CONCLUSION

Supporting the formation of pharmacy students' professional identity, while recognized as an important goal for pharmacy education, requires further empirical inquiry. Pedagogical practices focused on identity formation including adopting an integrative curricular approach are required.

Definition of professionalism and tools for assessing professionalism in pharmacy practice: a systemic review

PURPOSE

In contemporary pharmacy, the role of pharmacists has become more multifaceted as they now handle a wider range of tasks and take more responsibility for care provision for patients than 20 years ago. Such an evolution in the pharmacist's responsibilities is accompanied by the need for pharmacists to display high-quality patient-centred care and counselling, and to demonstrate professionalism, which now needs to be taught and assessed are part of pharmacy education and practice. This workaimed at identifying definition of professionalism in pharmacy practice and critically evaluatingpublished instruments for assessing professionalism in pharmacy practice.

METHODS

We searched the medical literature listed in Scopus, Medline, andPsycINFOdatabasesfrom 1 January 2000 to 31 December 2018. All papers meeting our selection criteria, were reviewed and summarised into a clear review of professionalism requirements in pharmacy practice. Details of the instruments measuring professionalism were reviewed in detail.

RESULTS

There is no accepted simple definition of professionalism, although we identified several theoretical and policy frameworks required for professional pharmaceutical practice. We identified 4 instruments (Behavioural Professionalism Assessment Instrument (BPAI), Lerkiatbundit's Instrument, Pharmacy Professionalism Instrument (PPI) and Professionalism Assessment Tool (PAT) that build on these frameworks and measure professional practice in pharmacy students. These were found to be reliable and valid but had only been used and tested in student populations.

CONCLUSION

Given the increasing role of community pharmacisits there is a need for assessment of professionalism in practice. Professionalism is a complex concept that is challenging to measure because it has no standardised definition and existing literature related to the topic is limited. Current instruments available focus on measuring the development of the elements of professionalism among pharmacy students rather than pharmacists.

A comparison of baseline professional attitudes and behaviors among student pharmacists to inform a co-curricular professional engagement program

BACKGROUND

Professionalism in pharmacy students is an area of great focus with the release of Accreditation Council for Pharmacy Education (ACPE) Standards 2016. This study assessed and compared student pharmacists' professionalism at one college of pharmacy to inform the implementation of a co-curricular professional engagement program.

METHODS

Two validated instruments (Behavioral Professionalism Assessment Instrument [BPAI] and Pharmacy Professionalism Instrument [PPI]) were administered to assess baseline professionalism. Kruskall-Wallis tests compared responses among the three pharmacy classes. Analysis was conducted using SPSS. This research was approved by the Mercer University's Institutional Review Board.

RESULTS

A total of 362 students completed the survey (75% response rate), of which 131 were first-year, 139 were second-year, and 92 were third-year students. There were significant differences in agreement among these classes of students as to whether a program focused on professional engagement was important and helpful (p < 0.001). Seven BPAI statements and five PPI statements demonstrated significant differences in the level of agreement among the professional years. These behaviors include: completing assignments independently and without supervision (p = 0.004); commitment to helping others (p = 0.004); reporting a medication error (p = 0.005); using time efficiently (p = 0.02); and being respectful (p = 0.04).

DISCUSSION

At baseline, 12 statements were significantly different in the level of agreement among the three pharmacy classes. Differences may be explained by perceived professionalism (in first-year students) versus actual professional behaviors (second- and third-year students), as well as breadth and depth of experience. A co-curricular professional engagement program could increase student awareness of professionalism and professional behaviors and be tailored to meet assessed student needs.

Longitudinal evaluation of student professionalism throughout the professional didactic curriculum of a pharmacy program

INTRODUCTION

The purpose of this study is to evaluate longitudinal changes in professionalism of pharmacy students across the curriculum using a validated instrument that minimizes ceiling effect.

METHODS

The Professionalism Assessment Tool (PAT) was administered to first, second, and third year PharmD students twice throughout the first and second professional year (P1 and P2) and three times throughout the third professional year (P3).

RESULTS

Longitudinal increases in all five domains of professionalism of the PAT were noted as students progressed through each year of the didactic curriculum. Most demographic categories (sex, age, employment in a pharmacy, and number of other degrees held) of respondents did not affect self-assessment results. Two demographic categories, the number of student organizations and age group, had statistically significant impact on self-reported professionalism.

CONCLUSIONS

This pilot study showed longitudinal improvement in student self-assessment of professionalism over the course of the didactic curriculum at one school. Self-assessment of pharmacy student professionalism increased over the course of the didactic curriculum and was not affected by most demographics.

Validation of a motivation survey tool for pharmacy students: Exploring a link to professional identity development

INTRODUCTION

Self-determination theory (SDT), which describes a continuum of motivation regulators, is proposed as an appropriate framework to study pharmacy student motivation. The aim was to develop a Pharmacy Motivation Scale (Pharm-S) to determine motivation regulators in undergraduate students and explore a possible link to professional identity development.

METHODS

The Pharm-S was adapted from the SDT-based, Sports Motivation Scale (SMS-II), and administered to undergraduate students in an Australian pharmacy course. Convergent validity was assessed by conducting a correlation analysis between the Pharm-S and MacLeod Clark Professional Identity Scale (MCPIS-9).

RESULTS

Face, content and construct validity were established for the Pharm-S through the analysis of 327 survey responses. Factor analysis extracted four of the six theoretical subscales as proposed by SDT (variance explained: 65.7%). Support for the SDT structure was confirmed by high factor loadings in each of the subscales and acceptable reliability coefficients. Subscale correlations revealed a simplex pattern, supporting the presence of a motivation continuum, as described by SDT. A moderate positive correlation (0.64) between Pharm-S responses and the validated professional identity instrument, MCPIS-9, indicated a possible link between levels of motivation and professional identity.

DISCUSSION

and conclusions: Content and structural validity and internal consistency of the Pharm-S confirmed the reliability of the Pharm-S as a valid tool to assess motivational regulators. Pharm-S and the MCPIS-9 were positively correlated, lending support to a link between motivation and professional identity. This suggests a potential role for the Pharm-S as a valid tool to measure pharmacy student professional identity development.

Using longitudinal mixed methods to study the development of professional behaviours during pharmacy work-based training

Recent longitudinal investigations of professional socialisation and development of professional behaviours during work-based training are lacking. Using longitudinal mixed methods, this study aimed to explore the development of professional behaviours during a year of intensive work-based (pre-registration) training in pharmacy. Twenty trainee pharmacists and their tutors completed semi-structured interview and professional behaviour questionnaires at four time points during 2011/2012: months 1, 4 and 9 during training and 4 months after registration; tutors participated in months 1 and 9. Interviews were analysed thematically using template analysis, and questionnaires were analysed using ANOVA and t-tests. Self-assessed (trainee) and tutor ratings of all elements of professional behaviours measured in questionnaires (appearance, interpersonal/social skills, responsibility, communication skills) increased significantly from the start of pre-registration training to post-registration. Some elements, for example, communication skills, showed more change over time compared with others, such as appearance, and continued to improve post-registration. Qualitative findings highlighted the changing roles of trainees and learning experiences that appeared to facilitate the development of professional behaviours. Trainees' colleagues, and particularly tutors, played an essential part in trainees' development through offering support and role modelling. Trainees noted that they would have benefited from more responsibilities during training to ease the transition into practising as a responsible pharmacist. Longitudinal mixed methods can unpack the way in which professional behaviours develop during work-based training and allow researchers to examine changes in the demonstration of professional behaviours and how they occur. Identifying areas less prone to change allows for more focus to be given to supporting trainees in areas where there is a development need, such as communication skills and holding increasing responsibility.

Professional identity development: Learning and journeying together

BACKGROUND

Pharmacy students start to develop their professional values through engagement with the course, practice exposure, staff and fellow students. Group working is an element of pedagogy which draws on the social aspects of learning to facilitate knowledge and skills development, but its potential role in facilitating professional identity formation has as yet been under researched.

OBJECTIVES

This study aimed to explore the potential of mutual learning through group work to contribute not only to academic knowledge and understanding, but also to the development of students' professional values and selves.

METHODS

Semi-structured interviews were conducted with 17 home and international first year undergraduate pharmacy students in a UK School of Pharmacy, to explore their experiences of interacting for learning with other students on the course.

FINDINGS

Thematic analysis of the interview data highlighted four main benefits of mutual learning, which are that it: promotes friendly interactions; aids learning about the subject and the profession; opens the mind through different opinions and ways of thinking; and enables learning about other people. Through working together students developed their communication skills and confidence; reflectively considered their own stance in the light of others' experiences and healthcare perspectives; and started to gain a wider worldview, potentially informing their future interactions with patients and colleagues. Some difficulties arose when group interactions functioned less well.

CONCLUSIONS

Opportunity for collaboration and exchange can positively influence development of students' professional outlook and values. However, careful management of group working is required, in order to create a mutually supportive environment wherein students feel able to interact, share and develop together.

Developing Professional Identity in Undergraduate Pharmacy Students: A Role for Self-Determination Theory

Professional identity development, seen as essential in the transition from student to professional, needs to be owned by the universities in order to ensure a workforce appropriately prepared to provide global health care in the future. The development of professional identity involves a focus on who the student is becoming, as well as what they know or can do, and requires authentic learning experiences such as practice exposure and interaction with pharmacist role models. This article examines conceptual frameworks aligned with professional identity development and will explore the role for self-determination theory (SDT) in pharmacy professional education. SDT explains the concepts of competence, relatedness and autonomy and the part they play in producing highly motivated individuals, leading to the development of one’s sense of self. Providing support for students in these three critical areas may, in accordance with the tenets of SDT, have the potential to increase motivation levels and their sense of professional identity.

Professional Identity Formation in an Advanced Pharmacy Practice Experience Emphasizing Self-Authorship

Objective. To examine the extent to which reflective essays written by graduating pharmacy students revealed professional identity formation and self-authorship development. Design. Following a six-week advanced pharmacy practice experience (APPE) grounded in Baxter-Magolda's Learning Partnerships Model of self-authorship development, students completed a culminating reflective essay on their rotation experiences and professional identity formation. Assessment. Thematic and categorical analysis of 41 de-identified essays revealed nine themes and evidence of all Baxter-Magolda's domains and phases of self-authorship. Analysis also suggested relationships between self-authorship and pharmacist professional identity formation. Conclusion. Results suggest that purposeful structuring of learning experiences can facilitate professional identity formation. Further, Baxter-Magolda's framework for self-authorship and use of the Learning Partnership Model seem to align well with pharmacist professional identify formation. Results of this study could be used by pharmacy faculty members when considering how to fill gaps in professional identity formation in future course and curriculum development.

How Do Pharmacists Construct, Facilitate and Consolidate Their Professional Identity?

The pharmacy profession continues to experience change regarding roles and responsibilities. The supply of medicines still remains a central function, but patient-facing, clinical roles are now becoming more commonplace, where pharmacists use their expert knowledge to maximise patient use of medicines. This transitional state from supplier of medicines to medicines expert raises questions over the contemporary professional identity of pharmacists. This literature-informed commentary highlights the current situation regarding how pharmacists’ identity is formed and reinforced. The authors suggest that the profession needs to be clearer in articulating what pharmacy does, and advocate the need for strong branding that the profession, public and other healthcare practitioners understand.

Pharmacists' perceptions of professionalism on social networking sites

BACKGROUND

Social networking sites (SNS) are a new venue for communication, and health care professionals, like the general population, are using them extensively. However, their behavior on SNS may influence public perceptions about their professionalism.

OBJECTIVE

This study explored how pharmacists separate professional and personal information and activities on SNS, their perceptions of professional behavior on SNS, and opinions on guidelines in this area.

METHODS

In-depth, semi-structured interviews were conducted with international practising pharmacists (n = 31) recruited from a range of countries (n = 9). Initially, pharmacists known to the research team were invited, and thereafter, participants were recruited using a snowballing technique. The interviews lasted from 30 to 120 min. All interviews were recorded, transcribed verbatim, and thematically analyzed.

RESULTS

A majority of participants mixed professional and personal information and activities on SNS, and about one third adopted a separation strategy where professional information and activities were clearly separated from personal ones (e.g. two different SNS accounts, or one particular SNS for professional use and another platform for personal purposes). Most participants expressed concern over how pharmacists present themselves and behave in SNS when they reported (un)professional behaviors of peers they had observed. Examples of perceived unprofessional behaviors included revealing details of personal life and activities; open complaints about the pharmacy sector, co-workers, physicians, and patients; inappropriate description of pharmacists' roles and activities; and breaches of patient confidentiality. Positive professional behaviors, such as expression of compassion for patients, examples of effective patient management, promotion of pharmacists' role, and correction of misleading health information being spread online were also observed. There was no consensus on having professional social media guidelines. Some preferred SNS to be unregulated while most believed certain guidance was needed to maintain high professional standards in the online environment.

CONCLUSIONS

A definitive strategy to separate professional and personal information and activities on SNS was not adopted by most pharmacists. E-professionalism issues could negatively impact on the standing of individual practitioners and the profession. Most agreed that education about SNS use would be beneficial; however, support for guidelines or regulations for pharmacists' use of SNS was not unanimous.

Exploring the process of professional socialisation and development during pharmacy pre-registration training in England

Objectives

To explore the process of professional socialisation in pharmacy trainees during pre-registration training.

Methods

A prospective, longitudinal qualitative design was used. A purposive sample of 20 trainees from community and hospital pharmacy in North West England was recruited. A total of 79 semi-structured interviews were conducted with trainees on three occasions during training and once four months after training. Data were analysed thematically using template analysis.

Key findings

Early on in training, non-pharmacists played a significant role in socialising trainees into the work setting; pharmacists played the stronger role towards the end. Pre-registration tutors were strong role models throughout training. Training experiences differed between settings, where services provided and patient mix varied. Hospital trainees learnt about specialist medicines on ward rotations. Community trainees developed knowledge of over-the-counter, and less complex, medicines. In hospital, trainees were exposed to a range of role models in comparison to community where this was generally limited to a small pharmacy team. Newly qualified pharmacists were challenged by having full responsibility and accountability.

Conclusion

This study showed the experiences encountered by trainees that affect their professional socialisation. More standardisation across training sites may reduce the variation in experiences and professional socialisation and development. Formal training for pre-registration tutors and support staff that play a key role in supporting trainees could be considered. Support for newly qualified pharmacists may allay the challenging transition they face when entering practice.

Professionalization in Pharmacy Education as a Matter of Identity

Little research exists on the formation of professional identity in higher education health programs. Such programs may approach the teaching, learning, and assessment of professionalism based upon a suite of attitudes, values, and behaviors considered indicative of a practicing professional. During this transition, professional identity formation can be achieved through student engagement with authentic experiences and interaction with qualified professionals. This paper examines the shift toward identity formation as an essential element of professional education and considers its implications for pharmacy curriculum design.

Patient-centred professionalism in pharmacy: values and behaviours

PURPOSE

Research on patient-centred professionalism in pharmacy is scarce compared with other health professions and in particular with pharmacists early in their careers. The purpose of this paper is to explore patient-centred professionalism in early career pharmacists and to describe reported behaviours. DESIGN/METHODOLOGY/APPROACH - This study explored patient-centred professional values and reported behaviours, taking a qualitative approach. In all, 53 early-career pharmacists, pharmacy tutors and pharmacy support staff, practising in community and hospital pharmacy in England took part; the concept of patient-centred professionalism was explored through focus group interviews and the critical incident technique was used to elicit real-life examples of professionalism in practice.

FINDINGS

Triangulation of the data revealed three constructs of pharmacy patient-centred professionalism: being professionally competent, having ethical values and being a good communicator.

RESEARCH LIMITATIONS/IMPLICATIONS

It is not known whether our participants' perspectives reflect those of all pharmacists in the early stages of their careers. The data provide meaning for the concept of patient-centred professionalism. The work could be extended by developing a framework for wider application. Patient-centred professionalism in pharmacy needs further investigation from the patient perspective.

PRACTICAL IMPLICATIONS

The findings have implications for pharmacy practice and education, particularly around increased interaction with patients.

SOCIAL IMPLICATIONS

The data contribute to a topic of importance to patients and in relation to UK health policy, which allocates more directly clinical roles to pharmacists, which go beyond the dispensing and supply of medicines.

ORIGINALITY/VALUE

The methods included a novel application of the critical incident technique, which generated empirical evidence on a previously under-researched topic.

Becoming a pharmacist: the role of curriculum in professional identity formation

Objective

To understand how the formal curriculum experience of an Australian undergraduate pharmacy program supports students’ professional identity formation.

Methods

A qualitative ethnographic study was conducted over four weeks using participant observation and examined the ‘typical’ student experience from the perspective of a pharmacist. A one-week period of observation was undertaken with each of the four year groups (that is, for years one to four) comprising the undergraduate curriculum. Data were collected through observation of the formal curriculum experience using field notes, a reflective journal and informal interviews with 38 pharmacy students. Data were analyzed thematically using an a priori analytical framework.

Results

Our findings showed that the observed curriculum was a conventional curricular experience which focused on the provision of technical knowledge and provided some opportunities for practical engagement. There were some opportunities for students to imagine themselves as pharmacists, for example, when the lecture content related to practice or teaching staff described their approach to practice problems. However, there were limited opportunities for students to observe pharmacist role models, experiment with being a pharmacist or evaluate their professional identities. While curricular learning activities were available for students to develop as pharmacists e.g. patient counseling, there was no contact with patients and pharmacist academic staff tended to role model as educators with little evidence of their pharmacist selves.

Conclusions

These findings suggest that the current conventional approach to the curriculum design may not be fully enabling learning experiences which support students in successfully negotiating their professional identities. Instead it appeared to reinforce their identities as students with a naïve understanding of professional practice, making their future transition to professional practice challenging.

Organizational philosophy as a new perspective on understanding the learning of professionalism

OBJECTIVE

To define the concept of "organizational philosophy" through identification of elements within undergraduate pharmacy curricula in the United Kingdom that contribute to students' learning of professionalism.

METHODS

A qualitative study using curriculum mapping was conducted to identify "intended," "taught," and "received" curriculum in 3 schools of pharmacy. The study involved review of course materials, interviews with teaching staff members, focus groups with final year students, and observation of classes.

RESULTS

"Organizational philosophy" (totality of all contributors) played a vital part in students' professionalism learning. Key contributions were not restricted to the "taught" curriculum but extended to the wider academic environment. Setting of high standards appeared important; role models had particular significance. Importance of professionalism learning being grounded and longitudinal throughout the curriculum was highlighted. An "integrated" organizational philosophy appeared to be achieved where maximum overlap occurred between "intended," "taught," and "received" curricula.

CONCLUSIONS

Professionalism learning goes beyond the "taught" curriculum in pharmacy schools. The concept of "organizational philosophy" acknowledges the importance of integration between "intended," "taught," and "received" curriculum in the context of overall organization.