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

A Scoping Review of the Hidden Curriculum in Pharmacy Education

Objective. The hidden curriculum has been defined as teaching and learning that occur outside the formal curriculum and includes the knowledge, skills, attitudes, behaviors, values, and beliefs that students consciously or subconsciously acquire and accept. It has been identified as an inherent part of learning in health professions education and may affect students' formation of professional identity. This scoping review investigated the definition and evidence of the hidden curriculum for pharmacy education.Findings. A comprehensive literature search was conducted for primary articles investigating the hidden curriculum in pharmacy education through August 2021. A total of five papers were included in the review: four papers from the United Kingdom and one from Sweden. The focus of each paper and the elements of the hidden curriculum, along with the study quality as assessed by the quality assessment tool, varied. Three papers focused on professionalism or professional socialization, and the other two focused on patient safety. All five studies used qualitative methods including focus groups and semistructured interviews of the students and faculty. Studies also identified approaches to addressing the hidden curriculum, such as integrating formal and informal learning activities, integrating work experiences, providing sustained exposure to pharmacy practice, and development of professionalism.Summary. The definition of the hidden curriculum varied across the five studies of varying quality. The evidence of the hidden curriculum was measured qualitatively in experiential and academic settings. Recognition of the impact of the hidden curriculum and strategies for addressing its negative effects are critical to the success of not only the students but also the pharmacy profession at large.

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.

Perceptions of organizational culture and organizational citizenship by faculty in U.S. colleges and schools of pharmacy

OBJECTIVES

(1) Describe perceptions of organizational culture and prevalence of organizational citizenship behaviors (OCBs) among faculty at United States (U.S.) colleges/schools of pharmacy; (2) determine which aspects of those phenomena are strongest and which are most problematic; (3) evaluate the psychometric properties of measures for organizational culture and OCBs in academic pharmacy; and (4) identify any relationships between organizational culture and organizational citizenship among academic pharmacy faculty.

METHODS

A random sample of 600 U.S. academic pharmacists acquired from the American Association of Colleges of Pharmacy were distributed an email survey through the use of Qualtrics technology. The procedures closely resembled the Total Design Method advocated to maximize survey response, including use of a pre-notification letter, reminders, and a nominal financial inducement. In addition to demographic questions, the survey employed multiple-item measures of organizational culture and OCBs described previously in the literature and derived from Delphi consensus-building procedures. The analysis plan incorporated use of factor and item analyses to evaluate psychometric properties of the measure and elicit the inherent domains comprising these phenomena, along with descriptive statistics to describe facets of organizational culture and OCBs that were most prevalent.

RESULTS

A total of 177 responses were delivered. Factor analysis of organizational culture revealed a five-factor solution emphasizing achievement orientation, professionalism, stability, supportiveness, and reflectiveness. OCB domains were along the possibility of faculty being virtuous, disrespectful, sportsmanlike, and benevolent/malevolent. Even while multi-faceted and avoiding a simple typological descriptor, academic pharmacy cultures were reportedly healthy. Sportsmanship, while still somewhat commonly observed, was seen less frequently than other behaviors. The measures demonstrated logical, cogent factor structures and excellent internal consistency reliability.

CONCLUSIONS

Psychometrically well-performing measures were used to assess the multi-faceted organizational culture of academic pharmacy programs and the organizational citizenship behaviors of its constituent faculty. The results can be used to measure these phenomena at individual organizations for benchmarking and to inform future inquiries that can assist with development of strategies that impact academic worklife and outcomes.

Exploring the challenges for clinical pharmacists in Sudan

Background Clinical pharmacy practice in hospitals is a new role for pharmacists in Sudan. Pharmacists have to face the challenge of moving from their traditional roles within the pharmacy premises to new roles on the wards with direct contact with patients and other healthcare professionals. Objectives To explore the role and challenges facing the clinical pharmacists of Sudan. Settings Two of the main government hospitals in Sudan and an online survey. Method This study applied a two phase mixed method, a focus group discussion and a survey. A FGD was conducted with the clinical pharmacists in two of the main government hospitals in Sudan. This was followed by an on-line survey among the clinical pharmacists of Sudan. Main outcome measure The role of the clinical pharmacists of Sudan and the challenges facing clinical pharmacy practice. Results Four pharmacists participated in the focus group and 51 out of 140 pharmacists (34%) completed the on-line survey. The roles that were perceived by the majority of pharmacists as part of their duties in hospitals in Sudan were identifying drug-related problems (100%, n = 51), providing drug-related information to healthcare professionals by (96%, n = 47), and educating patients about their medicines (96%, n = 48). The pharmacists identified a number of obstacles that hindered their progress in practice. These obstacles were related to the pharmacists themselves, the lack of senior clinical pharmacists for leadership, the environment they were working in and the training they had received in clinical pharmacy. Conclusion The new clinical pharmacists in Sudan faced several challenges that need to be overcome in order to move forward in their clinical practice. To do so they will require support from pharmacy educational institutions, other healthcare professionals and the healthcare institutions they are working within.

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 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.

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.