Professional Identity Formation in Pharmacy Students During an Early Preregistration Training Placement

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, besides 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 the society demands and expectations.

Impact of Pharmacy-Related Memes on Students' Professional Identity Formation

OBJECTIVE

Professional identity formation (PIF) is the process which one internalizes the values and norms of a profession, ultimately becoming a member of that profession. The objective of this study was to determine the perceived professional identities of pharmacists in memes and how pharmacy-related memes affect students' PIF.

METHODS

Student pharmacists from a single academic institution participated in focus groups to discuss the concept of professional identity, view self-submitted pharmacy-related memes, and reflect on the memes' impact on their PIF. An inductive, thematic content analysis was performed, and a theoretical model was developed to illustrate the themes observed.

RESULTS

Twenty-six student pharmacists participated in the study. Before exposure to the self-submitted memes, the participants described the professional identity of a pharmacist in a more idealistic way, noting pharmacist roles such as medication expert, educator, and patient care provider. After exposure to the memes, the participants' responses reflected a pharmacist identity based on feelings of being antagonized, overwhelmed, and misperceived. Despite these challenges, the participants noted the importance of remaining professional.

CONCLUSION

When exposed to pharmacy-related memes, the students' perceptions of the pharmacist identity changed from one based on idealistic roles to an identity based on negative feelings and interactions. Owing to memes' ability to reflect one's experiences, it is important to recognize the impact memes may have on PIF. Further research is needed to determine how pharmacy educators can help students navigate identity dissonances that arise from the students' pharmacy experiences.

Perceptions of formal pharmacy leadership on the social role of the profession and its historical evolution: A qualitative study

Background

In recent years, pharmaceutical professionalism has been questioned due to the social role of pharmacy, which is ambiguous in the literature. This raises questions about the purpose of the profession among pharmacists, despite the efforts of their professional organizations and formal leaders to consolidate the occupational status of the profession.

Objective

To understand the social role of pharmacy in Brazil through its historical evolution based on the perceptions of formal leaders of the profession.

Methods

A qualitative study was conducted between July 2020 and February 2021 with pharmacists who held leadership positions in formal and professional pharmacy organizations in Brazil. The data obtained from the interviews were submitted to content analysis.

Results

A total of 17 pharmacists participated in this study. The data analyzed presented perceptions about the social role of the pharmaceutical profession in Brazil, which promotes access to health through different means. These include the manager pharmacist, who facilitates access to public health policies; the caring pharmacist, who promotes health education and the rational use of medicines; and the technologist pharmacist, who researches, develops, and promotes access to safe and cost-effective medicines. The interviewees also discussed the evolution of this social role based on influential factors such as legislation, clinical movement, pharmaceutical education, labor market, behaviors, and attitudes of pharmacists.

Conclusion

In this study, pharmaceutical professionalism was conceptualized based on its social role, which should be centered on the patient. Understanding such issues is part of the evolutionary purpose of the profession in Brazil and should be encouraged in the behaviors and attitudes of pharmacists despite the challenges faced by the profession.

Teaching Strategies for Professional Identity Education in Pharmacy: A Scoping Review

OBJECTIVES

To characterize which strategies of professional identity formation and professionalism are being used in Pharmacy.

FINDINGS

We gathered 5004 articles from 5 databases with the descriptors "pharmacy" "professionalism," "professional identity" and their synonyms. The professional identity is a set of values and behaviors common among professionals. Professionalism is the moral compass of these values, used as a strategy to own social authenticity. After excluding duplicate texts, analyzing titles, abstracts, and full articles, 17 studies met the inclusion criteria and presented strategies for the formation of professional identity and professionalism in pharmacy students. We did not find studies with pharmacists. The quality of reports was assessed using 2 instruments recommended by the literature. All studies were conducted from 2007 onwards, and the United States is the country with the most publications. The identified strategies consisted of extracurricular activities, thematic courses, lectures, and counseling sessions and did not follow standards of theoretical reference, method, execution, duration, and effectiveness of evaluation.

SUMMARY

The interest of Pharmacy about professional identity and professionalism has grown substantially in recent years. Teaching strategies are essential alternatives to improve professionalism, reinforce its importance, and acknowledge its heterogeneity and differences. For that, they must be in line with the aims of the profession in society. This review highlights the need to develop standardized and reproducible teaching strategies to guarantee the effectiveness of students' professional socialization during graduation, as well as to instruct professionals to deal with the changes in the profession, increasing the influence of Pharmacy in society.

Using Emotional Intelligence as a Framework for Students' Professional Identity Formation

Emotional intelligence and professional identity formation (PIF) intersect at various levels. Professional identity formation requires acute observation of others in the profession and the ability to decipher intentionality in behaviors. The developing pharmacist must make a deliberate effort to emulate positive norms and values that coincide with those associated with the profession while deliberately ignoring those that are incongruent. To learn from others in the profession, social skills are required, so one can ask questions, determine the best course of action, set goals, grow, and maintain relationships, and ask for help. The ability to manage one's emotions regardless of external circumstances can be valuable for any profession. Self-regulation and self-assessment of one's emotions and motivations can be useful for reevaluating our perspectives and priorities as pharmacists. Emotional intelligence is a critical component of building, demonstrating, and improving PIF. This commentary will provide strategies to facilitate and solidify the connection between the two.

Impact of Experiential Education on the Intersectionality of Pharmacy Student Personal and Professional Identity Formation

OBJECTIVE

The objective of this review was to summarize evidence relating to the impact of experiential education on the development of professional identity formation (PIF) and determine areas for future research and development to improve the integration of a professional identity within the student's unique personal identity within experiential education programs.

METHODS

A systematic scoping review was conducted using the systematic evidence-based approach following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles published between 2012 and 2022 related to the development of PIF in relation to the experiential experience were researched using PubMed, MEDLINE, ScienceDirect, Eric, and JSTOR (search engines) to find relevant articles.

RESULTS

A total of 986 articles were identified from the literature search. After undergoing an exclusion criterion, the total number of articles was reduced to 23 to be included in this review. Following the full-text review of the 23 articles, the authors identified common themes or domains and key findings relating to PIF and pharmacy experiential education. Articles were then assigned to 1 or more of the following domains: Experiential Education and PIF, Experiential Education and Professional Socialization, and Factors that influence PIF.

CONCLUSION

This review found that professional identity is highly impacted by experiential education and that pharmacy students cannot rely on didactic teaching alone but need to be exposed to authentic practice settings early within their curriculum by means of experiential education.

Pharmacy Students' Perceptions of the Pharmacist Role: An Arts-Informed Approach to Professional Identity Formation

Elements of professional identity are closely intertwined with professional roles, and individuals perceive themselves in relation to their roles. How pharmacists perceive their professional identity influences how they enact their roles in practice. For pharmacy students, understanding the pharmacist role and envisioning themselves in that role supports the formation of their professional identity. This study explores students' perceptions of the pharmacist role. First-year pharmacy students enrolled in the Doctor of Pharmacy program at the University of Alberta were invited to participate in this study. Using an adapted version of the draw-and-write technique, participants were asked to express their understanding of the pharmacist role visually. An analysis of the results was guided by established discourses related to pharmacist identity derived from pharmacy education literature. In total, 100 pharmacy students participated in this study. The findings indicate that pharmacy students have a comprehensive understanding of the pharmacist role, especially the dispenser and health care provider aspects of a pharmacist's professional identity. Additionally, students acknowledged the involvement of pharmacists in health care teams, in public health, and primary health care services. A discourse related to professional identity, the multi-faceted professional, emerged to describe the coexistence of multiple roles in modern pharmacy practice. An arts-based activity successfully facilitated the exploration of pharmacy students' perceptions of the professional role of pharmacists. This approach has potential in supporting instruction regarding professional identity formation within the curriculum.

Guidance for Qualitative Research Manuscripts in Pharmacy Education

The goal of this Best Practice Review is to support researchers in successfully preparing and publishing qualitative research in pharmacy education. Standard practice from the literature and journals' guidance from related fields were reviewed, and recommendations and resources applicable to qualitative research in pharmacy education were compiled for researchers planning to conduct and publish qualitative research. This review provides recommendations, not requirements, for publication in the Journal and is intended to be a guide, especially for authors and reviewers relatively new to the field of qualitative research. Additionally, researchers planning to publish their qualitative research are advised to review available best practices and standards, such as the Consolidated Criteria for Reporting Qualitative Research checklist and the Standards for Reporting Qualitative Research. Given the diverse methodology of qualitative research, it is important for authors to provide sufficient details and justifications of selected methods for transparency and to report collected results in a manner that allows reviewers and readers to adequately assess the validity of their study and the applicability of the findings.

Pharmacy from the perspectives of other health professions: An intervention to foster professional identity among freshmen pharmacy students

Background

Professional identity is crucial for the development of pharmacy students' professional confidence, learning motivation and future career choices. However, how to develop students' professional identity in pharmacy education is an underdeveloped field of research. The critical component of professional identity has been considered formed as a result of stepwise socialization. Therefore, pharmacy professional identity might be influenced by associations with other health care professionals, such as physicians and nurses, who are involved in health care collaboration with pharmacists.

Objectives

This work aimed to investigate the effect of a student-led interview intervention called "Pharmacy from the perspectives of other health professions" as an intervention on pharmacy freshmen's perceptions and positivity toward the pharmacy profession.

Methods

In this prospective pre/postintervention study, the effect of the interview intervention on students' job preferences as well as attitudes toward the pharmacy profession and pharmacists' role in health care was evaluated among 70 first-year pharmacy undergraduates equally divided into intervention and control groups using a self-developed questionnaire.

Results

Compared with the controls, the numbers of respondents reporting no specific reasons for selecting the pharmacy profession and stating that they were unclear about their preferred post-graduation work sector were significantly reduced after the intervention. Participating in the intervention increased the number of students who agreed or strongly agreed that they would have a fulfilling and socially respectable career. Significantly more students in the intervention group agreed with the pharmacists' role in health care as well as the current situation of pharmacy human resources than in the control group.

Conclusion

This student-led interview intervention could be applied as an effective tool for improving students' professional identity and positivity in pharmacy education.

Factors Influencing Professional Identity Construction in Fourth-Year Pharmacy Students

Objectives. To explore the key factors that influence professional identity construction in fourth-year pharmacy students enrolled in a Doctor of Pharmacy program.Methods. A single-site instrumental case study of current fourth-year pharmacy students from the Leslie Dan Faculty of Pharmacy, University of Toronto, was used. Thirteen students participated in semistructured interviews. Poststructural social identity theories were used to analyze the data and identify themes that influence identity construction in pharmacy students.Results. Data analysis identified five overarching themes that influence pharmacy student professional identity construction: path to pharmacy, curriculum, environment, preceptors, and patient interactions. The Leslie Dan Faculty of Pharmacy curriculum prioritized the health care provider identity, which influenced the students desire to "become" clinicians. Based on their internalized health care provider identity, they rejected preceptors and practice environments that negatively impacted their ability to embody this identity.Conclusion. The findings of this study suggest that pharmacy students align themselves strongly with health care provider identities at the cost of other potentially relevant identities. Pharmacy education programs may benefit from curricular reforms that incorporate and legitimize multiple pharmacist identities to ensure a strong pharmacy workforce for the future.

Qualitative Analysis of Pharmacy Students' Self-identified Preconceptions Regarding the Term Clinical Pharmacy

Objective. To evaluate third-year pharmacy students' self-identified preconceptions regarding the term clinical pharmacy as defined by the American College of Clinical Pharmacy (ACCP).Methods. Third-year pharmacy students were led in a multipart activity focused on evaluating their preconceptions about the term clinical pharmacy after exposure to the unabridged definition published by ACCP. Students were asked to identify two preconceptions they had before the activity that were dispelled after reading the article. Thematic coding was used to identify semantic themes and generate summaries of student perceptions.Results. Three hundred twenty-two third-year pharmacy students' assignment data was coded to reveal six major themes about their preconceptions related to the term clinical pharmacy: setting, required training, job responsibilities, scope within the health care system, job environment (physical, emotional, financial), and limited knowledge about clinical pharmacy. Consistencies in thought were found within two of these themes, namely setting and required training. Significant variance was seen in the remaining four themes, specifically regarding types of activities performed, job environment, the scope of practice, and impact in the health care system.Conclusion. Third-year pharmacy students' preconceptions about clinical pharmacy were related to the exclusivity of where it can be practiced and the need for additional training as a requirement. However, high variability was seen in the majority of the remaining themes, illustrating an inconsistent view of what clinical pharmacy is and the need for intentional focus on professional identity formation within the pharmacy curriculum.

Indicators, influences, and changes in professional identity formation in early experiential learning in community pharmacy

BACKGROUND

Experiential education is a key area in the pharmacy curriculum that professional identity formation (PIF) occurs. However, little is known about PIF influences and supports for pharmacy students during early experiential placements. The study aimed to explore pharmacy student PIF in an early experiential rotation in community pharmacy using reflective writing.

EDUCATIONAL ACTIVITY AND SETTING

First-year pharmacy students completed written reflections describing their professional identity and influencing experiences, before and after a four-week community introductory pharmacy practice experience. Qualitative content analysis of the written reflections was performed using three analytical approaches: (1) deductive coding based on professional identity indicators; (2) inductive coding to identify influences; and (3) inductive coding of field notes to identify changes between pre- and post-written reflections.

FINDINGS

Twelve students participated. All participants described discrete professional attributes and behaviors and valuing a patient-centered approach as part of their professional identity. Participants reported observation of pharmacists, the curriculum, and previous work experience influenced PIF prior to the experiential rotation. A strong influencer of PIF during the rotation was observation of pharmacist preceptors, whereas participants' own experiences were described less often. Changes in professional identity among participants were subtle and categorized as affirmation, acquisition, and growth.

SUMMARY

Pharmacy students' markers and influencers of PIF should be considered when developing curricular experiences and preceptor development that support PIF. The use of professional identity indicators and analysis of written reflections as a method to uncover PIF, shows promise and warrants further investigation.

To be or not to be: The identity work of pharmacists as clinicians

This study explores how pharmacists legitimise the expansion of their clinical work and considers its impact on pharmacists' professional identity work. In the context of pharmacy in the English NHS, there has been an ongoing policy shift towards pharmacists moving away from 'medicines supply' to patient-facing, clinical work since the 1950s. Pharmacists are continuously engaging in 'identity work' and 'boundary work' to reflect the expansion of their work, which has led to the argument that pharmacists lack a clear professional identity. Drawing insights from linguistics and specifically Van Leeuwen's 'grammar of legitimation', this study explains how the Pharmacy Integration Fund, a nationally funded learning programme, provides the discursive strategies for pharmacists to legitimise their identity work as clinicians.

Preceptor Perceptions of Pharmacy Student Performance Before and After a Curriculum Transformation

Objective. To explore preceptors' perceptions about the performance of undergraduate pharmacy students during experiential placements in Australia, before and after curricular transformation.Methods. Using a semi-structured approach, we interviewed 26 preceptors who had recently supervised students who took part in the transformed curriculum and students from the previous curriculum. A directed content analysis approach was used to analyze the transcripts.Results. Preceptors described students from the transformed curriculum as having improved professional skills, behaviors, and attitudes and as having an increased ability to perform clinical activities compared to students of the previous curriculum. Preceptors also perceived that students in the transformed curriculum had improved clinical knowledge and knowledge application. They less frequently expressed that students in the transformed curriculum had lower-than-expected knowledge levels.Conclusion. The results of this study suggest that curricular transformation with a focus on skill-based and active learning can improve the performance of pharmacy students in terms of their professional behaviors and attitudes, skills, knowledge, and clinical abilities, as perceived by preceptors.

Preparing Pharmacy Educators as Expedition Guides to Support Professional Identity Formation in Pharmacy Education

Objective. To provide an educator-friendly travel guide for supporting pharmacy students' lifelong journey to professional identity formation.Findings. In contrast to professionalism, which has emphasized externally visible behaviors, professional identity focuses on the internalization of the attitudes, standards, and behavioral norms of a profession, such that one "thinks, acts, and feels" like a member of that profession. Identity, whether personal or professional, is continuously developed in part during interactions with others and in response to internal and external feedback on those interactions. Educators play a critical role in helping students navigate the "provocative moments" (eg, transitions, dissonance) that accompany identity formation. To help educators travel with purpose, several identity formation theories suggest means of creating learning experiences and supporting the development of a professional identity. Additionally, guidebooks for the trip (ie, published literature) provide examples of didactic and experiential teaching approaches that can be used to promote professional identity formation. While further exploration and research are necessary, traveling this journey with colleagues can help members of the Academy succeed in sustainably and effectively infusing intentional professional identity formation within pharmacy education and training.Summary. There are myriad ways for educators to develop and support professional identity formation, which can present a challenge when defining the role that educators play in this complex, dynamic process. Educators must understand the reasoning behind various approaches and the common dialogue used to engage and support learners as their expedition guides on the lifelong journey to professional identity formation.

Reflective Practice: Co-Creating Reflective Activities for Pharmacy Students

Reflective practice is important in pharmacy education to support skill development for decision-making, critical thinking, problem-solving, and in continuing professional development and beyond. Despite the importance of reflective practice in higher education and professional practice, reflection assignments are not universally embraced by students. This project was initiated due to recent interest in the co-creation of pharmacy curriculum by students and faculty. The purpose of this project was to develop reflection assignments for pharmacy students. The principles of the analysis, design, development, implementation, evaluation (ADDIE) instructional design framework guided the development of reflection assignment templates for three focus areas: personal development, professional development, and professional identity formation. Templates included background and definitions for these specific focus areas as well as objectives, instructions, guiding questions, assessment methods, and submission requirements. A previously tested assessment rubric was adopted for reflection assignments. Development involved target audience and expert reviews and a trial implementation was held in a year 3 patient care skills course. The co-creation process enriched the experiences of students and faculty involved in it. Future co-creation projects including groups of students, formal evaluation of outcomes, and impact on the program will further support integration of reflective practice in the pharmacy curriculum.