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Hardy YM, Gaither C, Holiday-Goodman M, Little M. Creating Competencies for Providing Care in a Diverse, Equitable, and Inclusive Manner: A Delphi Technique. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100749. [PMID: 38960070 DOI: 10.1016/j.ajpe.2024.100749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 06/10/2024] [Accepted: 06/25/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVE Competencies related to diversity could be essential to training and assessing student pharmacists in their readiness to provide equitable and inclusive care. Such competencies are lacking in pharmacy education; therefore, this study aimed to explore the development of diversity competencies and supporting factors needed to prepare students to meet the competencies and provide patient care in a diverse, equitable, and inclusive manner. METHODS Pharmacy diversity thought leaders were invited to participate in a 3-round modified Delphi survey. Survey items were created using a Backward Design. Qualitative data were analyzed using the Constant Comparative Method. Draft competency statements were created based on the collective comments from Round 1 along with themes related to the supporting factors needed to achieve the competencies. Consensus on themes, competency statements, and edits were identified in Round 2. Additional comments and feedback on edits were gathered in Round 3. Consensus was preset at 85.7%. RESULTS Seven competency statements were created. Knowledge, skills, attitudes, behaviors, values, curricular content/pedagogy, and resources needed to prepare students to meet the competencies and support faculty would need were identified. CONCLUSION Preliminary diversity competencies and supporting factors needed were developed using the perspective of thought leaders. Further evaluation, including the development of student-appropriate competencies, testing and validation of content and assessment tools, and determining place in the pharmacy curriculum, are future steps that should be considered in the competency development process.
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Affiliation(s)
- Yolanda M Hardy
- Palm Beach Atlantic University Lloyd L. Gregory School of Pharmacy, West Palm Beach, FL, USA.
| | - Caroline Gaither
- University of Minnesota College of Pharmacy, Minneapolis, MN, USA
| | - Monica Holiday-Goodman
- The University of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, OH, USA
| | - Meg Little
- University of Minnesota College of Pharmacy, Minneapolis, MN, USA
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Lewis TL, Tupas KD. Enhancing hypertension pharmacotherapeutics education by integrating social determinants of health. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100727. [PMID: 38844067 DOI: 10.1016/j.ajpe.2024.100727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 05/07/2024] [Accepted: 05/29/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE Social determinants of health (SDOHs) play a significant role in hypertension management. Pharmacy program accreditation standards include that students should understand SDOHs. However, there are limited data regarding approaches to incorporating SDOHs within pharmacotherapeutics courses. This study evaluated the changes in student knowledge, understanding, perceptions, beliefs, and confidence by integrating SDOH topics in hypertension pharmacotherapeutics lectures. METHODS The study invited students enrolled in cardiovascular pharmacotherapeutics courses at 2 institutions to participate. Participation involved a preintervention questionnaire, a lecture on clinical management of hypertension incorporating SDOH concepts, an assignment involving reading a journal article and answering related questions, and a postintervention questionnaire. Data analysis was conducted using SPSS, with a predetermined α level of 0.05 for statistical significance. Mean composite questionnaire scores were calculated and compared with Wilcoxon signed rank test. RESULTS Of 109 students, the response rate was 85.3 % (93 participants). The combined questionnaire results demonstrated a statistically significant improvement in all questionnaire item composites. The open-ended knowledge assessment yielded a mean score of 5.75 (range 3-6). CONCLUSION The study intervention enhanced student knowledge, understanding, perceptions, beliefs, and confidence regarding the impact of SDOHs on hypertension. This practical and reproducible approach offers a valuable method for incorporating SDOH concepts into pharmacotherapeutics courses.
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Affiliation(s)
- Troy Lynn Lewis
- Wilkes University Nesbitt School of Pharmacy, Wilkes-Barre, PA, USA.
| | - Kris Denzel Tupas
- Roosevelt University College of Science, Health, and Pharmacy, Schaumburg, IL, USA
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Logan LD, Johnson BR, Grout K, Gyamfi K, Fulford M. Developing Confidence in Engaging in Diversity, Equity, and Inclusion and Social Determinants of Health Topics Through Self-Authorship. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100746. [PMID: 38944281 DOI: 10.1016/j.ajpe.2024.100746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/22/2023] [Accepted: 06/22/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE This study used a self-authorship framework to explore if diversity, equity, and inclusion (DEI) and social determinants of health (SDoH)-focused laboratories and learning activities increase student confidence in understanding aspects of implicit bias and SDoH, and how these activities impact student comfort in discussing and confidence in initiating conversations on DEI/SDoH topics with colleagues, faculty, supervisors, and patients. METHODS First-year PharmD students engaged in 3 learning activities across 2 courses. Students were challenged to evaluate their biases and incorporate DEI/SDoH into their professional identity formation. This study used a mixed-methods, embedded approach to analyze assessment data collected via a questionnaire and assignments administered at 3 points during the fall semester. Quantitative analysis used a quasi-experimental, between-participants, pretest-posttest design. The qualitative component used open-ended questions to gain additional insight into participant experiences, gathered detail on perceptions, and provided context. RESULTS A 1-way analysis of variance showed statistically significant increases between assessment points for all items related to confidence in understanding implicit bias and SDoH. Comfort in discussing DEI/SDoH topics with supervisors/faculty and patients increased over time. Comfort in discussing DEI/SDoH topics with colleagues did not increase. Three salient themes emerged from qualitative analyses: bias and privilege awareness, education, and professionalism. CONCLUSION This study found that students started evaluating their own knowledge, beliefs, and claims in social and professional settings as defined by the self-authorship framework. Student comfort and confidence in discussing DEI/SDoH topics increased over time. Findings support that engaging students in multimodal programming may support incorporation of DEI/SDoH into professional identity formation.
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Affiliation(s)
- Linda D Logan
- University of Georgia College of Pharmacy, Athens, GA, USA.
| | | | - Kaitlin Grout
- University of Georgia College of Pharmacy, Athens, GA, USA
| | - Konadu Gyamfi
- University of Georgia College of Pharmacy, Athens, GA, USA
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O'Donnell EP, Arif SA. Validating identities: The pharmacist's role in providing affirming care and services to sexual and gender minority patients. Am J Health Syst Pharm 2024; 81:334-339. [PMID: 38156465 DOI: 10.1093/ajhp/zxad321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Indexed: 12/30/2023] Open
Affiliation(s)
| | - Sally A Arif
- Department of Pharmacy Practice, Midwestern University College of Pharmacy, Downers Grove, IL, USA
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Lau LHC, Wong JXN, Azfar J, Gallagher PJ, Koh L. Evaluating the internalisation of the intrinsic role of health advocacy of student pharmacists in a new integrated Bachelor of Pharmacy curriculum: a mixed-methods study. BMC MEDICAL EDUCATION 2023; 23:900. [PMID: 38012606 PMCID: PMC10680209 DOI: 10.1186/s12909-023-04877-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 11/15/2023] [Indexed: 11/29/2023]
Abstract
To keep up with the contemporary health landscape, there is an imperative need for healthcare professionals to practise health advocacy through health promotion on the individual, population, and systems levels. In the Academic Year of 2020/2021, the National University of Singapore (NUS) Department of Pharmacy implemented a new spiral curriculum integrating basic, clinical, and systems sciences with one of its aims to deepen students' health advocacy internalisation and prepare them as future health advocates. A mixed-methods approach was adopted. Questionnaires were disseminated across three time-points to elicit students' levels of internalisation of health advocacy, which were then categorised into levels, and a Mann-Whitney U test was conducted. In comparison with prematriculation, no significant difference was found after students underwent the first year of the curriculum, while a significant difference was found after students underwent two years of the curriculum. Semi-structured interviews were also conducted after each Academic Year to gain deeper insights into the questionnaire results. Thematic analysis of the interviews revealed that curricular integration in the first year was perceived to be lacking. However, with learnt knowledge constantly reinforced and more experiential learning opportunities incorporated throughout the second year, students found the integrated curriculum beneficial in instilling confidence to practise health advocacy. This study offers insights into the prospects of a spiral integrated curriculum in imparting health advocacy, and may even suggest its potential to be applied to other educational settings. Future follow-up studies can also be conducted on the same study population to evaluate long-term impacts and areas for improvement of the curriculum.
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Affiliation(s)
- Li Hui Candice Lau
- Department of Pharmacy, National University of Singapore, Singapore, Singapore.
| | - Jolin Xin Ni Wong
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Julian Azfar
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Paul John Gallagher
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Leroy Koh
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
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Rockich-Winston N, Robinson A, Arif SA, Steenhof N, Kellar J. The Influence of Intersectionality on Professional Identity Formation among Underrepresented Pharmacy Students. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100108. [PMID: 37597916 DOI: 10.1016/j.ajpe.2023.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/18/2023] [Accepted: 02/15/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVE The objective of this study is to explore professional identity formation (PIF) among student pharmacists from underrepresented groups (URGs). METHODS In this qualitative study, 15 student pharmacists from the University of Georgia and Midwestern University Colleges of Pharmacy were recruited for interviews to explore the influence of intersectionality of race, ethnicity, and gender on PIF. Interview data were analyzed using constructivist grounded theory to identify themes and then further analyzed using Crenshaw's theory of intersectionality, namely structural, political, and representational intersectionality. RESULTS Intersectionality of identities created situations where participants expressed advantages belonging to certain social categories, while simultaneously being disadvantaged belonging to other social categories. This awareness led to strategies to overcome these collective obstacles for themselves and their communities. Participants then described ways to shift perceptions of how society depicts pharmacists and the pharmacy profession. The results depict these processes and how intersectionality influences PIF for URG student pharmacists. CONCLUSION The sociocultural aspects of race, ethnicity, and gender influence the PIF of student pharmacists who belong to URGs. Intersectionality helps us better understand the ways in which inequality compounds itself, and this results in URG student pharmacists creating opportunities for belongingness and representation. Resultantly, URGs create opportunities for inclusivity and representation. To continue to facilitate this it is essential for educators and university systems to promote ways to foster and incorporate PIF in student pharmacists.
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Affiliation(s)
| | | | - Sally A Arif
- Midwestern University College of Pharmacy, Downers Grove, IL, USA
| | - Naomi Steenhof
- University of Toronto, Leslie Dan Faculty of Pharmacy, Toronto, Canada
| | - Jamie Kellar
- University of Toronto, Leslie Dan Faculty of Pharmacy, Toronto, Canada
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Tupas KD, Campbell HE, Lewis TL, Leslie KF, McGee EAU, Blakely ML, Kawaguchi-Suzuki M. Baseline Assessment of Systemic Racism Education in Pharmacy Curricula. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:ajpe9028. [PMID: 35470174 PMCID: PMC10159528 DOI: 10.5688/ajpe9028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/19/2022] [Indexed: 05/06/2023]
Abstract
Objective. To determine, by survey, the inclusion of systemic racism education in US Doctor of Pharmacy (PharmD) curricula and identify barriers and facilitators to addressing this content.Methods. A survey was developed and distributed to curricular representatives at US colleges and schools of pharmacy. The survey assessed inclusion of systemic racism education in curricula, faculty involvement in teaching systemic racism content, barriers to adding systemic racism content in curricula, and future curricular plans. Data were analyzed using descriptive statistics for institutional background information, curricular content, and barriers to inclusion. Relationships between the inclusion of systemic racism content at public versus private programs were examined, and associations between traditional and accelerated programs were assessed.Results. Fifty-eight colleges and schools of pharmacy provided usable responses. Of the respondents, 84% indicated that teaching systemic racism content and its impact on health and health care was a low priority. For 24% of respondents, systemic racism content was not currently included in their curriculum, while 34% indicated that systemic racism content was included in one or more courses or modules but was not a focus. Despite systemic racism content being offered in any didactic year, it was rarely included in experiential curricula. Top barriers to inclusion were lack of faculty knowledge and comfort with content and limited curricular space. No significant differences were found between program types.Conclusion. Based on the current level of systemic racism education and barriers to inclusion, faculty need training and resources to teach systemic racism concepts within pharmacy curricula. The inclusion of systemic racism concepts and guidance in the Accreditation Council for Pharmacy Education's Accreditation Standards could help to drive meaningful change and promote health equity.
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Affiliation(s)
- Kris Denzel Tupas
- Roosevelt University, College of Science, Health and Pharmacy, Schaumburg, Illinois
| | - Hope E Campbell
- Belmont University, College of Pharmacy, Nashville, Tennessee
| | - Troy Lynn Lewis
- Wilkes University, Nesbitt School of Pharmacy, Wilkes-Barre, Pennsylvania
| | - Katie F Leslie
- Sullivan University, College of Pharmacy and Health Sciences, Louisville, Kentucky
| | - Edo-Abasi U McGee
- Philadelphia College of Osteopathic Medicine (PCOM), School of Pharmacy, Suwanee, Georgia
| | - Michelle L Blakely
- University of Wyoming, School of Pharmacy, Laramie, Wyoming
- Editorial Board Member, American Journal of Pharmaceutical Education, Arlington, Virginia
| | - Marina Kawaguchi-Suzuki
- Editorial Board Member, American Journal of Pharmaceutical Education, Arlington, Virginia
- Pacific University, School of Pharmacy, Hillsboro, Oregon
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DiPiro JT, Allen DD, Lin A, Scott SA, Sorensen TD, Maine LL. Impact of Social Forces and Environmental Factors on Healthcare and Pharmacy Education: The Report of the 2021-2022 AACP Argus Commission. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:ajpe9452. [PMID: 36781186 PMCID: PMC10159613 DOI: 10.5688/ajpe9452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
| | - David D Allen
- University of Health Sciences and Pharmacy, St. Louis, Missouri
| | - Anne Lin
- Notre Dame of Maryland University, Baltimore, Maryland
| | - Steven A Scott
- Purdue University, College of Pharmacy, West Lafayette, Indiana
| | - Todd D Sorensen
- University of Minnesota, College of Pharmacy, Minneapolis, Minnesota
| | - Lucinda L Maine
- American Association of Colleges of Pharmacy, Arlington, Virginia
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Argyriadis A, Patelarou E, Paoullis P, Patelarou A, Dimitrakopoulos I, Zisi V, Northway R, Gourni M, Asimakopoulou E, Katsarou D, Argyriadi A. Self-Assessment of Health Professionals' Cultural Competence: Knowledge, Skills, and Mental Health Concepts for Optimal Health Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811282. [PMID: 36141554 PMCID: PMC9517303 DOI: 10.3390/ijerph191811282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/23/2022] [Accepted: 09/06/2022] [Indexed: 05/06/2023]
Abstract
Current research often refers to cultural competence to improve health care delivery. In addition, it focuses on the cultural uniqueness of each health service user for optimal personalized care. This study aimed to collect self-assessment data from health professionals regarding their cultural competence and to identify their development needs. A mixed methods design was adopted using the Cultural Competence Self-assessment Checklist of the Central Vancouver Island Multicultural Society. This was translated into Greek, validated, and then shared with health professionals in Cyprus. Subsequently, a semi-structured interview guide was designed and utilized. This was structured in exactly the same question categories as the questionnaire. Data collection took place between October 2021 and May 2022, and convenience sampling was used to recruit 499 health scientists in Cyprus. The sample comprised doctors, nurses, psychologists, midwives, social workers, and physiotherapists. Subsequently, 62 interviews were conducted with participants from the same specialties. The results showed that (compared to other health professionals) nurses and psychologists are more sensitive to issues of cultural competence. It would appear that the more socially oriented sciences had better-prepared healthcare staff to manage diversity in context. However, there is a gap between knowledge and skills when comparing doctors to nurses; they seem to be more skilled and willing to intervene actively in cases of racist behavior or problem-solving. In conclusion, participants identified the importance of their cultural competence; they also realized the importance of optimal planning of personalized health care. There is a significant need for continuous and specialized cultural competence training for all health professions.
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Affiliation(s)
- Alexandros Argyriadis
- School of Health Sciences, Frederick University, Nicosia 1036, Cyprus
- Correspondence: ; Tel.: +357-22394394
| | - Evridiki Patelarou
- School of Health Sciences, Hellenic Mediterranean University, 714 10 Iraklio, Greece
| | | | - Athina Patelarou
- School of Health Sciences, Hellenic Mediterranean University, 714 10 Iraklio, Greece
| | | | - Vasiliki Zisi
- Department of Physical Education and Sport Science, University of Thessaly, 382 21 Volos, Greece
| | - Ruth Northway
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd CF37 1DL, UK
| | - Maritsa Gourni
- School of Health Sciences, Frederick University, Nicosia 1036, Cyprus
| | | | - Dimitra Katsarou
- Department of Pre-School Education and Educational Design, University of the Aegean, 811 00 Mitilini, Greece
| | - Agathi Argyriadi
- School of Education and Social Sciences, Frederick University, Limassol 3080, Cyprus
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Addressing cultural competence and bias in treating migrant workers in pharmacies: Pharmacy students learning and changing norms. Res Social Adm Pharm 2021; 18:3362-3368. [PMID: 34857481 DOI: 10.1016/j.sapharm.2021.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/13/2021] [Accepted: 11/24/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Little research addressed training pharmacy students on bias towards vulnerable patients such as migrant domestic workers (MDWs). This study evaluates a module addressing bias and cultural competence when working with MDWs in community pharmacies. METHODS Two cohorts of Lebanese Bachelor of pharmacy students completed this module as part of a core Public Health class. Guided by a social psychology framework, the module involved watching a lecture, discussing an article, watching a video addressing bias in healthcare, and taking an Implicit Association Test. Second, students interviewed one MDW and one pharmacist before filling a reflection worksheet. Students' reflections were analyzed qualitatively using content analysis. Further, to evaluate the module's impact quantitatively, an aggregate perception of helpfulness scale was created and validated. Items addressed students' own experience with the module as well as its impact on pharmacists interviewed by students. RESULTS Of 170 students completing the module and providing qualitative data, 131 were asked to fill a survey addressing perceptions of assignment helpfulness. Of those 131 students, 126 filled the survey. On a scale ranging from zero to four, the composite mean score for helpfulness was 3.4, SD = 0.5. Students reported a positive impact of the interview in improving awareness of bias for pharmacists they interviewed (mean = 3.5, SD = 0.6). Qualitative analysis produced insight into students' experience with the module including challenges in communication with MDWs; MDWs' experience with bias and its repercussions; predictability, or lack thereof, of assignment results; plans to address bias after taking the module; evaluation of interviewed pharmacist's service; and perceived pharmacists' impressions of the assignment. CONCLUSIONS A two-part module shows promise in educating pharmacy students about bias and cultural competence. Engaging target audience including pharmacists can make such experiences meaningful for students while providing a learning opportunity for those health professionals.
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