Developing the "Upstreamist" through Antiracism Teaching in Pharmacy Education

Perceptions of Diversity, Equity, Inclusion, and Anti-Racism Among Pharmacy Faculty by Racial and Ethnic Identity

OBJECTIVE

To compare perceptions of underrepresented minority (URM), non-URM people of color (POC), and non-minoritized pharmacy faculty in academia in relation to workplace diversity, equity, inclusion, and anti-racism landscape in the United States.

METHODS

This study utilized the Diversity, Equity, Inclusion, and Anti-Racism (DEIA) Faculty Perceptions of College Climate (FPCC) scale, which was developed and validated by the authors. The FPCC scale was used to investigate perceptions of pharmacy faculty from the AACP membership directory regarding DEIA within their respective academic pharmacy institutions. Demographic differences were examined using a Pearson Chi-Square test, while response disparities in FPCC questions were analyzed with a one-way ANOVA.

RESULTS

A total of 846 respondents met the inclusion criteria for the study and were included in the analysis. Results indicate disparities in perceptions within all four DEIA domains of the FPCC survey among the three demographic groups.

CONCLUSION

This study uncovers significant differences in how pharmacy faculty perceive DEIA within pharmacy education, with non-minoritized faculty expressing more positive views compared to their URM and non-URM minoritized counterparts. These results emphasize the need for focused interventions and institutional support to bridge DEIA disparities, emphasizing the importance of fostering an inclusive academic environment to enhance faculty well-being and empower the pharmacy profession to meet diverse needs more effectively.

Enhancing hypertension pharmacotherapeutics education by integrating social determinants of health

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.

Anti-oppression pedagogy in health professions: a scoping review

Health professional learners are increasingly called to learn about health inequity to reduce inequities and improve patient care and health outcomes. Anti-oppression pedagogy (AOP) addresses the need for health professional learners to understand multiple health inequities and the structures and systems that produce inequities. However, the inclusion of AOP in health professions education varies and there is a lack of clarity in its conceptualization and integration. A scoping review was conducted to address this gap and to understand how AOP is conceptualized and integrated in health professions education. Thirty-six articles met the inclusion criteria. The articles demonstrated that AOP is not commonly utilized terminology within health professions education. When AOP is integrated, it is not consistently conceptualized but is generally viewed as a broad concept that focuses on antiracism; decoloniality; intersectionality; and supporting learners to understand, critically reflect on, and act against structural and systemic forms of oppressions. In addition, there is variation in the integration of AOP in health professions education with the most common methods consisting of discussions, cases, reflection, learning through lived experiences, and the incorporation of humanities within a longitudinal curriculum. The results of this scoping review highlight the need for health professions education to develop one clear concept that educators use when teaching about anti-oppression, which may reduce working in silos and allow educators to better collaborate with each other in advancing this work. In addition, this review suggests that health professional programs should consider incorporating AOP in curricula with a broad and longitudinal approach utilizing the common methods of delivery. To better support programs in including AOP in curricula, further research is required to emphasize the benefits, provide clarity on its conceptualization, and determine the most effective methods of integration.

Baseline Assessment of Systemic Racism Education in Pharmacy Curricula

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.

Self-Assessment of Cultural Competence and Social Determinants of Health within a First-Year Required Pharmacy Course

As social determinants of health (SDOH) and health disparities are integrated with cultural competence in healthcare education, tools assessing multiple topics are needed. The Self-Assessment of Perceived Level of Cultural Competence (SAPLCC) survey is validated in student pharmacists and includes SDOH. The research objective was to determine if the SAPLCC survey can quantify cultural competence and SDOH course learning. First-year student pharmacists (N = 87) completed the SAPLCC survey anonymously before and after a social and administrative sciences course. The survey had 75 items with 1–4 Likert scales (4 high, total 300 points). All items were summed for the total score. Each item was assigned to a domain and factor. Factors were assigned to domains. The baseline total score was 190 ± 29 points, increasing by 63 ± 33 points post-course. All domains (i.e., knowledge, skills, attitudes, encounters, abilities, awareness), 13 of 14 factors, and total scores statistically increased. The SAPLCC tool captured student pharmacists’ self-reported changes in cultural competence and SDOH.