Academic journal article American Journal of Pharmaceutical Education

Organizational Philosophy as a New Perspective on Understanding the Learning of Professionalism

Academic journal article American Journal of Pharmaceutical Education

Organizational Philosophy as a New Perspective on Understanding the Learning of Professionalism

Article excerpt

INTRODUCTION

Pharmacy practice has an increasingly clinical focus, both in hospital and community pharmacy. This is evident in a revised community pharmacy contract. (1) which diversified remuneration away from payment by volume of items dispensed to one which remunerates services. Pharmacy curricula also have been revised to reflect this patient-centered role shift by incorporating more practice and clinical topics. (2) In the United Kingdom (UK), this was made possible partly through the extension of the 3-year bachelor degree to a 4-year undergraduate master of pharmacy (MPharm) degree in 1997. Practice exposure and placements are, however, relatively limited during the MPharm degree program, and a supervised pre-registration training year follows graduation with an MPharm degree and precedes qualifying for pharmacist registration.

In line with the shift towards more clinical and patient-centered roles for pharmacists, pharmacy educators and researchers in the United Kingdom are beginning to consider the concept of professionalism, most research and publications on which have come from North America. Pharmacy therefore has looked to other healthcare professions, medicine in particular, that have addressed the topic. While the definitions of professionalism share many features, definitions, particularly those of medical professionalism, are numerous .(3-8) The UK Royal College of Physicians (RCP) defined it as "a set of values, behaviors, and relationships that underpin the trust the public has in doctors." (9) Despite a reasonable degree of consensus on what constitutes professionalism in medicine, (10) questions remain as to whether the same characteristics are relevant to pharmacy, and particularly how their learning and development can be supported.

Attempts have been made to at least describe elements or attributes--of professionalism in pharmacy, and these generally refer to values, attitudes, and behaviors. (11-14) Pharmacy publications in North America have particularly focused on how the development of professionalism can be supported during professional pharmacy education. (12,15-18) This is indeed a good starting point, as there is general agreement that the process of becoming a professional starts early, while being a pharmacy student. (19) It therefore makes sense to explore how the foundations of pharmacy professionalism are laid during the MPharm degree program.

Though some studies have explored how to support the learning of professionalism during pharmacy education, (13,18) the medical education literature highlights the importance of teaching an often tacit concept such as professionalism continuously through the curriculum. (20-22) Besides the identification of specific areas in the curriculum where professionalism can be explicitly incorporated, the importance of indirect influences such as role models has been highlighted. (23-28) Students may be exposed to both bad and good role models, (25,29) which operate within an overall "culture" within individual medical schools. These less formal but nevertheless important influences on the development of professionalism are increasingly acknowledged and are commonly referred to as the "hidden curriculum." (30-34) This is defined as "a set of influences that function at the level of organizational structure and culture," thus acknowledging the impact organizational factors have on the learning process. (35)

The aim of this study was to understand and clarify how professionalism is learned, cultivated, and facilitated in the pharmacy academic environment. (36) This paper specifically aims to identify elements within MPharm curricula and teaching systems in the United Kingdom that particularly contribute to pharmacy students' learning of professionalism. The definition of professionalism which underpinned this study, though grounded in that provided by the RCP, (9) focused on attitudinal and behavioral elements of individual professionalism. …

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