Academic journal article American Journal of Pharmaceutical Education

Canadian Educational Approaches for the Advancement of Pharmacy Practice

Academic journal article American Journal of Pharmaceutical Education

Canadian Educational Approaches for the Advancement of Pharmacy Practice

Article excerpt


The role of the pharmacist is moving away from that of dispensing and information gathering to that of a clinical decision-making, advanced practitioner; (1,2) thus, the need for an educational shift is imperative. However, concerns have arisen regarding the culture of pharmacy and the barriers pharmacists themselves are creating, such as their perception that they lack the knowledge to undertake new clinical roles and their unwillingness to accept increased professional liability. (3,4) In 2010, a Canadian paper by Rosenthal and colleagues suggested that pharmacist characteristics such as lack of confidence, reluctance to take on new responsibilities, and discomfort with ambiguous decisions all contribute to the slow, arduous process of changing pharmacy practice. (5) In a 2012 Canadian paper, participants identified the following barriers to building confidence and responsibility: the hierarchical structure of the health care system, poor perception among the public and other health care professionals of the pharmacist's role, lack of responsibility-building through pharmacy education, lack of ownership of clinical decisions, poor mentorship by senior pharmacists, and innate personality traits. (6)

The Association of Faculties of Pharmacy of Canada has recommended entry-to-practice doctor of pharmacy (PharmD) programs for all pharmacy schools in Canada by the year 2020.7 Moreover, accreditation standards for the first professional degree in pharmacy have been revised to include standards for the entry-to-practice PharmD programs effective January 2013. (8) Those institutions that have not already moved to an entry-level program are actively committing resources to do so. For a student with an advanced clinical practice degree, an entry-to-practice degree would require an increase in baseline knowledge for the management of a broader scope of disease states, more training in management and communication skills, more clinical practice experiences, and development of cooperative abilities to work on interprofessional teams. (9-11)

The United States has already recognized the need for the advancement of pharmacy education. A "declaration of intent" by the American Council on Pharmaceutical Education in 1989 suggested that American pharmacy schools should shift to an entry-to-practice PharmD degree by the year 2000. (12) After much debate and drastic accreditation changes over the following decade, 2003 marked the first year all US pharmacy schools graduated only PharmD students from their respective programs. (13)

Restructuring the pharmacy curriculum for an entry-to-practice PharmD degree program provides a unique opportunity for significant change. There is little evidence regarding the optimal strategies to approach this task. The purpose of this review is to present and discuss educational changes that would promote the development of an entry-to-practice PharmD degree program that supports an advanced practitioner role. Admission requirements, critical-thinking methods, course content delivery, interprofessional education opportunities, practical experiential education, and mentorship strategies will be discussed.


Research on learning styles of pharmacists suggest that a majority of students attracted to the profession of pharmacy are assimilators. (14) Assimilators prefer analytical work, information gathering, and a focus on ideas, concepts, and logical arguments, on which one can take time to form decisions. In contrast, people who are convergers prefer abstract conceptualization, active experimentation, and high-pressure situations where decision-making and leadership skills are imperative. (15) (Interestingly, medicine tends to attract converger-dominant personalities. (15)) With the shift in pharmacy practice from pharmacists having an information-gathering role to having a decision-making role, the admissions process should perhaps select those students possessing innate leadership and decision-making skills, ie, those with converger-dominant personalities, to address the lack of confidence and responsibility documented within the profession. …

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