Becoming a pharmacist: the role of curriculum in professional identity formation
Main Article Content
Keywords
Students, Pharmacy, Professional Practice, Professional Role, Curriculum, Program Development, Qualitative Research, Australia
Abstract
Objective: To understand how the formal curriculum experience of an Australian undergraduate pharmacy program supports students’ professional identity formation.
Methods: A qualitative ethnographic study was conducted over four weeks using participant observation and examined the ‘typical’ student experience from the perspective of a pharmacist. A one-week period of observation was undertaken with each of the four year groups (that is, for years one to four) comprising the undergraduate curriculum. Data were collected through observation of the formal curriculum experience using field notes, a reflective journal and informal interviews with 38 pharmacy students. Data were analyzed thematically using an a priori analytical framework.
Results: Our findings showed that the observed curriculum was a conventional curricular experience which focused on the provision of technical knowledge and provided some opportunities for practical engagement. There were some opportunities for students to imagine themselves as pharmacists, for example, when the lecture content related to practice or teaching staff described their approach to practice problems. However, there were limited opportunities for students to observe pharmacist role models, experiment with being a pharmacist or evaluate their professional identities. While curricular learning activities were available for students to develop as pharmacists e.g. patient counseling, there was no contact with patients and pharmacist academic staff tended to role model as educators with little evidence of their pharmacist selves.
Conclusion: These findings suggest that the current conventional approach to the curriculum design may not be fully enabling learning experiences which support students in successfully negotiating their professional identities. Instead it appeared to reinforce their identities as students with a naïve understanding of professional practice, making their future transition to professional practice challenging.
References
2. Reid A, Abrandt Dahlgren M, Dahlgren LO, Petocz P, Dahlgren MA. How is professional identity developed? from expert student to novice professional. In: Vol 99 Professional identity. Netherlands; Springer; 2011. ISBN 978-94-007-0250-9
3. Bleakley A, Bligh J, Browne J, eds. Medical education for the future: identity, power and location. Dordrecht: Springer Netherlands; 2011.
4. Wledenmayer K, Summers R, Mackle C, Gous A, Everard M. Developing pharmacy practice: A focus on patient care. Geneva: WHO & FIP; 2006.
5. Elvey R, Hassell K, Hall J. Who do you think you are? Pharmacists' perceptions of their professional identity. Int J Pharm Pract. 2013;21(5):322-332. doi: 10.1111/ijpp.12019
6. Airley R. Are pharmacists considered scientists or clinicians? An undergraduate project. Pharm J. 2013;290:716.
7. Willis SC, Shann P, Hassell K. Pharmacy career deciding: Making choice a "good fit". J Health Organ Manag. 2009;23(1):85-102.
8. Eden M, Schafheutle EI, Hassell K. Workload pressure among recently qualified pharmacists: an exploratory study of intentions to leave the profession. Int J Pharm Pract. 2009;17(3):181-187.
9. Cooke M, Irby DM, O'Brien BC. Educating physicians: a call for reform of medical school and residency. Standford: Jossey-Bass; 2010.
10. Goldie J. The formation of professional identity in medical students: Considerations for educators. Med Teach. 2012;34(9):e641-e648. doi: 10.3109/0142159X.2012.687476
11. Johnson M, Cowin LS, Wilson I, Young H. Professional identity and nursing: contemporary theoretical developments and future research challenges. Int Nurs Rev. 2012;59(4):562-569. doi: 10.1111/j.1466-7657.2012.01013.x
12. Izadinia M. A review of research on student teachers’ professional identity. British Educational Research Journal. 2013:39(4):694-713. doi: 10.1080/01411926.2012.679614
13. Scanlon L. "Becoming" a Professional. In: Scanlon L, ed. "Becoming" a Professional. Dordrecht: Springer Netherlands; 2011.
14. Beauchamp C, Thomas L. Understanding teacher identity: an overview of issues in the literature and implications for teacher education. Cambridge Journal of Education. 2009;39(2):175-189. doi: 10.1080/03057640902902252
15. Ibarra H. Provisional selves: experimenting with image and identity in professional adaptation. Administrative Science Quarterly. 1999;44(4):764-791.
16. Wenger E. Communities of Practice: Learning, meaning and identity. Cambridge: Cambridge University Press; 1998.
17. Reid A, Abrandt Dahlgren M, Dahlgren LO, Petocz P, Dahlgren MA. Professional Pedagogies: what pedagogic approaches can enhance professional learning? In: From Expert Student to Novice Professional. Vol 99: Springer Netherlands; 2011. ISBN: 978-94-007-0249-3
18. Schafheutle EI, Hassell K, Ashcroft DM, Hall J, Harrison S. How do pharmacy students learn professionalism? Int J Pharm Pract. 2012;20(2):118-128. doi: 10.1111/j.2042-7174.2011.00166.x
19. Grossman P, Compton C, Igra D, Ronfeldt M, Shahan E, Williamson P. Teaching practice: A cross-professional perspective. The Teachers College Record. 2009;111(9):2055-2100.
20. Sutherland L, Markauskaite L. Examining the role of authenticity in supporting the development of professional identity: an example from teacher education. High Educ. 2012;64(6):747-766. doi: 10.1007/s10734-012-9522-7
21. Hunter L, Rossi T, Tinning R, Flanagan E, Macdonald D. Professional learning places and spaces: the staffroom as a site of beginning teacher induction and transition. Asia-Pacific Journal of Teacher Education. 2011;39(1):33-46.
22. Pratt MG, Rockmann KW, Kaufmann JB. Constructing professional identity: the role of work and identity learning cycles in the customization of identity among medical residents. Acad Manag J. 2006;49(2):235-262.
23. Nyström S. The dynamics of professional identity formation: graduates’ transitions from higher education to working life. Vocations and Learning. 2009;2(1):1-18. doi: 10.1007/s12186-008-9014-1
24. Reid A, Dahlgren LO, Petocz P, Dahlgren MA. Identity and engagement for professional formation. Studies in Higher Education. 2008;33(6):729-742.
25. Australian Pharmacy Council. The Australian Pharmacy Council Accreditation Standards Version 1.0. Canberra: Australian Pharmacy Council; 2009.
26. Marriott JL, Nation RL, Roller L, Costelloe M, Galbraith K, Stewart P, Charman WN. Pharmacy education in the context of Australian practice. Am J Pharm Educ. 2008;72(6):131.
27. Australian Government. Commonwealth Grant Scheme funding cluster amounts. In: Department of Industry Innovation Science Research and Tertiary Education, ed. Canberra; 2013.
28. Noble C, O'Brien M, Coombes I, Shaw PN, Nissen L. Concept mapping to evaluate an undergraduate pharmacy curriculum. Am J Pharm Educ. 2011;75(3):55.
29. Trede F, Macklin R, Bridges D. Professional identity development: a review of the higher education literature. Studies in Higher Education. 2012;37(3):365-384. doi: 10.1080/03075079.2010.521237
30. Willims DG. Participant Observation. In: Willims DG, Johnson N, eds. Essentials in Qualitative Research: A Notebook for the Field. 1993.
31. Creswell JW. Research design: Qualitative, quantitative, and mixed methods approaches 3rd ed. Thousand Oaks: SAGE; 2009.
32. Jorgensen KMl, Keller HD. The contribution of communities of practice to human resource development: learning as negotiating identity. Advances in Developing Human Resources. 2008;10(4):525-540. doi: 10.1177/1523422308320374
33. Yin RK. Case study research: design and methods. 4th ed. Thousand Oaks, CA: SAGE; 2009.
34. Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess R, eds. Analyzing Qualitative Data. London: RoutledgeFalmer; 1994.
35. Silverman D. Doing qualitative research: a practical guide. London: SAGE; 2004.
36. Packer MJ, Goicoechea J. Sociocultural and constructivist theories of learning: ontology, not just epistemology. Educ Psychol. 2000;35(4):227-241.
37. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533-543.
38. Cipolle R, Strand L, Morley P. Pharmaceutical care practice: the clinician's guide. 2nd ed. New York: McGraw-Hill; 2004.
39. Losinski V. Educating for action: understanding the development of pharmaceutical care practitioners: faculty of the Graduate School, University of Minnesota; 2011.
40. Bleakley A, Bligh J. Students Learning from Patients: Let’s Get Real in Medical Education. Adv Health Sci Educ Theory Pract. 2008;13(1):89-107
41. Kritikos V, Watt HMG, Krass I, Sainsbury EJ, Bosnic-Anticevich SZ. Pharmacy students perceptions of their profession relative to other health care professions. Int J Pharm Pract. 2003;11:121-129.
42. Taylor KMG, Harding G. The pharmacy degree: The student experience of professional training. Pharm Educ. 2007;7(1):83-88.
43. Towle A, Bainbridge L, Godolphin W, Katz A, Kline C, Lown B, Madularu I, Solomon P, Thistlethwaite J. Active patient involvement in the education of health professionals. Med Educ. 2010;44(1):64-74. doi: 10.1111/j.1365-2923.2009.03530.x
44. Bleakley A. The curriculum is dead! Long live the curriculum! Designing an undergraduate medicine and surgery curriculum for the future. Med Teach. 2012;34(7):543-547. doi: 10.3109/0142159X.2012.678424
45. Shah R, Savage I, Kapadia S. Patients' experience of educating pharmacy undergraduate students. Pharm Educ. 2005;5(1):61-67.
46. Austin Z, Duncan-Hewitt W. Faculty, student, and practitioner development within a community of practice. Am J Pharm Educ. 2005;69(3):55.
47. Egan T, Jaye C. Communities of clinical practice: the social organization of clinical learning. Health (London). 2009;13(1):107-125. doi: 10.1177/1363459308097363
48. Mehta BH. Advancing patient care through innovative practice: The Clinical Partners Program. Am J Health Syst Pharm. 2005;62(23):2501-2507.
49. Charon R. The patient-physician relationship. Narrative medicine: a model for empathy, reflection, profession, and trust. JAMA. 2001;286(15):1897-1902.
50. Clandinin J, Cave MT, Cave A. Narrative reflective practice in medical education for residents: composing shifting identities. Adv Med Educ Pract. 2010;2:1-7. doi: 10.2147/AMEP.S13241
51. Clandinin DJ, Cave M-T. Creating pedagogical spaces for developing doctor professional identity. Med Educ. 2008;42(8):765-770. doi: 10.1111/j.1365-2923.2008.03098.x
52. Haidet P, Stein H. The role of the student-teacher relationship in the formation of physicians. J Gen Intern Med. 2006;21(Suppl 1):S16-S20.
53. D'Eon M, Lear N, Turner M, Jones C; Canadian Association of Medical Education. Perils of the hidden curriculum revisited. Med Teach. 2007;29(4):295-296.
54. Hafferty FW. Beyond curriculum reform: confronting medicine's hidden curriculum. Acad Med. 1998;73(4):403-407.
55. Hafferty FW, Hafler JP. The Hidden Curriculum, Structural Disconnects, and the Socialization of New Professionals. In: Hafler JP, ed. Extraordinary Learning in the Workplace. Innovation and Change in Professional Education. 6: Springer Netherlands; 2011.
56. Lincoln Y, Guba E. Naturalistic Inquiry. Newbury Park, CA: Sage Publications; 1985.