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Geoffrey Harding is from Peninsula
College of Medicine and Dentistry, Exeter
Kevin Taylor is from the
School of Pharmacy,
University of London
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In the UK, schools of pharmacy in conjunction with the Royal Pharmaceutical Society are responsible for educating and training ever larger numbers of students, so that they are adequately equipped for registration as members of the pharmaceutical profession. As with other such professional courses, admission into the pharmacy profession is not based simply on individuals absorbing a body of facts. If it were, pharmacists could
qualify by distance learning. Undertaking a pharmacy degree requires
learning a considerable corpus of technical knowledge relating to medicines
and acquiring the appropriate attitudes and beliefs appropriate for the
application of that knowledge for the public good. Therefore, the training
years of any profession involve a process of acculturation — with
students being socialised into the behaviours, beliefs and values of
the
profession.
Values, attitudes, behaviours
Professional socialisation has been described as involving “the
transformation of individuals from students to professionals who understand
the values, attitudes, and behaviours of the profession deep in their
soul. It is an active process that must be nurtured throughout the professional’s/student’s
development. In pharmacy the socialisation process begins the moment
a student … interacts with pharmacists, evaluates what they do, or
actively seeks information about the profession. Beliefs, attitudes and
behaviours begin to develop with regard to pharmacists’ roles.”1
While debate about this process in the UK has been largely eclipsed by
exhaustive discussions concerning curriculum content, in the US pharmacy
student professionalisation is widely discussed and is recognised as
a vital component of pharmacy education. Factors that shape students’ attitudes
and behaviours include their own values, the academic and practice environments
they encounter and role models within those environments.
This fostering of a distinct occupational identity is clearly evident
in the training of student doctors and nurses in the UK, a significant
proportion of which takes place “on the job”. For pharmacy
students, professional socialisation only occurs through interaction
with those who embody and practise the profession’s cultural values.
Socialisation, whereby students internalise the “norms” and
values of pharmacy is essential in creating the cohesion necessary for
an occupational group that, through its relationships with the state
and public, will be successful in securing and retaining a privileged
and well remunerated social position.
However, the quality and appropriateness of pharmacy education in preparing
students for practice is potentially compromised by the shortage of a
pharmacy-trained faculty and a tendency for the bulk of learning to take
place in a purely academic environment. Consequently, we recently set
out to explore whether, and to what extent, pharmacy students considered
themselves to be assimilated into the pharmacy profession during their
education, and whether they had encountered pharmacy role models during
their courses.2 Our interviews, conducted
with groups of first- and third-year students at four UK pharmacy schools
yielded an interesting snapshot
of pharmacy students’ perceptions of their role and function.
In the main, pharmacy students perceived their courses as being distinct
from a general science degree and tended to identify themselves as pharmacy
students rather than just students. Although many recognised the importance
of pharmacist educators in their development as professionals, they were
acutely aware that many of their lecturers were not pharmacists.
Perhaps more interestingly, academic pharmacists (with whom students
have sustained interaction) were considered to be qualitatively different
from their professional colleagues in community or hospital practice,
whom students tended to label as “real pharmacists”. Students
believed the development of a professional identity within their pharmacy
school occurred almost exclusively during teaching and learning in pharmacy
practice classes where they observed the norms of professional practice.
Notably it was the science content, particularly at the beginning of
the degree course, that was perceived as distinct, outwith professional
practice and a necessary hurdle to be surmounted before students can
begin the fabrication of their identity as professionals, later in the
course.
With relatively few full-time pharmacists employed by many schools of
pharmacy, students’ interaction with teacher-practitioners during
their education is of pivotal importance. Teacher-practitioners then
play a key role in ensuring the appropriateness of the learning experience
for contemporary professional practice. Moreover, they have a particular
credibility in the eyes of students as they represent “licensed
practitioners” able to articulate practice “in the real world” and
represent what the students aspire to become: “When we go to pharmacy
practice sessions there are real pharmacists and it is nice to have real
health care professionals who are in the field as it were, working with
the public.”
Students’ exposure to practice settings represents another key
opportunity for socialisation during their training, allowing pharmacists
to be observed undertaking their professional activities. Such placements
are seen by pharmacy schools as being particularly attractive to students,
and are actively promoted on websites, prospectuses, etc. Not only do
these placements contribute educationally, they also promote professional
socialisation and if appropriately managed, students report them to be
highly inspirational and motivating.
However, if practice placements are few, are peripheral to the degree
programme and simply pay lip service to professional practice, they become
little more than cosmetic window dressing and, crucially, a missed opportunity
for professional acculturation: “We’ve had two days in the
first year and two days in the second year and a week in a hospital in
the third year. That wasn’t so vocational; it was really a day
out.” Crucial to student development
Professional socialisation is crucial to pharmacy students’ development
and cannot, and should not be neglected as a secondary concern divorced
from, and subsequent to scientific or indeed clinical knowledge. Responsibility
for professional socialisation rests with the students, pharmacy school
teaching staff and practitioners who interact with the students. Too
often this process is woefully inadequate. Students receive ambiguous
messages about what comprises professional practice during their undergraduate
years and consequently feel inadequately trained for the environment
in which they will practise. Pharmacists, both those responsible for
student education and those interacting with students in practice placements,
and during vacational employment are role models, embodying the attitudes,
values and behaviours expected of students as nascent professionals,
and need to be actively involved in shaping a professional identity.
References
1. Hammer DP, Berger, BA, Beardsley RS, Easton MR (2003) Student professionalism.
American Journal of Pharmacy Education 2003;67:Article 96.
2. Taylor KMG, Harding G. The Pharmacy Degree: the student experience
of professional training. Pharmacy Education (in press). |
The
Pharmaceutical Journal