The Pharmaceutical Journal
Vol 275 (Supplement) F15-F16
October 2005

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FIP Congress 2005

Concepts of social and administrative pharmacy need to be defined

Kath Ryan, University of Otago, New Zealand, described to participants a study she had carried out concerning the teaching of social pharmacy to undergraduates. The results of her study indicated that there is a need for the concept of social and administrative pharmacy to be defined.

Putting her findings in context, she said that it is recognised that across the western world, the cost of providing health care has continued to escalate, with a greater range of health technologies and therapeutic techniques available. Together with these comes increasing awareness of risks and errors, deregulation of medicines, pharmacists prescribing and changes in contracts and payment for cognitive services. Consequently, the pharmacy curriculum has undergone significant change over the past 20 years.

She explained that many courses have moved from being dominated by the physical sciences to include clinical, social, administrative and practice elements. This has led to a greater emphasis on subjects based around the clinical requirements of patients and a knowledge of drugs and diseases.

Ms Ryan said that there was a reluctance to do this in some areas but went on to describe how the role of the pharmacist now includes direct interaction with the public, provision of health information and the advice and counselling on safe and rational use of medicines. She explained that social pharmacy — perhaps similar to social medicine — is a multidisciplinary hybrid, drawing on theories and methodologies of social and behavioural sciences. She further developed this theme by explaining the impact on the development of the pharmacy curriculum. Ms Ryan provided several examples to show how the classification of undergraduate courses differs considerably at both national and international levels.

She used the Johnson and Wertheimer 1979 definition — “Behavioural pharmacy is the field concerned with the development of behavioural science, knowledge and techniques relevant to the understanding of drug use, drug effects, drug selection and prescribing, behavioural-therapy adjuncts and alternatives to drug therapies, the professional behaviour and well-being of pharmacy practitioners, and the application of this knowledge and these techniques to prevention, diagnosis, treatment and rehabilitation” — and the FIP Academic Pharmacy Group global survey of teaching social pharmacy and pharmacy administration to demonstrate various ways of supporting recognition of “social pharmacy”.

A website was established to provide an international, collegial, networking focal point for faculties engaged in social pharmacy teaching. The site included a web-based questionnaire that enabled the collection of data related to teaching. The site was also designed to enable the sharing of course outlines and teaching resources, curricula and research activities. The survey was designed to be ongoing and electronically self-analysing. While the responses were received and continually collated, these results reported here are up to 30 September 2004. Sixty-two respondents, representing schools of pharmacy from 17 countries, had taken part in the survey by this date.

Respondents said that social science disciplines included: economics, sociology, psychology, anthropology, history, communication skills, health promotion/education, public health and health policy, social epidemiology, geography, business management, marketing, social and administrative pharmacy, biostatistics, clinical epidemiology, evidence-based medicine, law and ethics, pharmacoeconomics, pharmacoepidemiology and pharmacoinformatics.

Respondents were asked to identify the level in the curriculum at which various social science disciplines were being taught to undergraduates. Answers were assigned an average ranking from 1 to 2 (1 being 100 per cent of respondents were teaching that discipline and 2 being none). Charting the average rankings across the undergraduate years and disciplines made it possible to see which disciplines were most commonly taught and at what levels. The most commonly taught discipline was communication skills, with anthropology and geography being taught the least.

The list of subjects being taught under social pharmacy banner was much larger and more diverse and included the social basis of health and illness, social theory, health inequalities, gender and health, ethnicity and health, national health systems, international health systems, development of health professions, professionalisation, pharmacy professional organisations, funding/financing of health systems, health policy, health services, public health, women’s health, complementary and alternative medicine, experiencing health and illness, help-seeking behaviour, lay health beliefs, and death and dying.

Ms Ryan then moved on to “the way forward” saying: “There is a need to define the concept of social and administrative pharmacy, and develop a taxonomy and framework that allows teachers to take on that part which deals with the priority needs of their particular country. There is also a need for a strong debate regarding the role of pharmacists [including] the foundational and applied competencies that they need to fulfil that role.”

Contribution of e-learning

Claire Anderson, Nottingham School of Pharmacy, UK, asked the audience: “Are you digital natives (who have grown up with technology and are younger than the computer) or digital immigrants (who have seen technology develop during your lifetime and who are more familiar with books and writing, talk and chalk)?”

She explained the impact technology has had on the way we think and act and therefore the effects it may have on the way everyone learns and thinks. For example:

• Computers are not technology

• The internet is better than television

• Reality is no longer real

• Doing is more important than knowing

• Playstation (trial-and-error, experimentation) is preferable to logic

• Multi-tasking is a way of life

• Typing is preferable to handwriting

• Staying connected is essential

• Zero tolerance for delays

• Blurred lines between consumer and creator

This, together with instant messaging, poses quite a challenge for the development of education and learning to meet individual and group needs for now and the future, particularly as many of us are involved in teaching undergraduates. Businesses invest heavily in IT; education needs to invest in it as well. It is key for many aspects of learning, including netting a qualification. Professor Anderson provided some reasons for this:

• Blurs distinction between classroom-based and distance education

• Provides a resource-based approach whereby teacher is no longer the main source of knowledge

• Fosters co-operative, group-based learning, building virtual communities

• Provides a new educational model — more than just a merging of classroom and distance education methods

She then went on to discuss delivering e-learning and the two formats that could be used: asynchronous (eg, e-libraries, bulletin boards) and synchronous (eg, video conferencing, electronic assessment). Both formats could be grouped into resources, interaction, assessment and support.

She told the audience that the internet and virtual learning environments (eg, WebCT, Blackboard) benefit the learning process and its role within education.

Professor Anderson concluded by saying that advanced telecommunication is becoming part of living and will have a bearing on where we work or study. There is a blurring of distinction between the owner, the creator and the user of information.

Online postgraduate pharmacy

What have Captain Frank Worsley Shackleton and parrots got to do with on-line web development? Alan Worsley, of the University of Sunderland, UK, aptly demonstrated the connections by saying one is an explorer (and a relation) and the web encourages exploration by individuals, and the other can repeat everything parrot fashion —so is it learning or teaching? He emphasised that learning is discovery and online facilities provide this opportunity for students. E-learning requires the student to participate, rather than to sit passively in a lecture theatre and be taught. He argued that e-learning is a more valuable tool because it requires active engagement and can give immediate feedback if necessary, it motivates individuals to do further research.

Dr Worsley said that online learning had been defined as “the use of network technology to design, deliver, select, administer and extend learning”.

He added that e-learning is a “systematic use of networked multimedia computer technologies that empowers learners, connects learners to people and resources supportive of their needs and integrate learning, performance and organisational goals”.

He reminded the audience that e-learning as it is today had predecessors and gave examples such as correspondence courses, shorthand, accredited school programmes and the Open University.

Dr Worsley gave hints and tips on how pharmacy education providers could use the different tools available to support learning on the web:

• Conduct an audit of your present course and resources

• Choose your delivery system — should you design your own or use an existing package?

• Audit your staff to find out who is computer literate

• Perform a crude cost-effectiveness analysis

• Have short-, medium- and long-term plans because e-learning technologies take time and organisation

• Assemble your team, trying to make it multidisciplinary

Dr Worsley concluded by saying that, based on his experience at Sunderland, this approach will only work if the right IT support is also provided. It is also important that the curriculum makes it clear what the provider is offering, eg, life-long learning, key skills, training. There needs to be recognition of a consumerist role which is now prominent in education, ie, the student determines the outcome. He concluded by saying the need for feedback from the students completing the course or programme cannot be overestimated.

A student's perspective

Pedro Coelho, of the Fernando Pessoa University, Porto, Portugal, focused on e-learning from the student’s perspective, giving a message that it was seen to be positive with many advantages. “It provides access to many areas and teachers even from different locations,” he said. “Students are more focused and involved in the process. It’s a just-in-time process and provides the facility for constant updating”.

But there were disadvantages, too. He described the reasons why e-learning sometimes fails: loneliness, technological barriers, lack of support, more graphics than content, inadequate content and, particularly, lack of interactivity.

“Plan as much interactivity as possible,” he said. “Ensure that evaluation is included — it helps the learning process and picks up the messages when things are not right so they can be acted up on.”

He acknowledged that giving e-certification comes with its own problems in terms of how it could be proved who did the test and how to eliminate cheating.

There have been a few really successful e-learning projects involving students and he encouraged the audience to get their students involved in developing e-learning programmes. “They have many innovative ideas and they are the key users and will benefit the most from the learning outcomes.”
Mr Coelho concluded by quoting an EU document: “E-learning has the potential of meeting some of the core demands of the knowledge society by creating new ways for employees to upgrade their skill and competencies.” A 97 per cent increase is expected during the next two years, he said.