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Teaching professionalism: A faculty’s perspective
Available online at www.sciencedirect.com
Currents in Pharmacy Teaching and Learning ] (]]]]) ]]]–]]]
Commentary
http://www.pharmacyteaching.com
Teaching professionalism: A faculty’s perspective Oluwaranti Akiyode, PharmD, BCPS, CDE* Howard University College of Pharmacy, Washington, DC
Abstract Professionalism is a relevant topic of discussion among all pharmacy schools in the United States because it is now a highly emphasized element in the pharmacy education standards. It behooves pharmacy programs to ensure the proper teaching of professionalism throughout the pharmacy curriculum. In as much that, professionalization of students includes the formal didactic teaching of professionalism behaviors and values, it is even more critical for the sound, informal, or tacit teaching of professionalism to be achieved via faculty role modeling. Thus, faculty plays a significant role in the professionalization of pharmacy students through both avoidance of unprofessional behaviors and through consistent demonstration of professional behaviors. r 2016 Elsevier Inc. All rights reserved.
Keywords: Teaching professionalism; Faculty behaviors; Faculty development
The conversation on the role of pharmacy faculty and preceptors in the development of student professionalism must be revived. The topic of professionalism has been widely discussed in pharmacy and other health professional literature over the last several decades.1–3 In fact, the Accreditation Council for Pharmacy Education’s (ACPE) recently released pharmacy education “Standards 2016” underscore the incorporation of professionalism within the pharmacy core curriculum.4 These updated standards are based on the American Association of College of Pharmacy’s Center for the Advancement of Pharmacy Education (CAPE) 2013 document.5 The greater emphasis on professionalism in the pharmacy curriculum demands effective teaching of student professionalism. Several experts in the field agree. According to the call to action article by Hammer et al.,6 “ … the role of practitioners in the professional socialization of pharmacy students is enormous and substantial.” Similarly, Berger * Correspondence to: Oluwaranti Akiyode, PharmD, BCPS, CDE, Howard University College of Pharmacy, 2300 4th Street, NW, Washington, DC 20059. E-mail: [email protected] http://dx.doi.org/10.1016/j.cptl.2016.03.011 1877-1297/r 2016 Elsevier Inc. All rights reserved.
et al.7 concluded that students would struggle in the absence of suitable role models during the course of professional socialization. Furthermore, 15 years ago, the American Pharmacists Association Academy of Students of Pharmacy and the American Association of Colleges of Pharmacy (AACP) Council of Deans Task Force on Professionalism both eloquently described the importance of pharmacy educators’ and practitioners’ roles in the professionalization of pharmacy students.8 Students learn professionalism through both explicit (formal teaching) and tacit learning (informal teaching). Literature supports the notion that professionalism is best taught via role modeling, mentoring, and observation of faculty and preceptors.3,9–11 In fact, it has been reported that both explicit and tacit of professionalism are necessary to professionalize students and to avoid sending contradictory messages to students.12–14 The informal teaching, also known as “hidden curriculum,” has been reported to be the most important in setting the culture of a learning environment for students to embed professionalism.12–14 In practical experience, student behavior often mirrors faculty and preceptors in both behaviors and actions. Faculty must not expect for students to “do as they say,
2
O. Akiyode / Currents in Pharmacy Teaching and Learning ] (]]]]) ]]]–]]]
and not as they do.” As faculty and preceptors, we must look in the mirror to reflect on the changes that are needed to serve as professional role models for our pharmacy students both in the classroom and practice setting. As such, there are certain behaviors that should not be exhibited among faculty and preceptors (Table 1). As faculty and preceptors, we should actively engage in professional role modeling and strive to professionally develop ourselves in order to facilitate the professionalization of our pharmacy students. Each faculty and preceptor should personally reflect on whether he or she is serving as a good role model of professionalism. Questions to consider include— (1) Do I exhibit any unprofessional behavior? (2) Which professional behaviors do I lack or need to develop? (3) Do I express other essential professionalism attributes including empathy, clinical proficiency, dependability, dignity with patient interactions, patient advocacy, and patientcenteredness in direct patient interactions?15 Thus, there is a need for faculty and preceptors to be personally responsible for developing their own professionalism through self-awareness and self-reflection. The continuing professional development framework could be a tool for faculty and preceptors to identify personal areas of improvement and develop strategies to ensure being excellent models of professionalism in an ongoing cyclical process.16 One college of pharmacy actually formed an Ad Hoc Professional Development Committee to conduct a comprehensive analysis of their professional development and to recommend approaches to enhance professionalism among students and faculty.10 Another college of pharmacy formed a Professionalism Committee whose charge was to build a professionalism competency statement within the curriculum.17 Other examples of strategies that may be considered by colleges of pharmacy to strengthen
Table 1 Examples of unprofessional faculty and preceptor behaviors21 Improper attire/untidy appearance Disrespect of students, faculty, staff, preceptors, administrators, patients, and clinicians Tardiness to class or practice site Partiality with student grades Absence from class or practice site Late submission of student grades/feedback Embarrassment of students in class or practice site Gossip between faculty/preceptors with students Use of cell phone in class or practice site Delivery of outdated lecture/clinical instruction Absence of continuous improvement in teaching strategies Use of profanity in educational/practice environment Disclosure of confidential student information to other students/ patients Indecent social media interactions with students/patients Provision of inaccurate information to patients and other health care providers
Table 2 Examples of strategies to enhance faculty and preceptor professionalism6–8 Inclusion of professionalism expectations in job description Orientation on professionalism culture Junior faculty/preceptor mentoring Evaluation of professionalism with promotion and/or tenure Recognition awards based on professional attributes Enforcement of honor code or other code of conduct policies Workshop trainings on professional development
professionalism among faculty and preceptors are listed in Table 2. It is necessary for faculty and preceptors to be held to the highest level of professionalism in order to promote a professionalism culture among students.18–20 In fact, department chairs and other administrators at colleges of pharmacy and practice sites should strongly consider the review of faculty and preceptor professional behaviors as an integral part of the promotion/tenure review and merit compensation evaluation, respectively. Consequently, pharmacy faculty and preceptors should be as diligent in exhibiting the high levels of professionalism as we expect our students to emulate. Let us be the professionals that we want to see! Conflicts of interest None. References 1. Montague JB. Pharmacy and the concept of professionalism. J Am Pharm Assoc. 1968;8(5):228–230. 2. Ghadirian F, Salsali M, Cheraghi MA. Nursing professionalism: an evolutionary concept analysis. Iran J Nurs Midwifery Res. 2014;19(1):1–10. 3. Birden H, Glass N, Wilson I, Harrison M, Usherwood T, Nass D. Teaching professionalism in medical education: a Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 25. Med Teach. 2013;35(7):e1252–e1266. 4. Accreditation Council for Pharmacy Education. Accreditation Standards and Key Elements for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree (“Standards 2016”). Available at: 〈https://www.acpe-accredit. org/pdf/Standards2016FINAL.pdf〉; 2015 Accessed May 7, 2016. 5. Medina MS, Plaza CM, Stowe CD, et al. Center for the Advancement of Pharmacy Education 2013 educational outcomes. Am J Pharm Educ 2013;77(8):Article 162. 6. Hammer DP, Berger BA, Beardsley RS, Easton MR. Student professionalism. Am J Pharm Educ. 2003;67(3): Article 96. 7. Berger BA, Butler SL, Duncan-Hewitt W, et al. Changing the culture: an institution-wide approach to instilling professional values. Am J Pharm Educ. 2004;68(1): Article 22. 8. White paper on pharmacy student Professionalism. American Pharmaceutical Association Academy of Students of Pharmacy-
O. Akiyode / Currents in Pharmacy Teaching and Learning ] (]]]]) ]]]–]]]
9.
10. 11.
12.
13.
14.
American Association of Colleges of Pharmacy Council of Deans Task Force on Professionalism. J Am Pharm Assoc 2000;40(1): 96–102. Kenny NP, Mann KV, MacLeod H. Role modeling in physician’s professional formation: reconsidering an essential but untapped educational strategy. Acad Med. 2003;78(12):1203–1210. Fehser J. Teaching professionalism: a student’s perspective. Mt Sinai J Med. 2002;69(6):412–414. Schafheutle EI, Hassell K, Ashcroft DM, Harrison S. Organizational philosophy as a new perspective on understanding the learning of professionalism. Am J Pharm Educ. 2013;77(10): Article 214. Brown D, Ferrill MJ. The taxonomy of professionalism: reframing the academic pursuit of professional development. Am J Pharm Educ. 2009;73(4): Article 68. Hafferty FW. In search of a lost cord—professionalism and medical education’s hidden curriculum. In: Wear D, Bickel J, eds. Educating for Professionalism—Creating a Culture of Humanism in Medical Education. Iowa City, IA: University of Iowa Press; 2000:11–34. Coulehan J, Williams PC. Professional ethics and social activism—where have we been? Where are we going? In: Wear D, Bickel J, eds. Educating for Professionalism—Creating
15. 16. 17.
18.
19. 20.
21.
3
a Culture of Humanism in Medical Education. Iowa City, IA: University of Iowa Press; 2000:57–61. Barondess JA. Medicine and professionalism. Arch Intern Med. 2003;163(2):145–149. Rouse MJ. Continuing professional development in pharmacy. J Am Pharm Assoc. 2004;44(4):517–520. Duke LJ, Francisco GE, Herist KN, McDuffie CH, White CA. Student professionalism: development and implementation of a curricular competency statement and professionalism policy at the University of Georgia college of pharmacy. J Pharm Teaching. 2005;12(2):5–24. Association of American Medical Colleges, National Board of Medical Examiners. Embedding Professionalism in Medical Education. 〈http://www.nbme.org/PDF/Publications/Professionalism-Con ference-Report-AAMC-NBME.pdf〉; Accessed May 7, 2016. Ludmerer KM. Instilling professionalism in medical education. J Am Med Assoc. 1999;282(9):881–882. Cohen JJ. Professionalism in medical education, an American perspective: from evidence to accountability. Med Educ. 2006;40(7):607–617. Tichenor M, Tichenor J. Comparing teacher and administrator perspectives on multiple dimensions of teacher professionalism. SRATE J. 2009;18(2):9–18.
Currents in Pharmacy Teaching and Learning ] (]]]]) ]]]–]]]
Commentary
http://www.pharmacyteaching.com
Teaching professionalism: A faculty’s perspective Oluwaranti Akiyode, PharmD, BCPS, CDE* Howard University College of Pharmacy, Washington, DC
Abstract Professionalism is a relevant topic of discussion among all pharmacy schools in the United States because it is now a highly emphasized element in the pharmacy education standards. It behooves pharmacy programs to ensure the proper teaching of professionalism throughout the pharmacy curriculum. In as much that, professionalization of students includes the formal didactic teaching of professionalism behaviors and values, it is even more critical for the sound, informal, or tacit teaching of professionalism to be achieved via faculty role modeling. Thus, faculty plays a significant role in the professionalization of pharmacy students through both avoidance of unprofessional behaviors and through consistent demonstration of professional behaviors. r 2016 Elsevier Inc. All rights reserved.
Keywords: Teaching professionalism; Faculty behaviors; Faculty development
The conversation on the role of pharmacy faculty and preceptors in the development of student professionalism must be revived. The topic of professionalism has been widely discussed in pharmacy and other health professional literature over the last several decades.1–3 In fact, the Accreditation Council for Pharmacy Education’s (ACPE) recently released pharmacy education “Standards 2016” underscore the incorporation of professionalism within the pharmacy core curriculum.4 These updated standards are based on the American Association of College of Pharmacy’s Center for the Advancement of Pharmacy Education (CAPE) 2013 document.5 The greater emphasis on professionalism in the pharmacy curriculum demands effective teaching of student professionalism. Several experts in the field agree. According to the call to action article by Hammer et al.,6 “ … the role of practitioners in the professional socialization of pharmacy students is enormous and substantial.” Similarly, Berger * Correspondence to: Oluwaranti Akiyode, PharmD, BCPS, CDE, Howard University College of Pharmacy, 2300 4th Street, NW, Washington, DC 20059. E-mail: [email protected] http://dx.doi.org/10.1016/j.cptl.2016.03.011 1877-1297/r 2016 Elsevier Inc. All rights reserved.
et al.7 concluded that students would struggle in the absence of suitable role models during the course of professional socialization. Furthermore, 15 years ago, the American Pharmacists Association Academy of Students of Pharmacy and the American Association of Colleges of Pharmacy (AACP) Council of Deans Task Force on Professionalism both eloquently described the importance of pharmacy educators’ and practitioners’ roles in the professionalization of pharmacy students.8 Students learn professionalism through both explicit (formal teaching) and tacit learning (informal teaching). Literature supports the notion that professionalism is best taught via role modeling, mentoring, and observation of faculty and preceptors.3,9–11 In fact, it has been reported that both explicit and tacit of professionalism are necessary to professionalize students and to avoid sending contradictory messages to students.12–14 The informal teaching, also known as “hidden curriculum,” has been reported to be the most important in setting the culture of a learning environment for students to embed professionalism.12–14 In practical experience, student behavior often mirrors faculty and preceptors in both behaviors and actions. Faculty must not expect for students to “do as they say,
2
O. Akiyode / Currents in Pharmacy Teaching and Learning ] (]]]]) ]]]–]]]
and not as they do.” As faculty and preceptors, we must look in the mirror to reflect on the changes that are needed to serve as professional role models for our pharmacy students both in the classroom and practice setting. As such, there are certain behaviors that should not be exhibited among faculty and preceptors (Table 1). As faculty and preceptors, we should actively engage in professional role modeling and strive to professionally develop ourselves in order to facilitate the professionalization of our pharmacy students. Each faculty and preceptor should personally reflect on whether he or she is serving as a good role model of professionalism. Questions to consider include— (1) Do I exhibit any unprofessional behavior? (2) Which professional behaviors do I lack or need to develop? (3) Do I express other essential professionalism attributes including empathy, clinical proficiency, dependability, dignity with patient interactions, patient advocacy, and patientcenteredness in direct patient interactions?15 Thus, there is a need for faculty and preceptors to be personally responsible for developing their own professionalism through self-awareness and self-reflection. The continuing professional development framework could be a tool for faculty and preceptors to identify personal areas of improvement and develop strategies to ensure being excellent models of professionalism in an ongoing cyclical process.16 One college of pharmacy actually formed an Ad Hoc Professional Development Committee to conduct a comprehensive analysis of their professional development and to recommend approaches to enhance professionalism among students and faculty.10 Another college of pharmacy formed a Professionalism Committee whose charge was to build a professionalism competency statement within the curriculum.17 Other examples of strategies that may be considered by colleges of pharmacy to strengthen
Table 1 Examples of unprofessional faculty and preceptor behaviors21 Improper attire/untidy appearance Disrespect of students, faculty, staff, preceptors, administrators, patients, and clinicians Tardiness to class or practice site Partiality with student grades Absence from class or practice site Late submission of student grades/feedback Embarrassment of students in class or practice site Gossip between faculty/preceptors with students Use of cell phone in class or practice site Delivery of outdated lecture/clinical instruction Absence of continuous improvement in teaching strategies Use of profanity in educational/practice environment Disclosure of confidential student information to other students/ patients Indecent social media interactions with students/patients Provision of inaccurate information to patients and other health care providers
Table 2 Examples of strategies to enhance faculty and preceptor professionalism6–8 Inclusion of professionalism expectations in job description Orientation on professionalism culture Junior faculty/preceptor mentoring Evaluation of professionalism with promotion and/or tenure Recognition awards based on professional attributes Enforcement of honor code or other code of conduct policies Workshop trainings on professional development
professionalism among faculty and preceptors are listed in Table 2. It is necessary for faculty and preceptors to be held to the highest level of professionalism in order to promote a professionalism culture among students.18–20 In fact, department chairs and other administrators at colleges of pharmacy and practice sites should strongly consider the review of faculty and preceptor professional behaviors as an integral part of the promotion/tenure review and merit compensation evaluation, respectively. Consequently, pharmacy faculty and preceptors should be as diligent in exhibiting the high levels of professionalism as we expect our students to emulate. Let us be the professionals that we want to see! Conflicts of interest None. References 1. Montague JB. Pharmacy and the concept of professionalism. J Am Pharm Assoc. 1968;8(5):228–230. 2. Ghadirian F, Salsali M, Cheraghi MA. Nursing professionalism: an evolutionary concept analysis. Iran J Nurs Midwifery Res. 2014;19(1):1–10. 3. Birden H, Glass N, Wilson I, Harrison M, Usherwood T, Nass D. Teaching professionalism in medical education: a Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 25. Med Teach. 2013;35(7):e1252–e1266. 4. Accreditation Council for Pharmacy Education. Accreditation Standards and Key Elements for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree (“Standards 2016”). Available at: 〈https://www.acpe-accredit. org/pdf/Standards2016FINAL.pdf〉; 2015 Accessed May 7, 2016. 5. Medina MS, Plaza CM, Stowe CD, et al. Center for the Advancement of Pharmacy Education 2013 educational outcomes. Am J Pharm Educ 2013;77(8):Article 162. 6. Hammer DP, Berger BA, Beardsley RS, Easton MR. Student professionalism. Am J Pharm Educ. 2003;67(3): Article 96. 7. Berger BA, Butler SL, Duncan-Hewitt W, et al. Changing the culture: an institution-wide approach to instilling professional values. Am J Pharm Educ. 2004;68(1): Article 22. 8. White paper on pharmacy student Professionalism. American Pharmaceutical Association Academy of Students of Pharmacy-
O. Akiyode / Currents in Pharmacy Teaching and Learning ] (]]]]) ]]]–]]]
9.
10. 11.
12.
13.
14.
American Association of Colleges of Pharmacy Council of Deans Task Force on Professionalism. J Am Pharm Assoc 2000;40(1): 96–102. Kenny NP, Mann KV, MacLeod H. Role modeling in physician’s professional formation: reconsidering an essential but untapped educational strategy. Acad Med. 2003;78(12):1203–1210. Fehser J. Teaching professionalism: a student’s perspective. Mt Sinai J Med. 2002;69(6):412–414. Schafheutle EI, Hassell K, Ashcroft DM, Harrison S. Organizational philosophy as a new perspective on understanding the learning of professionalism. Am J Pharm Educ. 2013;77(10): Article 214. Brown D, Ferrill MJ. The taxonomy of professionalism: reframing the academic pursuit of professional development. Am J Pharm Educ. 2009;73(4): Article 68. Hafferty FW. In search of a lost cord—professionalism and medical education’s hidden curriculum. In: Wear D, Bickel J, eds. Educating for Professionalism—Creating a Culture of Humanism in Medical Education. Iowa City, IA: University of Iowa Press; 2000:11–34. Coulehan J, Williams PC. Professional ethics and social activism—where have we been? Where are we going? In: Wear D, Bickel J, eds. Educating for Professionalism—Creating
15. 16. 17.
18.
19. 20.
21.
3
a Culture of Humanism in Medical Education. Iowa City, IA: University of Iowa Press; 2000:57–61. Barondess JA. Medicine and professionalism. Arch Intern Med. 2003;163(2):145–149. Rouse MJ. Continuing professional development in pharmacy. J Am Pharm Assoc. 2004;44(4):517–520. Duke LJ, Francisco GE, Herist KN, McDuffie CH, White CA. Student professionalism: development and implementation of a curricular competency statement and professionalism policy at the University of Georgia college of pharmacy. J Pharm Teaching. 2005;12(2):5–24. Association of American Medical Colleges, National Board of Medical Examiners. Embedding Professionalism in Medical Education. 〈http://www.nbme.org/PDF/Publications/Professionalism-Con ference-Report-AAMC-NBME.pdf〉; Accessed May 7, 2016. Ludmerer KM. Instilling professionalism in medical education. J Am Med Assoc. 1999;282(9):881–882. Cohen JJ. Professionalism in medical education, an American perspective: from evidence to accountability. Med Educ. 2006;40(7):607–617. Tichenor M, Tichenor J. Comparing teacher and administrator perspectives on multiple dimensions of teacher professionalism. SRATE J. 2009;18(2):9–18.