By Bethany Von Hoff, PharmD
A few months ago, I wrote that pharmacy education too often confuses professionalism with professional identity formation. I identified why I think encouraging professional identity formation is such a challenge in pharmacy education. This follow up will unpack some of the ideas, tools, and strategies that can be used to address the challenges identified in the first article.
1. As a profession, we often struggle with knowing our own identity.
Pharmacists struggle with role ambiguity. For so long, the pharmacist’s identity was tied to the dispensing of medication. Now, there is a shift towards patient centered care and clinical decision making, but many still struggle with finding their role on the healthcare team. We need to reconcile these old identities with new identities and recognize that both are important to the professional identity of a pharmacist. Students need to be taught that their professional identity extends beyond their practice setting.
Regardless of the practice setting, the professional identity of a pharmacist shares common features. We are all driven by the desire to promote and support the safe, effective, and rational use of medications.1 How can we focus on our commonalities instead of our differences? We are making steps in the right direction with the roll out and implementation of the JCPP Pharmacists’ Patient Care Process (PPCP).2 The PPCP provides common language and processes to use across practice settings. We should be able to provide students with consistency of what they hear a pharmacist is in the classroom with what they see a pharmacist is in practice. If we only focus on teaching students the roles of a pharmacist, they may miss the point that ALL pharmacists take ownership and responsibility for safe and effective medication use and patient centered care. This is just as important to the PGY-2 trained, decentralized pharmacist as it is to the dispensing, community pharmacist.
2. Professional identity formation must occur alongside the students’ own identity formation.
Many students are still undergoing their own personal identity formation at the same time as their professional identity formation. Although I initially saw this as a hurdle, it has been argued to be a blessing. As students are still in the stage of solidifying their own personal identity, they are predisposed to questioning experiences that are incompatible with their previous beliefs. “The process of negotiating such conflicts potentially spurs further identity development by encouraging us to question and at times reinforce core values and critical behaviors.”3 Because students are already in this questioning and negotiating phase for their personal identity, these same tools can be useful for navigating professional identity formation.
I also came to realize that no one’s personal or professional identity is ever truly set in stone. We are constantly adopting and adapting to new roles and identities within our personal and professional lives. Learning to reconcile these identities and questioning experiences through critical reflection will be a lifelong process for us all. It then becomes our role as teachers to provide students with experiences which may cause them to question previous identity beliefs in a safe environment to gain practice reflecting and reconciling these conflicts.
3. Assessing professional identity is hard
Not everything that is important can, or should, be graded. But– just because something cannot be given a grade in the traditional sense does not mean that it cannot be assessed. The word assess comes from two Latin words meaning “to sit by”. We need to sit by our students through didactic and experiential education as they slowly build their own professional identities and reconcile previous identities with new identities. Assessment and feedback is an important tool for students to reflect and evaluate their actions and behaviors related to identity formation.4 Useful feedback is not a checkmark on a rubric or a number or letter at the end of a rotation. Useful assessment might look like a conversation, helping students grapple with challenges and navigate decisions. We need to broaden the horizon of what we consider to be assessment.
Authentic learning experiences are crucial for successful identity development.5 Students should be offered frequent opportunities for authentic practice and patient interaction, as early as possible. Yes, students will be exposed to authentic experiences during experiential education, but we cannot expect that professional identities are only formed through IPPEs and APPEs. Providing a variety of authentic learning experiences (simulated patients, role play, OSCEs, etc.) will give students frequent opportunities to reflect on their growth and to recognize changes over time. It is important to remember that graduation day is not the finish line, marking the completion of professional identity formation.
What is your school or college doing to promote professional identity formation? Do you have other tools and strategies to overcome some of these challenges? We’d love to hear from you!
References
- Schindel, T. J., Yuksel, N., Breault, R., Daniels, J., Varnhagen, S., & Hughes, C. A. Perceptions of pharmacists’ roles in the era of expanding scopes of practice. Res Soc Admin Pharm. 2017; 13(1): 148-161.
- The Pharmacists’ Patient Care Process. (n.d.). Retrieved September 28, 2017, from https://jcpp.net/patient-care-process/
- Sharpless, J., Baldwin, N., Cook, R., Kofman, A., Morley-Fletcher, A., Slotkin, R., & Wald, H. S. The becoming: students’ reflections on the process of professional identity formation in medical education. Acad Med. 2015; 90(6): 713-717.
- Noble, C., Coombes, I., Shaw, P. N., Nissen, L. M., & Clavarino, A. (2014). Becoming a pharmacist: the role of curriculum in professional identity formation. Pharm Pract. 2014; 12(1): 380.
- Reid, A., Dahlgren, L. O., Petocz, P., & Dahlgren, M. A. Identity and engagement for professional formation. Studies in Higher Education. 2008; 33(6): 729-742.
Bethany Von Hoff, Pharm.D. is a third year PhD student in the Social and Administrative Pharmacy program at the University of Minnesota. Bethany’s education-related scholarship interest includes: the scholarship of teaching and learning and student development. In her free time, she enjoys traveling and listening to podcasts.
Pulses is a scholarly blog supported by a team of pharmacy education scholars.
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