By: Arcelio Benetoli, BPharm, MSc, PhD, Cherie Lucas, PhD, BPharm and Andi Hermansyah, S. Farm., M. Sc., Ph.D., Apt
The construct of professionalism is complex, and pharmacy education should foster professionals’ skills. As the term professionalism has been used extensively across many occupations, including those not traditionally linked to it, this broad usage can lead to misunderstandings. Generally, professionalism refers to the standards, practices, or motivations associated with a profession. Traditional professions are characterized by a body of theory and expert knowledge, societal endorsement of their authority and privileges, autonomy, a code of ethics, and a unique culture.1
As the pharmacy profession continues to evolve, it is essential to understand how these changes impact student professional identity development, the key frameworks defining professionalism, and the challenges in fostering PIF. Educators need to promote professional identity within pharmacy education that encourages reflection on how to better prepare future pharmacists for their roles in an ever-changing healthcare landscape.
Over time, the discussion of professionalism in pharmacy has evolved. In the mid-1960s, the sociological debate claimed pharmacy was in the process of professionalization. Recent discussions focus on the internalization of professionalism and the emergence of PIF. We argue that professional identity in pharmacy should encompass two aspects: the professional identity of those belonging to the pharmacy profession and those belonging to a profession that has undergone substantial changes over recent decades.
First, let’s focus on the professional identity shared among all healthcare professionals. PIF is one of three significant frameworks explaining professionalism.4 Professionalism is extensively discussed in healthcare due to behaviors, attitudes, and actions that negatively impact patient care, professional reputation, and the standing of an entire profession. Today, it is crucial to remember that a professional’s actions and behaviors are observed in real settings and virtual environments. PIF is suggested to help cultivate and sustain professionalism. Other traditional approaches or frameworks of professionalism include virtue-based and behavior-based professionalism.2
Table 1: Traditional Approaches or Frameworks Related to Professionalism
| Concept | Description |
| Virtue-based professionalism | Oldest professionalism approach Focus: Individual character Implications: One would place the needs of others before their own. Example: Ensuring an exchange of information is confidential, disclosing and managing conflicts of interest, altruism, honesty, reliability, and respectfulness. |
| Behavior-Based Professionalism | Emerged in an attempt to measure and evaluate an individual’s character. Basis: Premise that behavior and competencies can be defined, observed, and assessed. Dominant framework used in professional bodies/academics |
PIF has been advocated and discussed in pharmacy education to prepare students early on to become the professionals they aspire to be, extending beyond virtue and behavior-based approaches. Introducing students to the extrinsic (what is seen) and intrinsic elements (what is felt) helps them develop their professional identities, including how they are socialized into thinking, acting, and feeling like professionals. Many factors combine and interact in PIF, as Figure 1 from Lewis, Jamieson, and Smith (2023) illustrates.
Figure 1. Influences on PIF. Originally published by Lewis, A., Jamieson, J., & Smith, C. A. (2023). Professional Identity Formation in Allied Health: A Systematic Review with Narrative Synthesis. Teaching and Learning in Medicine, 1–17.
The second aspect of professional identity in pharmacy encompasses the significant transformation of pharmacy practice. Since the COVID-19 pandemic, pharmacists’ roles and scopes of practice have evolved, causing their PIF to become increasingly blurred compared to other health professionals. Pharmacy students have observed this evolution and its impact on PIF during their training.4 Although these new roles are positive, they may cause students to be uncertain about what it truly means to be a pharmacist.
Teaching students about professionalism and professional identity is challenging due to the diverse areas in which pharmacists practice. According to a recent study,5 student pharmacists continue to endorse concurrent, multiple professional identity constructs and perspectives. It is important to remember that professional identity can support practice transformation. The learning environment must provide guidance and practical opportunities to understand professionalism’s formal and informal tenets. For example:
Strategies for teaching professional identity formation:
- Authentic Activities: Engaging students with patient-facing professionals as role models, experiential learning, and ensuring curriculum alignment with work practices can effectively develop professional identity in pharmacy students.7
- Fluid Identity Development: A more radical approach involves educators encouraging students to develop a fluid (not permanent) identity. This approach empowers students to create professional identities that align with their inner selves. While this path may be uncomfortable for educators, incorporating critical reflexivity (a reasoning process for making meaning of an experience) as a key curriculum component holds significant potential.6
Other more traditional strategies for professional identity education identified in a recent scoping review5 include extracurricular activities, courses, thematic discussions, and lectures.
As educators and institutions continue to navigate the challenges associated with PIF in pharmacy, it is vital to share strategies and insights.
What strategies is your institution employing to foster professional identity formation in pharmacy students? Share your insights, and let’s continue this meaningful conversation.
References
1. Cruess SR. Professionalism and medicine’s social contract with society. Virtual Mentor, 2004. 6: 185–188. https://doi.org/10.1097/01.blo.0000229275.66570.97.
2. Irby DM, Hamstra SJ. Parting the Clouds: Three Professionalism Frameworks in Medical Education, 2016. Academic Medicine, 2016. 91: 1606–1611. https://doi.org/10.1097/acm.0000000000001190.
3. Lewis A, Jamieson J, Smith CA. Professional Identity Formation in Allied Health: A Systematic Review with Narrative Synthesis. Teaching and Learning in Medicine, 2023. 1–17. https://doi.org/10.1080/10401334.2023.2290608
4. Nagy DK, Hall JJ, Charrois TL. The impact of the COVID-19 pandemic on pharmacy students’ personal and professional learning. Curr Pharm Teach Learn. 2021 Oct;13(10):1312-1318. https://doi.org/10.1016/j.cptl.2021.07.014.
5. Araújo-Neto FC, Santos LGD, Tavares TMA, Fonseca FLD, Prado FO, Silva ROS, Mesquita AR, Lyra DP Jr. Teaching Strategies for Professional Identity Education in Pharmacy: A Scoping Review. Am J Pharm Educ. 2024 Jan;88(1):100597. https://doi.org/10.1016/j.ajpe.2023.100597.
Author Bios:
Dr. Arcelio Benetoli is a Senior Lecturer (Pharmacy Practice) at the State University of Ponta Grossa, Brazil. He also supervises research postgrad students at the State University of Maringá, Brazil. His educational scholarship interests include the use of social media in health and education and health services research. He enjoys spending time with friends, bushwalking, and reading in his free time.
Dr. Cherie Lucas, PhD, BPharm, Grad Cert Edu Stud (Higher Educ), FPS, is the Nexus Fellow (Educational Change Agent) for the School of Population Health, Faculty of Medicine and Health at the University of NSW, Sydney, Australia. Dr Lucas also holds Adjunct Positions with the Connected Intelligence Centre, University of Technology Sydney (UTS), and the Faculty of Health, UTS. Dr Lucas is a licensed pharmacist (> 34 years) and is Deputy President of the Pharmacy Council of NSW, Australia. Her educational research interests include pharmacy education curriculum design and instruction, reflective practice tools, and assessment strategies to enhance student engagement, experience, and learning; more recently, her research areas have extended to include artificial intelligence and its role in assessment. She has led teams in interprofessional education and reflective practice.
Dr. Andi Hermansyah is an Associate Professor at the Faculty of Pharmacy Universitas Airlangga Indonesia. Within almost two decades in academia, he has built a promising national and international reputation in pharmacy, pharmaceutical policy, and health services research in pharmacy, as evidenced by four books and book chapters, more than 70 refereed publications, and ten national and international projects. He holds the copyright of several pharmacy education products. Andi is also a registered pharmacist and a manager for quality education and business development at the university, teaching community pharmacy.
Pulses is a scholarly blog supported by a team of pharmacy education scholars.
Pulses 
One of the most important things we can do as pharmacy educators with professional identity formation is model that professional identity. We can’t expect our students to show up demonstrating the elements of professionalism when we, ourselves, don’t do that. If we don’t show respect for patients, neither will they. If we start lectures late or give subpar feedback, they will assume that is acceptable and do the same. Some of our students are the first people in their sphere to be in a professional role similar to this and they may have no one else to look up to.
However, if we consistently show them what it means to be a professional and live it out in all our interactions with them, they have the building blocks they need to translate that to practice.
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Absolutely agree with those comments Sara. We need to model professional behaviour.
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