The hidden curriculum of work-based learning for pharmacy students in public sector pharmacies in South Africa

BACKGROUND: The work-based learning environment encompasses a dynamic space where the implementation of theoretical knowledge and skills may prove to be at odds with routine service delivery practices, known as the hidden curriculum. OBJECTIVE: To describe incidents reflective of the hidden curriculum of fourth year pharmacy students from work-based learning experiences at public healthcare facilities. METHOD: A qualitative, descriptive study was conducted. Data from written student reflection reports were thematically analysed. RESULTS: From 35 reports, three primary themes including time, binaries, and students’ personal histories, influenced interactions in the workplace. These themes illustrated how the students’ professional and personal traits interlocked with historical, structural and cultural influences in the workplace as well as larger society. CONCLUSION: Uncovering of the hidden curriculum revealed that the students’ ability to navigate workload pressure, polarisation between groups and their own biases are crucial to firstly survive, and secondly to learn in the workplace

Be Mindful of Your Discomfort: An Approach to Contextualized Learning

Service-learning creates a space for contextualized learning whereby students connect classroom concepts to real-world practices relative to their own frame of reference. These experiences occur within a societal status quo rooted within historical and social inequalities. Affective responses to encounters with inequalities are not routinely addressed within the learning outcomes of formal curricula. Thus, the pedagogy of discomfort calls for an awareness and a critical self-examination among educators and students of how their passive acceptance or non-acceptance of apparent social injustices has been shaped by the status quo. By incorporating affective learning into the reflective process, we realized that contradictions in South African society permeate students’ experiences in ways that are indicative of the status quo. Increased recognition of the potential of affective learning to address social injustices in higher education could enable efforts toward social transformation.

Exploring practising pharmacy graduates’ views on improving the effectiveness of pharmacy education at the University of the Western Cape, South Africa

South African health professional education institutions have a mandate to produce graduates who are able to address priority needs of the healthcare system and larger society. However, evidence of the effective use of public resources by health education institutions is not routinely collected. Practising graduates are a target audience who could provide part of this evidence. To explore the views of University of the Western Cape (UWC) pharmacy graduates on the effectiveness of pharmacy education in relation to their current and anticipated practice aspirations. A cross-sectional electronic survey was administered to UWC pharmacy graduates through the university’s alumni office network. Twenty-five graduates responded, of whom 60% were male (average age 38.9 (standard deviation 9.52) years). One of the strongest themes that emerged was the need for exposing pharmacy students from early on in the curriculum to a broad range of pharmacy and healthcare sectors and addressing real issues in these changing and complex environments. Graduates stressed the importance of the development of generic skills, such as interpersonal skills, leadership, advocacy and innovative problem-solving, which are necessary to effect positive change through collaborative and equitable approaches

What if students could be transformational resources for pharmacy practice?

The pharmacists’ role in the healthcare system is expanding internationally beyond the traditional roles of compounding and medicine supply management, to providing patientcentred care and updating health care workers on relevant medicine therapies. Pharmacists are pivotal in meeting the medicine-related needs of patients and other health care professionals. Even though pharmacists will remain responsible for medicine supply management, the routine activities associated with this can be handled by qualified pharmacist’s assistants and/or pharmacy technicians, while allowing pharmacists to embark on pharmaceutical care, identifying and solving the risks associated with medicine use and therapeutic drug monitoring. With an increase in the development of new medicines, it has become imperative for pharmacists to be integral members of the multidisciplinary team in order to ensure rational use of these medicines. Patient safety with the use of medicines have become a global concern. Therefore, pharmacists engaging in patientcentred practices could contribute towards better patient outcomes

Service learning in pharmacy: Opportunities for student learning and service delivery

High patient load and understaffing in public health care facilities preclude the provision of optimal pharmaceutical services in South Africa. A Service Learning in Pharmacy (SLIP) programme for the University of the Western Cape's final year pharmacy students was implemented in health care facilities to assist in service provision. Students rotated between a pharmacotherapy (patient-oriented) and pharmaceutical formulation (product-oriented) activities to develop skills in prescription analysis, manufacturing and packaging of hospital pharmaceuticals. Structured focus group sessions were held with students and pharmacists to assess the integrated service learning experiences. Student feedback was positive, as the 'real world' experiences enabled them to adapt to intense work pressures, developed a sense of 'personal responsibility' towards patient health and they were sensitized to issues of social injustice. Students became competent in prescription analyses, counseling on medication use, manufacturing and pre-packing procedures. Pharmacists fully supported increased student involvement in the health services. Service learning in pharmacy schools is needed to contextualize learning and to address health care needs in South Africa

An assessment of social accountability among South African pharmacy schools from public domain information

Global health education reform requires training institutions to align their education, service and research activities with the values of social accountability, which include relevance, equity, quality and effectiveness. The alignment with these values aims to ensure graduates who are competent to meet society’s priority health needs, especially those of marginalised and underserved communities. This study aimed to qualitatively assess the alignment of activities of the nine South African pharmacy schools with the values of social accountability from information and evidence available in the public domain. Data were collected from pharmacy schools’ websites, and related publications and newsletters. Information was grouped into predetermined categories representing the different values of social accountability. A scoring rubric was adapted that assessed the alignment of the information and evidence collected to the values of relevance equity and quality. Each pharmacy school’s information was initially reviewed and scored by three independent reviewers. Each of the reviewers cross-checked each other’s allocated scores and any variations in scores were settled via consensus between the reviewers. The information of six pharmacy schools was assessed. For relevance, pharmacy schools scored over 50% and above for all their activities. For equity, schools showed most variation in their educational activities, and least variation in their service activities. For quality, schools showed most consistency with education and service activities but most variation occurred in the quality of services. Information from the public domain may be useful in assessing social accountability. The depth of information that schools could share publicly remains a key question.DHE

Exploring the implications of a needs-based pharmacy education framework modelled on population health: Perspective from a developing country

Globally, health education reform is directing efforts to strengthen the health system through collaboration between health education and health services. However, collaborative efforts vary between developed and developing countries as the health needs, economic constraints, and resource availability differs. In developing countries, resource allocation is weighed in favor of interventions that will benefit the majority of the population. The question that emerges is: How could health education, service, and research activities be (re-)aligned to optimize return on investment for the health system and society at large? This paper proposes a needs-based pharmacy educational approach by centralizing population health for a developing country like South Africa. Literature on systems-based approaches to health professional education reform and the global pharmacy education framework was reviewed. A needs-based pharmacy educational approach, the population health model which underpins health outcome measurements to gauge an educational institution’s effectiveness, was contextualized

Development and implementation of an integrated framework for undergraduate pharmacy training in maternal and child health at a South African university

The South African Pharmacy Council (SAPC) regulates undergraduate pharmacy education and pharmacy practice. The SAPC Good Pharmacy Practice manual describes the role of pharmacists in maternal and child health (MCH) in line with the recommendation of international health regulatory bodies. However, baseline study findings in 2017 supported literature from around the world that indicated a need for curriculum review and integration to address the knowledge and skills gap in pharmacists’ MCH training. This paper describes the development and implementation of an integrated framework for MCH training across the four years of a Bachelor of Pharmacy program. The intervention included didactic lectures, skills practical on infant growth assessment, and an experiential learning component at primary health care clinics and pharmacies. Knowledge and skills assessment on contraception, maternal and antenatal care, and neonatal and child care were carried out pre, eight weeks post, and two years post intervention using the same questionnaire. ANOVA and post hoc analyses showed that participants’ knowledge and skills increased post intervention but decreased significantly two years later except in contraception where students experienced longitudinal integration of the MCH component. Generally, participants performed above the university average except in maternal and antenatal care

Preceptor reflections on the Community Health clinical rotation for fourth year pharmacy students at the University of the Western Cape

This paper describes the community health clinic rotation of the Patient Care Experience programme (PaCE) offered to fourth year pharmacy students (2018) at the University of the Western Cape. Reflections from the collective experiences of the faculty and practice preceptors offer insight into integration of a clinically oriented medicine therapy management programme directed at the primary care level

Comparative evaluation of pharmacy students’ knowledge and skills in maternal and child health: Traditional versus integrated curriculum

: Reducing maternal and child mortality is a health priority in South Africa. Therefore, health professional education should produce graduates that can meet these needs. This study compared the maternal and child health (MCH) knowledge and skills of cohorts of final-year students exposed to a traditional (in 2017 and 2018) and integrated (2019) curriculum using a 34-item questionnaire. Between the 2019 and 2017 cohorts, ANOVA and post hoc analysis showed significant differences in the reproductive and sexual health component which was dispersed in the second and final years of study (p = 0.007, Mean Difference (MD) = 8.3) andneonatal and child care (p = 0.000, MD = 15). while it was only in maternal and antenatal care (p = 0.009, MD = 10.0) for the 2019 and 2018 cohorts. Significant differences were observed in participants’ average mean scores (p = 0.000 for 2018 and 2017). The highest mean scores were recorded by the 2019 cohort in the three assessments. A onesample t-test showed the highest mean differences in the reproductive and sexual health components (p = 0.000; MD 2017 = 12.4, MD 2018 = 14.8, MD 2019 = 20.7). Overall, the integrated MCH curriculum and the longitudinal dispersion of content enhanced students’ knowledge and skills