Why helping the public and the planet is important for pharmacy in the future
Beverley Lucas, Gill Hawksworth and Elizabeth Horncastle from the University of Bradford share their experience and reflections on developing an innovative workshop looking at education for sustainable development and the practical implications for future pharmacy practitioners
As the sustainability agenda gains momentum, there is a need for pharmacists and a concept of responsible professionalism increasingly to become a focus for action, since there are implications for the education of practitioners of the future.
The University of Bradford is part of the Ecoversity programme that aims to embed the principles and practice of sustainable development across the institution and is actively engaged in addressing the challenges of sustainable development.
The Bradford School of Pharmacy has been proactive in giving students the opportunity to debate topical issues that impinge on professional practice and the thought-provoking article encouraging pharmacists to “help the public and the planet by engaging in sustainable development” provided further impetus for workshop development.1
A three-staged pilot study was conducted over the academic year 2008/09. The first step was to undertake a literature review exploring ideas related to responsible professionalism within health care disciplines. An independent review of the curriculum also highlighted the potential at programme and modular level for incorporating education for sustainable development within pharmacy practice.2
From this, the implementation stage concentrated on a professional practice module within the MPharm programme that sought to develop critical awareness of the social and political context relevant to pharmacy practice. We were fortunate to access the PharmacyHealthLink and Department of Health evidence-based resources (available from www.phlink.org.uk) as materials that we thought could be used to support directed learning activity for the purpose of student education.
These leaflets and professional resources featured information and advice at the level of the individual, health care professional and community pharmacy perspectives. The directed learning exercises were designed to complement these levels of engagement, focusing on current and potential activities in looking after health, key factors and influences associated with sustainable development and the contribution of community pharmacy practice professionals in the sustainable development challenge.
The three-hour workshops were delivered to groups of 35 students and were facilitated by an academic and experienced community pharmacist. Students were also introduced to the Ecoversity staff, including a student ambassador with a major role in raising awareness and fostering student involvement. The workshops were evaluated using an anonymous scaled response questionnaire, with opportunities for qualitative comment and distributed after each session as part of a process evaluative approach.3
Overall, students’ comments (during the workshops) and more formal evaluative data showed that they had found the sessions useful and thought provoking, and they supported the inclusion of education for sustainable development within the curriculum.
The most useful points outlined in student feedback were the use of evidence-based resources, working in small groups with opportunities for collaborative learning and the chance to discuss sustainability in relation to pharmacy practice. We have grouped the following comments to illustrate student ideas and opinions related to these points.
The evidence-based resources introduced as part of the workshop captured the different structural levels of engagement. Of the first leaflet (“Healthy you, healthy planet”), students reported that “it gave us an idea of what information we are providing the patients with” and that “we could reflect on the information and the layout of the leaflet”.
The second leaflet (“Towards a healthier planet — guide to sustainable development”) introduced during the session was designed as a professional resource. One student’s comment reflected on issues of professional responsibilities: “The second leaflet was useful because I believe that as professionals we should inform people about how to save energy and save our planet.”
Exploring the resources within the broader structural context of pharmacy, one student who was “having a look through the resources that are going to be available in pharmacies in the future” appreciated looking at the resources that would be available within practice.
The group work activities captured viewpoints such as “informal discussion was thought provoking and allowed sharing of good ideas”, “being able to have a look at different opinions from other people” with opportunities for debate, “group work sessions bring in a lot of different perspectives” and “student collaboration”.
In terms of sustainability in practice, students related practical examples such as “ideas for how to improve sustainability in pharmacies”, “how to save energy in the pharmacy”, “involvement of the pharmacy in eco-friendly issues” and “steps to reduce CO2 footprint”.
Others reflected on being a university student on a professional programme such as “Ecoversity-related to health care”. Another theme explored professional responsibilities such as “the role of pharmacists in the promotion of health” and individual responsibility and “what I can do as a pharmacist”.
Student suggestions for development
Student feedback also highlighted areas for workshop development including specific learning and teaching considerations related to the timing of sessions (too long), the need for more interactive materials (make it more visual) and strengthening relevance for professional practice (more practice examples).
There were also a diverse range of general suggestions for future development that were wide-ranging in application. For example some students commented on the formal assessment strategy. Their comments included “make it part of the examinable material since it is vital for preventative healthcare”, “it should be integrated into the curriculum” and “make it compulsory”.
In another example the value of resources associated with the subject of sustainable development within a practice setting was questioned: “I don’t believe that the leaflet belongs in a pharmacy as pharmacists will not have time to go through environmental issues. It dilutes understanding of the pharmacist’s role in the community.”
In terms of the delivery of the project, the facilitators had not worked together before in this area, so we used the workshops as an opportunity to explore our reflections on the process as a means of development. One barrier that initially became evident was that the students were already familiar with concepts of energy conservation and recycling (within experiences such as general education).
It was only when we started to relate ideas to the practice of pharmacy that student interest was engaged (despite this not being an examinable part of the curriculum).
There was wide-ranging discussion that included health inequalities, such as the impact of poverty on health. Although this is a broad subject area, there were clear learning and teaching opportunities that this could lead onto further case-based learning, such as pharmacy playing a greater role in helping to tackle health inequalities4 and the public health agenda.
In reviewing the pilot study, we put forward the following learning points for consideration. First, students need the opportunity to debate topics such as education for sustainable development (ESD) and relate it within preparation for future practice roles, so the use of small group teaching may be the preferred learning and teaching strategy.
There is a need to provide a community practice perspective within educational delivery in order for students to appreciate the context and relevance for future professional development. In line with the pharmacy White Paper for England,5 the importance of enhancing pharmacy’s contribution to health and promotion of its potential to lead local communities is helpful to consider when preparing students for future practice opportunities.
Although community pharmacists have always had a clinical role, there have been concerns around the rate of change and associated lack of progress.6
If direction for the future enhances clinical focus within pharmacy, engaging in teaching and learning activities such as the one we have outlined provides students with opportunities to integrate knowledge using practical application to contribute towards providing holistic approaches to patient care.
The process of curricular review and development of pedagogical approaches to provide educational preparation are also important considerations of any new development, especially within the context of significant change. When considering these factors, we suggest that collaborative approaches between education (academics) and practice (practitioners) is a key factor for success.
The importance of embedding ESD will be relevant for preparing future pharmacists, who will require an understanding of issues aligned with roles and responsibilities. This is now a pressing matter within the context of primary professional responsibilities and planning for future health system scenarios (such as those featured by Watson in a recent Agenda article7) that provide students with further examples of relevance for pharmacy practice.
In summary, this small scale activity is one example of directed learning activity using evidence-based resources within workshop-facilitated sessions, but it is only the beginning. The Bradford School of Pharmacy has now scaled up this initiative to include all pharmacy student groups (from year 1 of their programmes) and post-registration provision.
The evidence-based resources provide information to help pharmacists play their part in the sustainable development challenge, but it is also equally important that preregistration trainees are able to debate topical issues within their educational preparation. This activity also needs to be integrated within a longer-term strategy for the future.
We would argue that in order to implement change, the case study approach can provide a useful platform for building a longer-term strategy.
We are grateful to the pharmacy students who have provided constructive feedback and colleagues who have embraced this initiative and we have responded accordingly.
We are now in the process of developing a community pharmacy-focused DVD presentation to support the directed learning activity and to provide additional student examples of relevance within professional practice.
1. Root G. Help the public and planet by engaging in sustainable development. Pharmaceutical Journal 2008;281:596.
2. Lindsay N, Hopkinson P, Hughes P. Embedding ESD in life sciences curriculum. Finalreport. Bradford: University of Bradford, 2007.
3. Hall I, Hall D. Evaluation and social research. Hampshire: Palgrave Macmillan, 2004
4. Anderson C, Blenkinsopp A. The contribution of community pharmacy to improving the public’s health: summary report of the literature review 1990–2007. PharmacyHealthLink report. London: PharmacyHealthLink, 2009.
5. Department of Health; Pharmacy in England: Building on strengths-delivering the future. London: DoH, 2008.
6. Rodgers A. Community pharmacists still don’t care. Pharmaceutical Journal 2009;283:413–4.
7. Watson C. How pharmacists could save lives by cutting pharmaceutical carbon. Pharmaceutical Journal 2009;283:623–4.
Citation: The Pharmaceutical Journal URI: 10992621
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