From pharmacy student to pharmacist: Exploring the journey of moral development

ABSTRACT

Introduction: It is widely accepted that the role of a pharmacist is becoming more complex and the scope of practice has broadened over the past decade. With restricted access to hospitals and general practice, the COVID-19 pandemic shone a light on the vital role that pharmacists play in maintaining patient care and disease management. Pharmacists have always been at the forefront delivering safe and effective care across all settings. Recent reforms to the education and training of pharmacists in the United Kingdom, will see that from day one on the register, pharmacists are expected to play an active role in the provision of clinical care and consultations including prescribing medicines. These advances make it more important now to have a better understanding of what moral development through pharmacy education and once in practice. Research has shown that healthcare professionals can make better decisions in the interests of their patients when they have advanced levels of moral decision making. Objective(s) It is hypothesised that as students' progress through pharmacy education they will demonstrate maturation in moral development, and this should continue as they progress through their careers. This research intends to measure and evaluate the pattern of moral reasoning of undergraduate pharmacy students at the University of Hertfordshire (UH) as they progress through formal education and practice. Method(s) A ten-year longitudinal study which employed the Defining Issues Test 2 (DIT2) to quantitatively measure the changes the participants' moral development. The DIT2 was completed by participants of a single cohort of students, who started the Master of Pharmacy (M.Pharm.) programme in 2008 in each year of study at the University of Hertfordshire, once after passing the General Pharmaceutical Council pharmacist registration exam (as Newly Qualified pharmacists) and a final time five years after they qualified (as matured Established Practitioners). Medians and standard deviations were calculated and compared analysed using pairwise comparison with the Wilcoxon signed-rank test. Result(s) The statistically significant changes were in N2 scores between Level 1 (Median = 22.07) and Level 3 (Median = 26.80) (p = 0.025), this is a positive finding which supports the research that shows that moral development can be taught. To further support these results there was an increase in N2 score between Level 1 and Level 4 (p = 0.011). Research has also shown that practice-based experience can give rise to maturation in moral development, this research showed a statistically significant difference between Level 4 (Median = 22.62) and NQ Level (Median = 40.53). Despite this, surprisingly, there was a marked decrease in p and N2 scores at Established Practitioner level. Conclusion(s) Overall, the research showed a general increase in moral development as the participants progressed through the M.Pharm. programme and in the first year after qualifying. However, with the decrease in moral development indices as an Established Practitioner qualitative research to investigate factors that may have caused this then recommend ways to support pharmacists better through education and practice.