Organizational Philosophy as a New Perspective on Understanding the Learning of Professionalism
This study was qualitative in nature, and further research is needed to confirm whether our findings apply to other colleges and schools of pharmacy. The international relevance and applicability of these findings would also need to be established, as the context here is specific to current arrangements in the United Kingdom, where pharmacy students have relatively little practice exposure during their 4 years at university. Nevertheless, this study provides valuable and novel insights, with a particular focus on learning professionalism in the university setting rather than the practice or clinical setting, which will be relevant in other countries. Our findings suggest that the process of learning and internalizing professional attitudes and behaviors goes far beyond simply teaching about the concept and elements of professionalism and informing students about school policies. Professionalism learning was not restricted to the “taught” curriculum, but included all aspects of the academic (university) environment (and beyond). A particular strength of this study lies in its novel approach to analyzing and interpreting the interplay between the “intended,” “taught,” and “received” curriculum, and comparing and contrasting these across 3 UK schools of pharmacy. The positive and effective learning and development of professionalism appears dependent on a high degree of overlap between the “intended,” “taught,” and “received” curriculum, which we term an “integrated” organizational philosophy, in contrast to a “diffuse” organizational philosophy, which lacks such overlap (Figure 1).
“Organizational philosophy” encompasses all aspects of professionalism teaching and learning (in the widest sense) that contribute to the students’ development of their individual professionalism attitudes and behaviors. It is proposed as a conceptual model for viewing and interpreting the way professionalism learning is delivered and achieved. Different schools could then be seen as being located along a continuum between the 2 extreme points: “integrated” and “diffuse.” An “integrated” organizational philosophy appears to be achieved by setting explicit standards that are enacted consistently by staff members and recognized by and reinforced among students. Early professionalization, the development of professional identity, and particularly a positive and grounded integration of professionalism learning throughout the whole 4-year degree program also appeared to be important. The concept of “organizational philosophy” may thus be helpful in incorporating all elements likely to enable (or hinder) professionalism learning. It takes account not only of the overt curriculum but also acknowledges what has been referred to elsewhere as the “hidden” curriculum, and proposes how it should be viewed and addressed. The concept of “organizational philosophy” thus describes the importance of aiming for, or achieving, positive integration through maximum overlap between the “intended,” “taught” and “received” curriculum. This paper has identified some of the elements and strategies which help achieve this, including setting high standards, “living” these standards consistently in the school, having strong role models, and establishing clear responsibilities and consequences for students. The importance of professionalism and its learning thus achieves strong and positive recognition at the individual and organizational level, and the importance of this has been recognized.
There, nevertheless, remain limits to what can be developed and achieved in the academic environment, and the importance of students having practice experience has been recognized. However, in UK undergraduate pharmacy education, such experience is mainly gained outside of the formal MPharm program, through part-time or vacation jobs, and after obtaining the MPharm degree, during preregistration training. The lack of pharmacy practice experience within the MPharm degree program may be reviewed following the Pharmacy White Paper, and under the ongoing Modernizing Pharmacy Careers program, which is now part of Health Education England. Further research then ought to explore how best to integrate practice experience into the undergraduate pharmacy curriculum, drawing on experience and evidence from pharmacy curricula in other countries with programs that include more clinical exposure. The effectiveness and impact of this on students’ learning of professionalism, and how best to support this, also need to be investigated further.