Objective. To investigate whether a profession-specific educational intervention affected the development of moral reasoning competencies in community pharmacists, as measured by the Defining Issues Test (DIT2).Methods. This research used a repeated measures pre-post educational intervention design as a quasi-randomized, controlled, crossover study to evaluate changes in the moral reasoning scores of 27 volunteer community pharmacists in Ireland.Results. Changes in pharmacists’ moral reasoning competencies development, as reported by P-Scores and N2-Scores, were found to be significant. In addition, interaction effects were observed between developmental scores on the DIT2 and whether participants were determined to be consolidated in their reasoning pre- and post-engagement with the educational intervention.Conclusion. Short profession-specific educational interventions have the potential to positively affect the development of moral reasoning competencies of community pharmacists.

This paper describes the design and implementation of elements of an integrated competency-focused pharmacy programme in the School of Pharmacy and Pharmaceutical Sciences (SoPPS), Trinity College Dublin (TCD), Ireland. Following a national review of pharmacy education and training in Ireland in 2010, and subsequent publication of legislation in 2014, the School has implemented a five-year integrated programme of pharmacy education and training, leading to the award of a Master’s degree in Pharmacy (M. Pharm.). Curricular integration has been achieved by underpinning the new programme with a national competency framework for pharmacists and through the utilisation of curricular integration themes. Programme integration also encompasses embedded experiential learning placements in Years 2, 4 and 5 of the five-year programme. The new five-year integrated pharmacy programme, which commenced in 2015, replaced the 4 + 1 model of education and training where a four-year Bachelor’s degree was followed by a one-year internship, which was a distinct and separate element of the students’ training.

Community pharmacy is often portrayed as a marriage of professional and business roles in a commercial domain, thereby creating a need for, and value in, pursuing the development of professional competencies for use in the community pharmacy business. In context, professional judgement is the application of knowledge, skills and attitudes (competencies) which, when applied to situations where there is no one or obvious right or wrong way to proceed, gives a patient a better likelihood of a favourable outcome than if a lay-person had made the decision. The challenge for community pharmacists is that professional judgement formation is influenced by professional, commercial and personal criteria with inherent interconnected challenges. In community pharmacy practice in the Republic of Ireland (ROI), this challenge is compounded by the fact that advice is normally provided in an environment where the pharmacist provides professional advice “for free” and then may offer to sell the patient a product or service based on that advice, an activity which amounts to a commercial transaction. While there is currently no evidence to confirm whether or not these professional judgement influences are resolved successfully, their very existence poses a risk that their resolution “in the wrong way” could compromise patient outcomes or professional standing following the delivery of pharmacy services. It is therefore apparent that a community pharmacist requires skills in identifying and analysing professional/commercial/personal influences in order to appreciate the criteria which may affect both parties’ (patient and pharmacist) decision making. By contemplating the interaction between the pharmacist’s professional competencies and the individual influences on that pharmacist, we can consider the enhancement of professional competencies that underpin the “best” advice being offered to the patient, regardless of whether that advice is offered in the course of dispensing prescriptions or delivering vaccination or other services, culminating in a framework of professional judgement formation.

Workshop analysis of scenarios or vignettes has traditionally been used to develop and demonstrate the moral reasoning underpinning professional decisions. However, in order to facilitate sufficiently individualized interaction to accommodate the assessment of student competencies related to decision-making through scenarios, such workshops are traditionally used with small groups. There are associated resource implications for the scheduling of sessions and implications for tutor time where large cohorts of students are targeted. In addition, the requirement that students be face-to-face is problematic when students are in practice placements that are geographically removed. This paper demonstrates how technology and an assessment tool, known as an “intermediate concept measure” (ICM), might help address these limitations. It introduces the background to ICMs and presents the ICM as a tool that has potential to support professional education. It also shares learning experienced by one pharmacist using ICMs in pharmacy education, provides an example of how a profession-specific ICM might be formatted, suggests how the methodology might be used in undergraduate and postgraduate education and provides samples of measurables that may be incorporated into evaluation and assessment systems; both for educational interventions delivered face-to-face or partly or entirely online. The limitations of the methodologies and suggestions for further research are included.