Describing pharmacists’ core public health competencies during post-graduate early career readiness: a case study in Ghana

Abstract

Background: Due to emerging complex disease states, and patients’ demands for high levels of care, it is imperative that health professionals, including pharmacists, are equipped with adequate educational and training competencies to meet those needs. To assist in formative evaluation and quality improvement, more information is needed on the competencies being promoted and developed in doctor of pharmacy (PharmD) programs, including how the program works and why? Training may be structured differently among institutions, even though the ultimate goal, to graduate professionals for the field, might be the same. Many western countries have had decades of experience in pharmacy education and yet, continue to refine and revisit educational content and training strategies. But many Low-to-Middle Income Countries (LMICs) are relative novices to the professional doctorate degree program. Hence the need to investigate and identify gaps for improvement. To further understand one of the four main domains of the GbCF, the study focused on Pharmaceutical Public Health. Aims: Aim 1: To describe the educational processes and outcomes that contribute to readiness of pharmacists to take on public health roles in LMICs using evaluation science approaches in a university Doctor of Pharmacy Program in Ghana as a case study. Aim 2: To assess new practitioners’ perceptions of readiness for the various Pharmaceutical Public Health competencies set forth in the Global Competency Framework (GbCF). Method: This case study involved a formative, evaluative approach to uncover new understanding of public health in the doctor of pharmacy (PharmD) degree program. This method was conducted to explicate current processes for education in public health and expected outcomes. Document reviews and interviews with program directors were conducted to begin understanding “how and why” the PharmD program was working. The exercise was needed to gather contextual information. Then, stakeholders were purposefully sampled and engaged in interviews or focus groups, including early career practitioners, faculty members and administrators from KNUST, seasoned pharmacists, leaders of the Pharmacy Council, Ghana and FIP members/officers in FIP’s academic section with public health interest. Thirty-three individuals participated in the study. Results: Findings indicating that the KNUST PharmD program intentionally created specific public health experiences/activities for students to get hands-on training. Participants reported that the theoretical aspects are efficient, but the practical opportunities are limited. Participants reported responding positively to experiential training, but they want more opportunities to discuss public health areas of practice where they can apply the competencies. In fact, some FIP members/officers with public health interest view engagement with local and national level health ministries and government as an advantage in assisting with training opportunities in areas like immunizations. Education outcomes evident in the study were: cognition, behavior, attitude, economic, affect, relationship, environment and status. The results were also evident that the program works by providing tools and sharing knowledge, testing students on specific public health competencies, and requiring relevant Continuing Professional Development (CPD) courses. Conclusion:The study demonstrates that just knowing the competencies alone is not adequate, practical training in addition to theoretical knowledge is essential for public health roles. Pharmacists’ readiness for public health roles is evident in their cognition, behavior, and attitude among other education outcomes. The recommendation is for KNUST educators to explore the addition of simulation-based learning in their pharmacy curriculum, for early career practitioners and seasoned pharmacists to mentor, advocate and become role models for students, for FIP members in the academic section to regularly direct focus on need for public health competencies in PharmD programs and for researchers to seek perspectives of current students and seek more evidence to add and teach specific content areas like counterfeit drugs, procurement and supply chain management. Evidence was provided that supports adequate theoretical knowledge, impact of program directors years of experience in developing competency-based curriculum and evidence in teaching and overall support for learners.