A Historical Discourse Analysis of Pharmacist Identity in Pharmacy Education

Abstract

Objective. To determine the discourses on professional identity in pharmacy education over the last century in North America and which one(s) currently dominate. Methods. A Foucauldian critical discourse analysis using archival resources from the American Journal of Pharmaceutical Education (AJPE) and commissioned education reports was used to expose the identity discourses in pharmacy education. Results. This study identified five prominent identity discourses in the pharmacy education literature: apothecary, dispenser, merchandiser, expert advisor, and health care provider. Each discourse constructs the pharmacist's professional identity in different ways and makes possible certain language, subjects, and objects. The health care provider discourse currently dominates the literature. However, an unexpected finding of this study was that the discourses identified did not shift clearly over time, but rather piled up, resulting in students being exposed to incompatible identities. Conclusion. This study illustrates that pharmacist identity constructs are not simple, self-evident, or progressive. In exposing students to incompatible identity discourses, pharmacy education may be unintentionally impacting the formation of a strong, unified healthcare provider identity, which may impact widespread practice change.

Report of the 2019-2020 AACP Student Affairs Standing Committee

“…5 As educators consider the prospect of influencing identity formation within our learners, a common concern is the apparent lack of a universally accepted 6 and singular identity for the profession of pharmacy. 7 Elvey 8 and Kellar 7 describe multiple identities described by practicing pharmacists (eg, "apothecary," "medicine supplier," "merchandiser," "expert advisor," etc.). If the profession is to transition as healthcare providers, we face challenges.…”

“…As the history of our profession suggests, these polymorphic identity constructs have accumulated rather than shifted over time. 7 The multiple seemingly incongruent or divergent identities described by practicing pharmacists may have an unintentionally negative impact on the formation of a uniform healthcare provider identity, thus hindering pharmacists' successful practice transformation. 7,8 If there is no agreement on identity within our profession, what are educators educating toward?…”

“…A solid professional identity can facilitate the internal regulation of pharmacists, as well as enable confidence for members to practice effectively." 7…”

Looking Ahead to 2030: Survey of Evolving Needs in Pharmacy Education

“…Pharmacy practice and education have continually evolved, but most changes have been subtle and not consistently informed by data or forecasts outside of the profession, leading to a lack of current professional identity and an unclear path for the future [ 8 ]. In its 2019–2020 report, the Argus Commission referred to the importance of routinely monitoring changes in the healthcare field to the academic pharmacy.…”

Relational professional identity: How do pharmacy students see themselves in relation to others?

“…4 Many pharmacists currently lack a clear professional identity, 4,5 and pharmacy has been in a state of transformation for decades, as it attempts to evolve into a role more focused on patient care. 1,6,7 Pharmacy students are faced with challenges in adopting the health care provider identity in the context of constant changes to the profession’s roles and confusion stemming from multiple, often incompatible, pharmacy identities. 7 Despite these challenges, there is limited evidence to suggest pharmacy curricula are being designed with a strong focus on professional identity formation.…”