Exploring the Requisite Skills and Competencies of Pharmacists Needed for Success in an Evolving Health Care Environment

Jacqueline E. McLaughlin, PhD, MS; Antonio A. Bush, PhD; Philip T. Rodgers, PharmD; Mollie Ashe Scott, PharmD; Meg Zomorodi, PhD; Nicole R. Pinelli, PharmD, MS; Mary T. Roth, PharmD, MHS

Disclosures

Am J Pharm Educ. 2017;81(6):116 

In This Article

Abstract and Introduction

ABSTRACT

Objective. To identify and describe the core competencies and skills considered essential for success of pharmacists in today's rapidly evolving health care environment.

Methods. Six breakout groups of 15–20 preceptors, pharmacists, and partners engaged in a facilitated discussion about the qualities and characteristics relevant to the success of a pharmacy graduate. Data were analyzed using qualitative methods. Peer-debriefing, multiple coders, and member-checking were used to promote trustworthiness of findings.

Results. Eight overarching themes were identified: critical thinking and problem solving; collaboration across networks and leading by influence; agility and adaptability; initiative and entrepreneurialism; effective oral and written communication; accessing and analyzing information; curiosity and imagination; and self-awareness.

Conclusion. This study is an important step toward understanding how to best prepare pharmacy students for the emerging health care needs of society.

Introduction

The US health care system needs change to improve the quality of care, enhance the patient experience, and reduce health care costs.[1] Care is fragmented and poorly coordinated, and interprofessional, team-based care is not where it needs to be to facilitate the delivery of high quality care. Further, a critical component of improving national health care centers is the need to improve the safe and effective use of medications. Numerous calls have emerged for reform in health professions education and highlight ongoing concerns about the ability of current curricula to prepare students for the continual improvement of health and health care.[2–6] Employers within and outside health care are increasingly seeking graduates who are able to think critically, work in highly collaborative environments, communicate clearly, ask good questions, and solve complex problems.[7] Medicine, nursing, and pharmacy schools are further challenged with educating students amid rapidly expanding information about health and medicines, increasingly complex health care systems, ongoing shifts in legislative and regulatory requirements, and emerging models of care delivery and payment reform. Embedded in this challenge are the evolving roles of health care providers who must effectively respond to these changes and work collaboratively to proactively identify solutions that promote and improve the health and well-being of patients.

Although a growing body of evidence highlights the importance of designing practice models to achieve interprofessional care that is patient-centered and effective, many health care professionals do not fully understand the capabilities of other health care team members and often struggle to effectively capitalize on the expertise and talents of each other.[6] The Interprofessional Education Collaborative (IPEC) identified roles and responsibilities as a core interprofessional collaborative practice competency domain for collaborative practice, proposing that providers "use the knowledge of one's own role and those of other professions to appropriately assess and address the health care needs of the patients and populations served."[6] Understanding the skills and competencies needed by members of the health care team is critical for ensuring that educational experiences and curricula are structured to prepare aspiring health professionals for contemporary health care challenges. Further, elucidating the skills desired from specific health professions disciplines will facilitate work aimed at optimizing the roles and responsibilities of team members serving to improve patient care.

Across multiple health professions, curriculum accreditation standards are emphasizing interprofessional education (IPE) to better prepare students for the challenges of real world practice. The Liaison Committee on Medical Education (LCME), for example, mandates in Standard 7.9 that "the faculty of a medical school ensure that the core curriculum of the medical education program prepares medical students to function collaboratively on health care teams that include health professionals from other disciplines as they provide coordinated services to patients."[8] In addition, the Accreditation Council for Pharmacy Education (ACPE) details in Standard 11 the need to prepare all "pharmacy students to provide patient-centered care in a variety of practice settings as a contributing member of an interprofessional team with competency in team expectations, education, and practice," and the American Association of Colleges of Nursing (AACN) includes "interprofessional communication for improving patient outcomes" as a critical component of undergraduate and graduate accreditation.[9,10] The National League for Nursing (NLN) has challenged nurse educators to collaborate with other health professions to develop meaningful interprofessional education and practice opportunities for students as part of undergraduate and graduate learning experiences.[11]

Meeting the health care needs of society, optimizing team-based care, and developing effective programs that foster interprofessional education and care will require a more rigorous and nuanced understanding of the knowledge, skills, and abilities of graduates emerging from health professions curricula and the job to be done by specific members of the health care team. Literature that describes the qualities and characteristics requisite for success in the various health professions appears largely descriptive and positional in nature. In pharmacy, recent white papers propose core competencies for pharmacy practice. Jungnickel and colleagues, for example, projected future practice competencies in a white paper for the American Association of Colleges of Pharmacy (AACP) that included professionalism, self-directed learning competencies, leadership and advocacy, interprofessional collaboration, and cultural competency.[12] In an American College of Clinical Pharmacy (ACCP) white paper on clinical pharmacist competencies, Burke and colleagues identified and advocated for clinical problem-solving, judgment, and decision-making; communication and education; medical information evaluation and management; management of patient populations; and therapeutic knowledge.[13] The Center for the Advancement of Pharmaceutical Education (CAPE) 2013 Educational Outcomes, derived from a literature review and vetted with various stakeholders, included foundational knowledge, essential for practice and care, approach to practice and care, and personal and professional development.[14]

For many professions, there remains a need for research that examines the contemporary skills associated with 21st century health care. The purpose of this study was to identify and describe the core competencies and skills deemed essential for success of pharmacists in today's health care system. As described below, this research is framed by Christensen's jobs-to-be-done theory,[15] analyzed according to Tony Wagner's New World of Work and the Seven Survival Skills[16] and presented within the context of interprofessional health care and education. Identifying these qualities provides critical insight into curriculum design and practice innovation for pharmacy and other health professions striving to improve patient care and care delivery.

In his book, Wagner describes a core set of skills identified as necessary for success in today's workplace.[16] These skills, Wagner argues, define a "new and very different kind of worker (p. 41)" and that those without these skills are "unprepared to be active and informed citizens…who will continue to be stimulated by new information and ideas (p. 14)."[16] Specifically, the seven survival skills include: critical thinking and problem-solving, which is reflected by asking good questions, dealing with vast amounts of information, deciding what's accurate and what's not, and having a plan of action; collaboration across networks and leading by influence, which includes working in teams, making your own decisions, understanding and respecting difference among people, leading and influencing the people around you; agility and adaptability, characterized by working with disruptions, using various tools to solve new problems, ability to work when there isn't a right answer, and adapting to constant change; initiative and entrepreneurialism, which means being proactive, actively looking for ways to improve systems, courage to try and fail, generating your own answers and solutions; effective oral and written communication, which includes clear and concise writing and speaking, discretion for using different levels of communication, and presentation skills; accessing and analyzing information, which encompasses finding and synthesizing information, using information from a variety of sources, and understanding and responding to how rapidly information is changing; and curiosity and imagination, which is reflected by the ability to continually ask great questions (eg, "What if…?"), dreaming, searching for unique solutions, dissatisfaction with the status quo, and empathy.[16,19]

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