Teaching decision-making and professional ethics for pharmacy practice: a mixed methods study

Little has been published on whether or not ethics teaching during undergraduate study effectively prepares pharmacy students for dealing with dilemmas in future practice. The aim of this study was to explore the user’s perspectives on the effectiveness of Values Exchange (Vx), an online decision-transparency tool, in facilitating pharmacy students’ learning and development in professional ethics and decision-making, and its potential use by pharmacy graduates. A mixed methods approach was employed. A profession specific test (the PEP test) measuring moral reasoning was applied for the first time in the UK to provide a measure of principled thinking across 4 cohorts of Pharmacy students and alumni. Descriptive and inferential statistics were applied to the data. In addition, semi structured interviews were undertaken with 9 pre registration trainees (PRTs) and 9 early career pharmacists (ECPhs) to ascertain their experiences of ethical dilemmas in practice and views on Vx. It is clear from the findings of this study that Vx was perceived by the interviewees as a valuable tool for undergraduates in the development of ethical and professional decisionmaking skills. Consideration should also be given to the incorporation of Vx into postgraduate teaching and policy. Its use in professional practice was perceived as limited. Although Vx appears to help MPharm students prepare for facing ethical dilemmas in practice, real world experience is also necessary. Interviewees continued to learn during their pre-registration year and early practice through interactions with their pre-registration tutors and other pharmacists and staff, and by supporting each other via social media networks. Positive role models were valued, but participants also learned how not to behave through working with negative role models. Findings also suggest a need for further training of pre registration tutors to improve support for PRTs, as well as more widespread adoption of peer supervision. This study was unique since no previous research has explored the impact of long-term use of Vx during undergraduate education on practice, or considered the potential longerterm impact on practice of having used this tool. In addition, this study is the first to use the PEP test outside Australia. The study is also unique in that it has provided a pedagogical underpinning for Vx which has been mapped to Vx activities and to the Royal Pharmaceutical Society’s Exercising professional judgement model of decision making. This output provides, therefore, both theoretical pedagogical reasons and also data-driven evidence to support the use of Vx as a teaching tool to help MPharm students develop the skills to make professional decisions in practice