Professionalism ethics in pharmacy education: Do students have acceptable knowledge or it is a white paper in pharmacy education curriculum?

Dear Editor,

In pharmacy, professionalism must contain the skills necessary to be a capable pharmacy practitioner. It seems that pharmacy students do not become professionals after graduation from the pharmacy school. To be a professional pharmacist, students should have a lifelong commitment to the society and patients.

Evolving professional knowledge, attitudes and behaviors is a critical step in providing high quality patient care (1). In the last previous years, pharmacy practice has changed from drug prescription to patient-centered communication and more stress on pharmacists’ accountability for the best treatment outcomes. Thus, pharmacists are accountable for providing good health care facilities. In this regard, pharmacists should cooperate well with other health care professionals and patients (2).

An important component of professionalism in pharmacy is ethics education (3). The necessity of ethics education in pharmacy highlights the significance of ethical considerations by pharmacists (2). The significant service delivered by pharmacists in Iran is responding the patients’ questions. Therefore, pharmacists must be up to date with ethical issues and apply the best ethical responses to different patients’ problems (2). In Shiraz University of Medical Sciences, the medical ethics department is responsible for ethics education for all medical and paramedical students including pharmacy students. This education consists of one week workshop including important issues in pharmacy ethics. This is a part of core pharmacy education curriculum and all of the students should participate in this course.

In order to measure the students’ knowledge about ethics in pharmacy education, we conducted a survey with an 18 item valid and reliable questionnaire containing three major domains: truthfulness, professional commitment, respect for patients' rights and confidentiality of patients’ information). 162 pharmacy students in 7 to 12 semesters in Shiraz pharmacy school were selected through simple random sampling method. All of the students filled out the questionnaire based on a 5 point Likert scale. The results showed that 14 (8.6%) students had a moderate level of knowledge, 68 (42%) had a good level of knowledge, and 80 (49.4%) had a very good level of knowledge. There was no significant relationship between gender and level of knowledge. There was a significant relationship between the level of knowledge and educational semester. Senior students had higher knowledge. The best results were in the domain of respect for patients’ right and confidentiality of patients’ information. These results showed that students had an acceptable level of knowledge, especially in the field that is necessary for their future profession (patients’ right and patients’ confidentiality). Pharmacy students should establish good relationships with each other, patients, and other health care professionals. Therefore, a professional behavior should be encouraged more than focusing on knowledge. In this study, it was not possible to follow the students in future years to measure their professional behavior, but it is recommended for future studies. However, it seems that this knowledge will not necessarily change to improvement in practice in pharmacist because pharmacy is not a science of pure knowledge. The closer integration of knowledge and practice named “practice-based knowledge” is an important area that is essential to be considered by pharmacists (4).

Pharmacy students must remain up to date with changes in their profession, which may contain new practice guidelines, new pharmacy and therapeutic products, and new technologies. In order to improve the students’ professional behavior, they should participate in community services, volunteering programs, (serving and helping others), health education services and local health care organizations. After graduation, participation in Continuing Professional Development instead of Continuing Pharmacy Education is necessary to maintain the knowledge and behavior in this field. In Continuing Professional Development, learning occurs in lifetime and continues after the classroom in everyday practice (5). Excellence should be considered not only in the undergraduate pharmacy education, but also after graduation training, and during practice. Finally, it should be mentioned that pharmacy students must remain knowledgeable and pursue guidance to achieve the goal of excellence in professional ethics.