Aiding Transformation from Student to Practitioner by Defining Threshold Concepts for the Pharmacists' Patient Care Process.

Objective. To explore critical milestones in the transition from student to practitioner by identifying the threshold concepts associated with learning the Pharmacists' Patient Care Process (PPCP). Methods. A threshold concept represents a transformed way of thinking about a topic or discipline. This study convened five focus groups to identify possible threshold concepts related to learning the PPCP. The data were analyzed by deductive content analysis and confirmed by an expert consensus panel using a modified nominal group technique. Results. Moving beyond the process outlined by the PPCP, the five focus groups identified additional elements of learning required in becoming a patient care practitioner. These elements were focused on the more intangible aspects of patient-centered care, such as practitioner priorities, attitude, and approach. As such, the data help to describe how practitioner's think, feel, and act (ie, their identity). Deductive content analysis resulted in five Patient Care Threshold Concepts (PCTC), which were confirmed by the expert consensus panel. Conclusion. The five PCTCs provide pharmacy educators with an additional tool to use in teaching the PPCP. The PCTCs can aid in the student-practitioner transformation by helping to make implicit aspects of patient care more explicit. They are supplements to patient care competencies that help explain the practitioner's priorities, attitude, and approach. They can also serve as guidance to pharmacy educators in evaluating curricular activities and assessments, as well as identity formation. This approach can be applied to the identification of threshold concepts in other areas of pharmacy education, such as leadership.