Bridging community based pharmacy outreach with service-learning principles

American Journal of Pharmaceutical Education,  Summer 2002  by Nichols-English, Gloria J,  White, Catherine A,  Brooks, Paul J

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A course was designed to introduce Service-Learning and community based health promotion into the pharmacy curriculum. Optimum experiences for developing social responsibility and heighten civic awareness are provided to students in the third year of their didactic training. An interdisciplinary team of faculty provides a meaningful educational and mentoring experience for students. The curriculum is designed to promote community service and heightened sensitivity and awareness of the culturally diverse, social, and economic components of health and illness that impact the quality of life in the surrounding community. The three credit-hour course provides 15 hours of didactic training in community outreach principles, patient education strategies for compliance management; 15 hours for planning the implementation of disease state management models; and 15 hours of portfolio development of a pharmaceutical care service (PCS) program. Through this design the student is able to integrate academic and clinical skills with principles of community health promotion and prevention.

INTRODUCTION

Faculty designed a preparatory course for students to develop their communication, planning, decision-making, and social behavioral skills in dealing with special populations in the community. Its purpose was to teach the principles and techniques for planning, evaluating, and implementing pharmacy directed prevention and health promotion programs. The role of the pharmacist in public health is emphasized, including discussion of approaches used to effectively collaborate with other professionals and community members to improve the public's health.

Applying some of the concepts and principles of Service Learning (S-L) can serve as prerequisites for community-based interventions. This course is intended to prepare students for S-- L experiences through planning exercises, and making meaningful exploration of community resources. Historically, the pharmacy profession has recognized the value of community involvement and has received high marks for trust and respectability by community residents. The course is designed to make students aware of pharmacy's long-term community involvement and lead them through a series of exercises to show how they could utilize their pharmaceutical care training to expand the role of pharmacists in community based health promotion programs.

BACKGROUND

The American Council on Pharmaceutical Education (ACPE) and the American Association of Colleges of Pharmacy (AACP) have encouraged schools of pharmacy to integrate early experiences with the didactic curriculum to engage students in the clinical, behavioral, emotional, and economic dimensions of patient centered care. The intent is to reinforce learning from the classroom and problem-based simulations with challenging experiences in the patient care environment.

Recommendations for the adoption of competencies that promote professionalism and caring within the social context of pharmacy practice were advanced between 1991-1996 through a series of AACP sponsored commissions and tasks forces to implement change in pharmacy education(1-3). Included in these curricular changes were recommendations to introduce ability-based competencies into the experiential curriculum such as: problem solving skills; communication of values; ethical principles; personal awareness and social responsibility. Formal conceptualization of S-L principles in the pharmacy curriculum is fairly new. Although a number of pharmacy schools have attempted to accomplish these goals through implementing service oriented experiences based on a range of interpretations and approaches of the S-L Model(4-14), a 1999 report by Murawski noted few pharmacy schools have actively adopted S-L into their curriculum(15).

Despite the consensus of the need for S-L, there are variations in how it is conceptualized and implemented in pharmacy schools across the country. The Pharmacy profession's approach to S-L may be fundamentally different from that of other professions(16). Because of the broad disparity in the implementation of S-L, Murawski challenged institutions to adopt fundamental approaches, and to differentiate S-L from other experiential learning courses(15). To implement effective S-L strategies, pharmacy schools must identify the unique characteristics of the conceptualization of its curricular intent.

There are overarching definitions from which S-L approaches are operationalized in the pharmacy education community. Jacoby describes Service-Learning as: " A form of experiential education in which students engage in activities that address human and community needs together with structured opportunities intentionally designed to promote student learning and development."(17) He also states that "reflection and reciprocity" are its key concepts(17). Eyler and Giles hyphenated the term (S-L) to indicate the role of reflection in integrating the components of service and learning and reciprocity in which the relationship between the server and recipient is beneficial to both parties(18). In a literature review, Barner describes S-L as, "a term that equally emphasizes Service (community action) and Learning (additional knowledge gained), with the two components equally balanced and integrated"(19). Six key elements that differentiate S-L from voluntary activities, community service, and experiential strategies have been delineated by Wigert and are listed in Appendix A(20).