Assessment of student pharmacists’ ethical decision-making

Myers, Jaclyn; Kiersma, Mary E.; Plake, Kimberly S.

doi:10.1016/j.cptl.2017.07.014

Cited by 8 publications

(9 citation statements)

References 21 publications

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“…In an assessment of students' attitudes and responses to practice-based ethical dilemmas, Myers and colleagues identified considerable uncertainty regarding dispensing decisions and high levels of perceived difficulty in responding to ethical dilemmas. 22 Evaluating students' attitudes, subjective norm beliefs, and perceived behavioral control beliefs can guide development of efficient and effective interventions that inform and modify students' default beliefs and behaviors. In the current study, emphasizing students' self-reflection on beliefs and outcome evaluations through learning experiences, including listing of all beliefs, could encourage students to thoroughly construct and consider their attitudes.…”

Section: Discussionmentioning

confidence: 99%

Explaining Pharmacy Students’ Dispensing Intentions in Substance Abuse-Related Gray Areas Using the Theory of Planned Behavior

Dowling-McClay

Mospan

Subedi

et al. 2019

American Journal of Pharmaceutical Education

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Objective. To examine the extent to which theory of planned behavior (TPB) constructs and demographic characteristics explain pharmacy students' dispensing intentions in ethically or legally gray areas involving potential substance misuse or abuse. Methods. Two cohorts of third-year Doctor of Pharmacy (PharmD) students (n5159) were provided with five written cases describing common "gray area" dispensing scenarios in community practice involving medications and devices with potential for misuse or abuse (eg, long-term buprenorphine maintenance prescription without evidence of tapering, early refill of a narcotic for an out-of-town patient, non-prescription sale of pseudoephedrine). Students completed a 12-item survey instrument for each case. Items assessed whether the student would dispense the medication or device in the given scenario, how many times in 10 similar scenarios the student would dispense the medication or device, attitudes regarding dispensing, and subjective norm and perceived behavioral control beliefs. Results. Wide variation in the percentages of students who would dispense the medications or devices was noted across the five scenarios (14% in the buprenorphine scenario to 61% in the pseudoephedrine scenario). Attitude scores significantly predicted dispensing decisions in all scenarios (p,.001), whereas subjective norm and perceived behavioral control beliefs were significant predictors of dispensing only in select case scenarios. Gender and community pharmacy work experience did not consistently predict dispensing intentions. Conclusion. Student attitudes consistently predicted intent to dispense across five gray practice scenarios. These findings can be used to inform development of educational interventions that influence students' attitudes and self-awareness in community practice decision-making scenarios involving potential substance misuse or abuse.

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Section: Discussionmentioning

confidence: 99%

Explaining Pharmacy Students’ Dispensing Intentions in Substance Abuse-Related Gray Areas Using the Theory of Planned Behavior

Dowling-McClay

Mospan

Subedi

et al. 2019

American Journal of Pharmaceutical Education

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“…Conversely, an unethical decision is either illegal or morally unacceptable [11]. The ethical decision theory has been extensively studied in many fields, such as business, pharmacy, and accounting [12][13][14][15][16][17][18].…”

Section: Ethical Decision Theories and Modelsmentioning

confidence: 99%

Key person ethical decision-making and substandard drugs rejection intentions

2020

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Substandard drugs are a major public health issue worldwide. Key person such as the Qualified Person in China and Europe is responsible for rejecting substandard drugs during the manufacturing stage. This study applies the Hunt-Vitell ethical decision-making model to study their rejection intentions on substandard drugs. Using the experimental vignette methodology, two scenarios were developed to represent different levels of deviation from regulations in pharmaceutical manufacturing. Responses from 204 Chinese key persons show a decline in deontology, ethical judgment, and rejection intention, and an increase in teleology in the minor deviation scenario, in comparison with the major deviation scenario. The results from the two scenarios show that the Hunt-Vitell ethical decision-making model is well fitted to explain substandard drug rejection intentions. Organizational and occupational commitments have a significant positive impact on deontological evaluation. Whereas, occupational commitments have a significant negative impact on teleological evaluation. This study suggests that strengthening occupational commitment can significantly affect key person's rejection intentions of substandard drugs.

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“…In pharmacy, we identified previous studies exploring the therapeutic reasoning processes of students and practicing pharmacists. [11][12][13][14] These studies utilized a think-aloud protocol, a survey, and post-interaction interviews to generate new frameworks, identify themes, and explore factors influencing therapeutic reasoning. [11][12][13][14] The only study focused on pharmacy students' reasoning processes concentrated on ethical decision-making.…”

Section: Introductionmentioning

confidence: 99%

“…[11][12][13][14] These studies utilized a think-aloud protocol, a survey, and post-interaction interviews to generate new frameworks, identify themes, and explore factors influencing therapeutic reasoning. [11][12][13][14] The only study focused on pharmacy students' reasoning processes concentrated on ethical decision-making. 11 Although this is a crucial area, the field would also benefit from exploring pharmacy students' therapeutic reasoning during management of clinical patient cases.…”

Section: Introductionmentioning

confidence: 99%

Cognitive and Metacognitive Processes Demonstrated by Pharmacy Students When Making Therapeutic Decisions

Walker

Pham

Duong

et al. 2023

American Journal of Pharmaceutical Education

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To characterize the types of cognitive and metacognitive processes demonstrated by third-year pharmacy students during a therapeutic reasoning activity. Methods. A qualitative, descriptive study following a think-aloud protocol was used to analyze the cognitive (analytical) and metacognitive processes observed by third-year pharmacy students as they completed a 25-minute therapeutic reasoning activity. Using a deductive codebook developed from literature about reasoning, two independent coders characterized processes from audio-recorded, transcribed student think-aloud episodes while making therapeutic decisions about simulated clinical cases. Results. A total of 40 think-aloud episodes were transcribed amongst the cohort. Categorization of the think-aloud transcriptions revealed a series of cognitive analytical and metacognitive processes demonstrated by students during the therapeutic decision-making activity. A total of 1,792 codes were categorized as analytical processes, falling into six major themes: 69% gathering information (1,232/1,792), 13% processing information (227/1,792), 7% making assessments (133/1,792), 1% synthesizing information (19/1,792), 7% articulating evidence (117/1,792) and 4% making a recommendation (64/1,792). In comparison to gathering information, a much lower frequency of processing and assessment was observed by students, particularly for those that were unable to resolve the case. Students' movement between major analytical processes co-occurred commonly with metacognitive processes. Of the 918 codes categorized as metacognitive processes the two major themes were: 28% monitoring for knowledge or emotions (257/918) and 72% controlling the planning of next steps or verification of correct information (661/918). Sequencing the codes and co-occurrences of processes allowed us to propose an integrated cognitive/metacognitive model of therapeutic reasoning for students. Conclusion. This study categorizes the cognitive (analytical) and metacognitive processes engaged during pharmacy students' therapeutic reasoning process. The findings can inform current instructional practices and further research into educational activities that can strengthen pharmacy student therapeutic reasoning skills.

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Assessment of student pharmacists’ ethical decision-making

Cited by 8 publications

References 21 publications

Explaining Pharmacy Students’ Dispensing Intentions in Substance Abuse-Related Gray Areas Using the Theory of Planned Behavior

Explaining Pharmacy Students’ Dispensing Intentions in Substance Abuse-Related Gray Areas Using the Theory of Planned Behavior

Key person ethical decision-making and substandard drugs rejection intentions

Cognitive and Metacognitive Processes Demonstrated by Pharmacy Students When Making Therapeutic Decisions

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