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Pharmacy Technician Book

"Though I never arrived at the perfection I had been so ambitious of obtaining, but fell far short of it, yet I was, by the endeavor a better and happier man than I otherwise should have been if I had not attempted it."

Benjamin Franklin

INTRODUCTION

For the last five years, you and your faculty colleagues have been climbing Mt. Pharmacy Education with anticipation that once you reach the peak of full implementation of the entry-level degree program you will be able to rest, smell the roses of learning, and move on to other important academic issues such as research. Then, just as you are about to reach the peak, outcomes assessment is mandated and you realize there are more mountains to climb before you reach the peak of perfection. In fact, there are many mountains to climb because you realize that the new outcomes assessment mandate calls for continuous improvement not only in teaching, but also research, service, and patient care activities conducted by your pharmacy school. We can safely predict that change will not only continue, but will likely be accelerated as educators continue to strive for perfection(1).

Although you may be reflecting that you are either currently or previously have been involved in continuous quality improvement, total quality management, or outcomes assessment at your institution, is it achieving its potential? Experts have concluded that very few institutions have truly successful programs and the primary cause is that the concept is not an integral part of what "we" do everyday(1-6).

It has also been predicted that the focus on quality and continuous improvement will most likely be one of biggest roles that faculty will have in the future(1). Therefore, how can the Council of Faculties help all pharmacy education faculty value continuous improvement and make it an integral part of what we do as a faculty? This year the Council of Faculties will address the following question, "Pharmacy Educators: How can we be better tomorrow than we are today?" My premise is that we can be better tomorrow than we are today if we use a strategic map to get there and we nurture a culture within our "faculty learning communities" that will engender their success.

The term "faculty learning community" is used here to encourage a faculty to view themselves as a learning community. A learning community consists of a group of individuals who are working collaboratively to achieve a set of shared goals in their environment. Although this concept has been advocated for sometime, I assert that few institutions have achieved its potential. A major attribute of a learning community is that individuals learn from each other and as a result, the sum of the whole is greater than its parts(7). The "culture" of a community consists of it's shared beliefs, behaviors, and values and serves as the foundation for an effective learning community. In a pharmacy school, these attributes are socially transmitted from one generation of faculty to the next and may be either explicit or implicit.

WHO ARE WE?

The word "we" in this year's agenda emphasizes that success is likely to be greater if we strive for improvement as a unified force. In order to achieve this, The Council of Faculties needs to identify all stakeholders who are pharmaceutical educators and involve them in a focus on continuous improvement.

Again, experience to date suggests we all have to know where we are headed and how we can get there. As we think about where we are headed, will these changes be an improvement over what we are doing today? I recommend that we assist all of those involved in teaching our students to understand why we need to focus on continuous improvement and how to successfully accomplish this both at the personal individual level and as a member of a learning community.

Who are the various constituent groups that we need to dialogue with about this? The Council of Faculties currently reaches members of our sections. However, could we reach even higher levels of achievement by having others as active members of the Council of Faculties? For example, could we develop more effective approaches to preparing pharmacy practitioners by having individuals such as part-time and volunteer faculty, pharmacy technician faculty, and those involved in postgraduate residencies and fellowships sit beside us at our meetings?

You may be questioning how bringing together such individuals who have focused teaching responsibilities could make us better tomorrow. I encourage you to look at the business world and what they doing to continuously improve and grow in today's global environment. The book Enabling Knowledge Creation(8) provides case studies of successful companies that have realized in order to meet the needs of consumers, they needed to unleash the creativity and knowledge of a group of people rather than relying on one or two individuals. Although the benefits of group effort are well established, the authors of this book provide new insight into the importance of nurturing not only explicit knowledge, but also tacit knowledge. Examples of tacit knowledge are individual perceptions and intuition; Such information is not routinely conveyed in written documents. In my career, I have assumed that knowledge creation is a routine part of what we do in academic settings. However, after reading this book I believe we have a lot to learn from the business world about how to effectively enable the creation of new knowledge.

WHAT STRATEGIC MAP SHOULD WE USE?

"We" all need a strategic map that defines our endpoint as we continuously strive to improve and a strategy for how to accomplish this goal. This year, it was realized that the Council of Faculties does not have a strategic plan to guide its continual growth and improvement. Therefore, I have charged the Resolutions, Standing Rules, and Strategic Planning Committee to: (i) develop a strategic plan that is congruent with the Association's strategic plan and addresses the needs of faculty today and tomorrow, and (ii) recommend who should be responsible for reporting to the Council of Faculties our annual progress in achieving the established priorities and goals.

I propose we can also be better tomorrow than we are today by using more scholarly approaches in making decisions that impact pharmacy education. This will allow us to climb towards perfection in a stepwise manner and not reach a plateau or fall into the crevices of reinventing history. For example, although the scientific method is an integral part of what we do in research, deliberations about curricular change often refer back to opinions and teaching the same way we were taught without questioning whether there is a better way. If we apply what has been learned in health care, perhaps one piece of the strategic map is to enable faculty to routinely use "evidence-based practice" so that they critically reflect on current literature findings and what they are doing today and critically appraise options for tomorrow.

The use of evidence-based practice has expanded beyond decisions about patient care into the education of health professionals. Citing the need to make medical education evidence-based rather than "opinion-based," medical educators have formed a collaborative group to promote the rationale and resources for Best Evidence Medical Education (BEME). They have defined BEME as, "the implementation, by teachers and educational bodies in their practice, of methods and approaches to education based on the best evidence available"(9).

To help Council of Faculties members develop a strategic map about how to make education-related decisions based on the best evidence, I have charged the "Task Force on Best Evidence Pharmacy Education to: (i) scan the external environment and introduce how evidence-based methodologies are being used by other educators to make curriculum and teaching decisions, and (ii) recommend whether AACP and/or the COF would benefit from involvement with the Best Evidence Medicine Collaborative Group. The Task Force includes individuals with expertise in either evidence-based medicine or education. Therefore, after reading the bibliography of articles outlined in the charge, the group is encouraged to share their knowledge, and assess the applicability of the work underway by the Best Evidence Medical Education Collaboration to pharmacy education. Their final report should include a brief summary of what they have learned so that they can increase pharmacy faculty understanding about evidence-based education. The report should also outline recommendations for how the Council of Faculties can promote greater attention to the QUESTS (ie., quality, utility, extent, strength, target group, and setting) of current and future research or scholarly works pertaining to instructional methods and other aspects of pharmacy education(10). The Task Force is encouraged to carefully critique the pros and cons about whether evidence-based approaches are sensible for pharmacy education.

WHAT IS NEEDED FOR SUCCESS?

Although "we" can learn how to critically reflect on how we can be better tomorrow than we are today and critically assess options in an evidence-based manner, we will only be successful if the "culture" of the learning organization also changes(11,12). Specifically, the term "culture" refers to the way that people act, think, and perceive(13). There may be both an "explicit" and an "implicit" culture within a learning organization. An example of a cultural barrier is "pseudo-- acceptance" where individuals may display enthusiasm about implementing a change but their actions demonstrate that their commitment level is very low(14). Such barriers have been associated with why quality assurance programs in universities have had limited success(14,15).

The culture of a learning organization is possible if "we" have genuine conversations such as "why are we doing this" and if there is trust and honesty so that individuals a comfortable in sharing their views. In order to achieve this, "we" need to provide opportunities for candid conversations both formally and informally and to self-assess whether the learning organization exhibits the qualities of a "healthy" culture. To help our members better understand the culture of their own learning organization and how to monitor its quality the Task Force on Cultural Change has been formed for 2001-2002. This group will be developing a one-page self-assessment instrument that a faculty can use to collaboratively reflect about whether a School/College culture engenders an energetic and thriving environment. I envision a faculty using the instrument by completing the instrument annually and then, discussing the results as a group and reflecting on how well the collective group understands their vision and the congruence of explicit and implicit values and behaviors.

WHAT YOU CAN DO

Where do you think "We" will be tomorrow? Last week's news (August 10, 2001) announced that twenty years ago the PC computer was born and reflected on how it has changed society. How has birth of the PC in 1981 changed our lives as teachers, researchers, and practitioners? How will changes in technology and economics impact education and healthcare in 2020? What will be the roles and responsibilities of faculty in 2020? In order to achieve excellence tomorrow, we need to have a "2020 vision" for faculty roles and responsibilities. Introspection of these thoughts can assist our Resolutions, Standing Rules, and Strategic Planning Committee as the group drafts a Strategic Plan this year.

Although AACP members have highlighted these issues and these are largely a part of our organization's strategic plan, our next step is to paint a clearer picture of what faculty and pharmacy schools will look like in 2020. In an upcoming issue, I will share thoughts and insights I have gained through readings and discussions with my mentors, AACP members, and other colleagues. You can collaborate with me by doing the same and calling or sending me an email with your thoughts. My email address is beckdia@auburn.edu. Within the Council of Faculties, let's enable knowledge creation on this issue by joining together and dialoging as a community of learners.

References

(1) Benor, D.E., "Faculty development, teacher training and teacher accreditation in medical education: Twenty years from now," Med Teach., 22, 503-512(2002).

(2) Angelo, T.A., "A vision worth working toward: Assessment in support of learning communities." Assessment Update, 12(2), (March-April, 2000). (3) Banta, T.W., "Summary and conclusion: Are we making a difference?"

in: Making a Difference: Outcomes ofa Decade of Assessment in Higher Education, Banat, T.W. and Associate edits: Jossey-Bass, San Francisco CA, (1993) pp. 357-376.

(4) Marchese, T.J., "Assessment, quality, and undergraduate improvement." Assessment Update, 6(3), 1-2, 12-14(1994).

(5) Ewell, P.T., "Organizing for learning," AAHE Bulletin, (October 1997). (6) Angelo, T., "Doing assessment as if learning matters most: Three steps to transformative practice." ibid., 51, 3-6(1999).

(7) Dibella, A.J., "Gearing up to become a learning organization," J. Quality Participation, 20, 12-15(1997).

(8) Von Krogh, G., Ichijo, K. and Nonaka, I., Enabling Knowledge Creation: How to Unlock the Mystery of Tacit Knowledge and Release the Power of Innovation, Oxford University Press, England (2000).

(9) BEME Group., "Best Evidence Medical Education (BEME): Report of meeting - 3-5 December 1999," London, UK. Med Teach., 22, 242245(2000).

(10) Hart, LR. and Harden, R.M. "Best evidence medical education (BEME): A plan for action," ibid., 22,131-135(2000).

(11) Fried, R.L., "7 Habits of Schools Where Cultural Change Happens" Thrust for Educational Leadership. May-June 28, 8-11(199).

(12) Spencer-Matthews, S., "Enforced cultural change in academe. A practical case study: Implementing quality management systems in higher education," Assessment Eval. Higher Educ. 26, 51-59(2001).

(13) Bate, P., Strategies for Cultural Change, Butterworth-Heinemann, Oxford, (1995).

(14) Dyer, W.G., Strategies for Managing Change, Addison-Wesley, Reading PA (1984).

(15) Ellis, R., Quality Assurance for University Teaching, The Society for Research into Higher Education and Open University Press, Buckingham (1993).

Diane E. Beck

Harmon School of Pharmacy, Auburn University, Auburn AL 36849

Copyright American Association of Colleges of Pharmacy Winter 2001
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