ABSTRACT
Background: A history of medical abuse and social inequality confounded by persistent racial discrimination in health care has triggered mistrust between Black patients and health care providers. Although the consequences of systemic racism on health outcomes are well understood, little is known about how they manifest in pharmacy practice. The objective of this study was to explore the experiences of Black Nova Scotians with community pharmacists. Methods: This was a qualitative study that used focus groups and one-on-one interviews. Black Nova Scotians 18 years of age and older who have had interactions with community pharmacists were invited to participate. Focus groups and interviews were audio-recorded, transcribed and analyzed thematically. Results: Two focus groups (n = 10) and 6 one-on-one interviews were held between May and June 2021. Three major themes were identified: 1) difficulties navigating a pharmacy as a Black person, 2) lack of inclusivity and cultural competence in the pharmacy and 3) transactional relationships with pharmacists. Discussion: Most participants felt their race negatively affected the quality of care they received from the pharmacist and that pharmacists were not culturally competent. Most participants did not consider pharmacists to be part of their health care team and described feeling unsafe or uncomfortable in the pharmacy. Conclusions: Pharmacists have an important role in closing the health equity gap. This research highlights the need for pharmacy education to include cultural competence and will be used to guide strategies to improve access to culturally safe pharmacy services for Black Nova Scotians.
ABSTRACT
OBJECTIVE: The purpose of this study was to develop research-informed guidance on how to better prepare students for working with diverse populations through exposure to diversity representation within case-based learning materials. METHODS: This was a qualitative interpretive phenomenological study using audio-recorded semi-structured interviews for data collection. Interviews were conducted virtually with 15 recent program alumni from Dalhousie University and 15 members from underrepresented communities in Nova Scotia, Canada. Audio-recordings were transcribed verbatim and framework analysis was used to code and categorize data. Themes were interpreted from categorized data and a conceptual model was developed based on the results. RESULTS: The conceptual model highlighted that awareness of diversity and health equity paired with practice and application of learning were perceived to be important for preparing graduates for practice. It was found that awareness could be best achieved through exposure to diversity within cases. To effectively expose students, programs must deliberately identify diverse populations to include, seek perspectives and engagement from those populations when writing cases, ensure conscientious representation of diversity without reinforcing stereotypes, and provide resources for discussion and further learning. CONCLUSION: Through the development of a conceptual model, this study provided research-informed guidance representing diversity within case-based learning materials. Findings support the notion that representation of diversity must be deliberate, conscientious, and collaborative with those offering diverse perspectives and lived experiences.
