Towards addressing the awarding gap-Using critical race theory to contextualise the role of intersectionality in Black pharmacy student attainment.

INTRODUCTION: The awarding gap between White and Black students in UK health curricula is well established. Critical race theory (CRT) is a lens to deconstruct pedagogic practice and consider the intersectionality of Black student lived experience to provide a realist critique of the phenomenon of Whiteness in higher education and the impact this has on Black attainment. Using one UK pharmacy programme as a case study, this paper aims to explore Black lived experience as a means of problematising and disrupting structural oppressions. METHODS: Sixteen Black students from one UK pharmacy degree programme were purposively recruited to the study. Love and breakup letter methodology (LBM) was used to facilitate sharing experiences of intersectionality in relation to their undergraduate education, with data thematically analysed through the lens of CRT. RESULTS: Two meta-themes (identity and inclusion; and cultural capital) and four subthemes (social capital; access; family expectations; and help-seeking) were identified. The intersectionality of Black students was articulated as not possessing the social capital and the 'language' to succeed within the White structures of the curriculum. The conflict of capital and the absence of Black culture gave rise to confined help-seeking behaviours. Whilst Black students experienced equality of access to the curriculum, an absence of rights to legitimate involvement (inclusion) worked to diminish participation in the curriculum. DISCUSSION: This is the first study to consider the intersectionality of Black pharmacy students in relation to academic awarding gaps and has found that oppressive educational structures marginalise and other Black experience. Black students experience the curriculum as a place where their social and cultural capital is undervalued, and as a White space where they lack the artefacts to succeed, leading to peripheral participation and detachment. The approach used in this study can be adopted across medical and health education as a means to problematise racial inequality through the exemplar of White:Black awarding gaps.

Evaluating Heteronormative Attitudes and Beliefs of United Kingdom Pharmacy Educators.

United Kingdom (UK) pharmacy curricula have previously been shown to be hetero- and cis-normative. A possible reason may be that educators hold binary beliefs and attitudes toward sexuality and gender norms, and that these are manifest in teaching practice and discourse. The purpose of this study is to investigate these attitudes and beliefs. A cross-sectional survey using the 16-item heteronormative attitudes and beliefs scale (HABS) was distributed to educators at UK universities teaching on undergraduate Master of Pharmacy degree programs, with 123 surveys returned. Total HABS scores and subscales measuring normative beliefs (NB) and essential sex and gender (ESG) were calculated with non-parametric statistics comparing scores based on demographic and contextual characteristics of the sample. The mean total HABS score was 40.06, for NB it was 16.46 and ESG it was 23.60 indicating moderate-low normative beliefs and attitudes. Two demographic categories reached statistical significance: gender (p = .049 total HABS score) and sexuality (p = < .001 total HABS score, p = .008NB subscore and p = < .001 ESG subscore) (p < .05) indicating that female and queer identifying educators have significantly lower heteronormative attitudes and beliefs. Findings indicate that UK pharmacy educators do not hold normative values and beliefs; curricula are influenced by the normative structures within higher education.

Academic resilience in UK pharmacy education - a pilot study applying love and break up letters methodology.

INTRODUCTION: Academic resilience is seen as a positive attribute that supports academic attainment and protects against attrition and burnout. Studies have reported that UK pharmacy students have lower academic resilience and wellbeing than the general UK student population but the reasons for this have not been established. This study pilots the use of a novel methodology, love and break-up letter methodology (LBM), to explore these issues focusing on the lived experience of pharmacy students. METHOD: Final year undergraduate pharmacy study were purposely recruited to the study. Employing LBM, each participant was invited to write reflective love and break-up letters to their academic resilience in higher education during a focus group. Letters and transcripts of subsequent focus group discussion on the feelings and ideas expressed in the letters were thematically analysed. RESULTS: Three meta-themes were identified within the data; the curriculum as gas lighting; the curriculum as abusive; and the curriculum as controlling. Students described how the curriculum diminishes academic resilience by working against their sense of agency and self-esteem. A constant threat of failure emerged as defining the student lived experience; students felt controlled by a curriculum with negative impacts on wellbeing and perseverance. DISCUSSION: This is the first study to use LBM to explore academic resilience in UK pharmacy students. The results provide evidence that some students view the pharmacy curriculum as a source of relentless adversity that is responsible for promoting a hidden negative connection between students and their education. Further study is required to determine if the results can be generalised across the UK pharmacy student body to explain why UK pharmacy students have lower academic resilience than other UK university students and the steps needed to improve academic resilience in UK pharmacy students.

Hetero- and cisnormativity-UK pharmacy education as a queer opponent.

INTRODUCTION: Queer pedagogy is a lens through which the hegemonic discourses of curricula and the heterosexual assumptions within them can be made visible. Using this lens, sexuality and gender norms incorporated in undergraduate medical and health curricula can be located and the lived experience of a curriculum examined. This paper seeks to determine the extent of hetero/cisnormativity within UK pharmacy education with the aim of problematising the normalisation of heterosexuality; following this, strategies to disrupt structured hetero/cisnormativity are considered. METHODS: Online cross-sectional surveys were distributed to course leads (n = 29) and students enrolled on undergraduate pharmacy (MPharm) programmes. Surveys captured quantitative data on curriculum design and perceived barriers to implementation of inclusive curriculum design (the espoused LGBTQI+ curriculum), as well qualitative data on the lived experience of the hidden curriculum. Quantitative data were analysed using descriptive statistics, whereas qualitative data were analysed thematically. RESULTS: Responses were received from 19 course leads and students from 25 MPharm programmes, representing varying completion rates. Findings suggest the shared values and goals of pharmacy education act to normalise and legitimise hetero and cis identities within curriculum design that othering as a consequence of heterosexual normativity is experienced and that pharmacy education is an LGBTQI+ opponent and does not adopt an ally attitude. Moreover, both educator and student data suggest that the enacted and experienced curriculum fails to prepare learners to care for LGBTQI+ people. DISCUSSION: Despite findings suggesting the espoused or enacted curriculum absents LGBTQI+ people, and the hidden curriculum is experienced as homonegative, learners are questioning, resisting and disrupting the hetero- and cisnormative benevolent heterosexism within UK pharmacy curricula. This method of curricula interrogation can be adopted across health professions education as a means for ongoing problematising and disruption of normativity in clinical education.

A Large-scale Multicenter Study of Academic Resilience and Well-being in Pharmacy Education.

Objective. Health care students are at particular risk of stress and exposure to adverse events, negatively affecting well-being and performance and leading to increased attrition. Academic resilience has been identified as one factor helping mitigate such negative effects in students. Despite this, there is limited research exploring the topic in pharmacy education.Methods. Using a cross-sectional survey design, students attending three schools of pharmacy in the United Kingdom (N=1161) completed psychometric measures of academic resilience and well-being. Comparative, correlational, and regression analyses were conducted, exploring the relationship between academic resilience and well-being.Results. Academic resilience and well-being were significantly lower in pharmacy students compared to other student populations. Academic resilience was a positive correlate and predictor for well-being. Academic resilience was highest in first-year students, declined over subsequent years of study, and varied by pharmacy school and gender but not ethnicity.Conclusion. Introducing and embedding strategies to enhance academic resilience in pharmacy education may improve well-being and performance and reduce attrition.

Exploring an integrated curriculum in pharmacy: Students' perspectives on the experienced curriculum and pedagogies supporting integrative learning.

INTRODUCTION: Pharmacy educators are designing integrated curricula to implement teaching that supports integrative learning. How students experience an integrated curriculum, and the extent a curriculum supports the development of integrative learners, has not been well explored. This study investigates students' experiences and meanings of an integrated Master of Pharmacy (MPharm) curriculum. METHODS: Focus groups were conducted with students from the MPharm program at a single study site. The research explored the following questions: what pedagogic strategies do students recognize as examples of integration and how does an integrated curriculum shape learning? RESULTS: Fifty-one participants took part over eight focus groups. Meta-themes identified mirrored the research questions. Findings suggest that integrative learning is experienced when teaching is purposively designed to be horizontally integrated between disciplines, when integration is made explicit, and when content is applied to pharmacy practice. Integrated assessments were considered to be cognitively difficult. CONCLUSION: Learners perceive horizontal integration as useful for promoting context and understanding how to apply science to practice. However, findings suggest the need for assessments to be better aligned with teaching to support the development of higher-order thinking skills.

Exploring an integrated curriculum in pharmacy: Educators' perspectives.

BACKGROUND AND PURPOSE: Lack of consensus regarding the benefits of an integrated curriculum, and ambiguity concerning what is being integrated within a pharmacy curriculum exists, but how an integrated curriculum is viewed, epistemologically, and subsequently incorporated into teaching practice has not been investigated. This study explores how educators conceptualize, experience and enact curricula integration both pedagogically and organizationally. EDUCATIONAL ACTIVITY AND SETTING: In-depth qualitative interviews with faculty members purposively sampled for maximum variation in disciplinary background and teaching experience were undertaken at a single site. Interviews addressed two research questions: how pharmacy educators understand an integrated curriculum and educators' experiences of it. FINDINGS AND DISCUSSION: Analysis of the interview data suggests four essential meanings of integration: integration as a method for organizing teaching and learning; integration as enacted by self and others; integration as tension between conflicting knowledge domains; and integration as an impossible concept to apply to teaching practice. Analysis suggests that integration is an abstract rather than enacted concept and although integration is viewed as learner-centered, integration is complex and associated with a loss of in-depth learning. SUMMARY: Differences in how faculty members conceptualize the purpose and effects of integration mean that the level and type of integration reported varied. A clearer understanding of the rationale for change, and methods for better applying theory of integration to teaching practice, may be needed to achieve curriculum standards required by bodies accrediting undergraduate pharmacy programs.