Chanakit, Teeraporn
(2016)
Thai stakeholder's perceptions of the introduction of the Doctor of Pharmacy programme.
PhD thesis, University of Nottingham.
Abstract
Global pharmacy education and pharmacy practice continue to face remarkable changes. Many countries are undergoing major transformations in the field of pharmacy education.
In developing countries, there is an increasing trend towards adopting the PharmD degree. Thai pharmacy education has transitioned from having two entry-level degrees – a 5-year BPharm (with three main tracks: pharmaceutical care, pharmaceutical sciences, social and administrative pharmacy) and a traditional 6-year PharmD (pharmaceutical care) programme – to a single national 6-year PharmD programme or ‘an all-PharmD programme’ (including industry pharmacy and pharmaceutical care tracks).
Similar to other countries that have also been transitioning to ‘an all-PharmD programme’, there was limited evidence for the merit of the transition in Thailand. Although opinions and questions put forth on social media networks triggered debates about the need for the transition, there is a lack of an evidence-based and in-depth investigation about the reasons for this transition.
This thesis explores the experiences and perceptions held by stakeholders concerning the transition towards an all-PharmD programme in Thailand. The study used a mixed methods approach through a quantitative analysis of surveys (Phase 1 and Phase 2) and interviews with stakeholders who were involved in pharmacy education (Phase 3). Findings from the three phases and other resources were triangulated and validated (by comparing and confirming them) to provide a better picture of the transition of pharmacy education in Thailand.
Phase 1: A survey of the status of Thai pharmacy education.
This study aimed to explore the status of pharmacy education in Thailand by using a questionnaire survey. The surveys were distributed to the deans of all 19 faculties of pharmacy in Thailand. The response rate was 84% (n = 16). Characteristics of the Faculties of Pharmacy, the teaching staff, types of PharmD programme, the number of training sites and quality assurance mechanisms were reported.
The results showed that the Thai PharmD curriculum includes industrial pharmacy and clinical pharmacy tracks that differentiate it from the traditional US PharmD programme, which only focuses on patient care. There was a shortage of academic staff in the pharmaceutical care area and some faculties needed to better prepare for their training sites.
Phase 2: A survey of the pharmacists’ perceptions towards the suitability of the PharmD graduates employed in hospital and community pharmacy settings and the competencies difference between the BPharm and the PharmD graduates.
This study aimed to explore Thai pharmacists’ perceptions regarding the suitability of the PharmD graduates employed in hospital and community pharmacy settings, as well as the competency differences between the BPharm and PharmD graduates. A cross-sectional survey questionnaire was distributed to 180 hospital pharmacists and 200 community pharmacists during two conferences. The response rate was 55.6% among hospital pharmacists and 20% in the community pharmacists group. The findings highlighted that the PharmD graduates were suited for large hospital settings as they were well coordinated with the health care team. However, there were concerns regarding the suitability of the PharmD graduates for primary care settings, because of their lack of training in health promotion. Half of the respondents perceived PharmD graduates as having higher competencies in clinical activities and being more prepared to work than BPharm graduates. However, the other half of the respondents perceived the competencies of both pharmacy qualifications as being similar; PharmD graduates provide non-clinical activities similar to BPharm graduates, due to numerous barriers (e.g., high workload in dispensing services and the shortage of pharmacists) preventing PharmD pharmacists from providing direct pharmaceutical care services.
Phase 3: Thai stakeholder’s perceptions of the introduction of the PharmD programme: a qualitative study.
This qualitative study aimed to understand the experiences and perceptions of stakeholders, regarding the transition to an all-PharmD programme in Thailand. Semi-structured interviews were conducted with 130 stakeholders (e.g., policy makers, educators, health care providers, patients, students, and parents). The data were audio recorded, transcribed verbatim and analysed using an inductive thematic analysis.
Three main themes were derived from the findings: 1) influences on the transition (e.g., the US-Thai consortium for the development of pharmacy education); 2) perceived benefits (e.g., improved pharmacy competencies from generalist to specialists); and 3) concerns (e.g., the higher cost of a longer period of study, and insufficient preceptors and training sites).
This PhD study carries important implications for both universities and policy makers. Faculties of pharmacy should consider a long-term plan to develop sufficient qualified academic staff and preceptors. Policy makers should prepare a strategic plan for the future workforce supply and requirements, increase the flexibility of the PharmD curriculum during its transition stage, and prepare a supportive and enabling system for PharmD graduates to provide advanced practice at their full potential. Close coordination between faculties, the Pharmacy Council of Thailand and pharmacy professional organisations is needed to ensure that pharmacy education provides the necessary competencies for graduates to offer a high level of needed pharmacy services. Further research focussing on the outcome, impact and efficiency of the PharmD programme is also needed.
To conclude, in this thesis, the issues surrounding the transition to an all-PharmD programme in Thailand were carefully investigated. This study reflects the influences and the requirements of the transition that it was initiated, in order to meet the need for higher levels of competency for the nation’s pharmacists and is influenced by many factors. The stakeholders perceived benefits from the transition. They thought that the PharmD graduates will have higher competencies and be ready to work as pharmacists compared to graduates from the previous pharmacy curriculum. The findings also addressed the following issues concerning curriculum change: the higher costs of a longer period of study, the mismatch between the pharmacy graduates’ competency and the job market’s needs and the shortage of qualified preceptors.
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