Promises and pitfalls of time and efficiency in pharmacy education

Chong, Chun Yin (2023) Promises and pitfalls of time and efficiency in pharmacy education. Doctoral (PhD) thesis, Memorial Univesity of Newfoundland.

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Abstract

Neoliberalism in higher education is geared towards preparing students for productivity and the workplace. Pharmacy education may be more affected due to the profession’s business origins and a clear path from education to pharmacy practice. Critical theorists have deemed neoliberalism problematic in education because it reinforces and perpetuates social hierarchies in the pursuit of profit. It also leads to the objectification of knowledge and a focus on outcomes and achievement rather than student learning and aspirations. The concepts of time and efficiency are related to neoliberalism and are influenced by ideological, historical, cultural, economic, and political factors. In pharmacy education, these influences can be found in the formal and informal curriculum and may be reflective of the nature of knowledge in the profession. My study problematized time and efficiency in pharmacy education drawing from critical theory and critiques of the hidden curriculum. I explored how the concepts of time and efficiency are perceived and enacted in pharmacy education. I used Foucault’s discursive practices and ideas of power, knowledge, and time as my theoretical framework. I conducted a case study in conjunction with Eisner’s educational connoisseurship and criticism approach to provide an in-depth and evaluative perspective of time and efficiency at one pharmacy school in Canada. My data included 113 observations from 12 courses, seven sets of institutional documents, 18 student interviews, 16 faculty interviews, and one year of reflexive journaling. I used multiple methods to critically analyze my data and subsequently examined patterns that emerged across all sources. Time in pharmacy education was characterized by the busy student, which was reflected in conceptions of the busy pharmacist. Students and faculty accepted the busyness of school and work life, while considering the management of time as a professional responsibility. This was reinforced by timed activities and accepted practices of a highly structured and controlled student time. Efficiency was valued because it promised more time for students and pharmacists. Subsequently, efficiency was encouraged in pharmacy education by regulatory authorities and mirrored in curriculum. Students and faculty accepted a system that employed multiple ways to ensure efficiency in education and the graduation of efficient pharmacists. However, many of these mechanisms, such as standardization and examination, were hidden or unrecognized by students and faculty. In my study, the strong interdependence of pharmacy education, pharmacy practice, and pharmacy business seems to facilitate a neoliberal agenda. When pharmacy education focuses on efficiency and achievement of educational outcomes, it can easily translate to practice that is defined by time and misses elements of good patient care. Healthcare professionals have a responsibility to provide care to improve the health and wellbeing of their patients. Therefore, pharmacy educators should consciously and actively refocus pharmacy education away from the promises and pitfalls of time and efficiency.

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