Focus on Current Thinking: Lifelong Learning and Health-System Pharmacists

A spirit of inquisitiveness and lifelong learning is essential to meeting the needs of pharmacy in the 21st century.

I recently read an article concerned with the need for transformation of medical education.¹ It provided background on how the current state of medical education came about as well as thoughts about its future. The article explained that in the early 1900s, Abraham Flexner, an education scholar, produced a report on the contemporary state of medical education based on visits to all 155 medical schools in the United States and Canada. The Flexner Report revealed that there was a great deal of variation in medical education at the time in areas such as admission practices, curriculum, and level of integration between the clinical and laboratory experiences. Based on his observations, Flexner laid out a vision for the future of medical education that emphasized scientific rigor and academic excellence. Much of what Flexner envisioned is still practiced in medical schools today.

To help adapt to the needs of the current century, the authors argued that medical education, among other things, should encourage future physicians to develop a habit of lifelong learning and a desire for continuing quality improvement. They suggested that doctors should continually strive to implement changes designed to improve care and should carefully monitor the impact of these changes. They noted that these new processes should be quality-focused and should stem from a habit of inquisitiveness.

As I was reading this article and thinking about the practice of health-system pharmacy, I wondered if we could confidently state that we have a standardized curriculum at all colleges of pharmacy. The Accreditation Council for Pharmacy Education (ACPE), the accrediting body for pharmacy schools, regularly updates accreditation standards and holds colleges accountable to them. Upon reflection, I feel confident that our curricula, as defined through the achievement and documentation of the same educational outcomes, are standardized.

But how are pharmacy schools doing in terms of integrating clinical and laboratory experiences? All schools of pharmacy have to balance didactic and experiential education. While some schools are located on a health sciences campus, others are far from one. Even though this variation provides differences in inter-professional educational experiences and the types of hospitals in which students train, all pharmacy students must meet similar requirements for experiential education. As such, I believe that there is integration between didactic and experiential education in pharmacy curricula today.

In light of the authors’ thoughts on the need to develop a habit of lifelong learning, I considered how effectively that is encouraged in pharmacy today. Pharmacy education should be designed in a way that students continue to pursue learning well after they have entered the profession. One might point out that every state requires continuing education (CE) hours as a condition of re-licensure. While this is a good start, I am concerned that it does not develop the necessary habits of inquisitiveness and lifelong learning. Far too often, it seems that pharmacists take just enough CE hours to meet the requirements and do so out of obligation, not because they are interested in developing a better understanding of a subject. I have noticed that many pharmacists fail to pay attention at CE events, while others attend a given program not because they are interested in its topic but because it was conveniently scheduled or because it came along with a meal. How does this demonstrate a habit of lifelong learning? I am fearful that this skill is missing in the majority of health-system pharmacists.

Continuing professional development (CPD), a concept that is slowly gaining momentum, has the potential to change this. CPD is defined as “the lifelong process of active participation in learning activities that assists individuals in developing and maintaining continuing competence, enhancing their professional practice, and supporting achievement of their career goals.” It demands a very different approach from simply counting CE hours, and I believe it has the potential to change the way pharmacists pursue knowledge. CPD is grounded in a learning plan developed by individual pharmacists to serve their educational needs and interests. As pharmacists take part in continuing education and apply their learning to patient care, progress toward their goals is documented. It will take a fair amount of work to make CPD mainstream in today’s practice setting, but I believe it has the potential to help encourage a much-needed spirit of inquisitiveness in practitioners. In the end, this will help improve care for the patients pharmacists serve on a daily basis.

I would appreciate hearing whether you agree with this perspective.

1. Calls for Reform of Medical Education by the Carnegie Foundation for the Advancement of Teaching: 1910-2010. Irby DM, Cooke M, and O’Brien BC. Academic Medicine 2010;85:220-227.