Rules of Engagement : The Why , What , and How of Professional Engagement for Pharmacy Students

The development of student pharmacists must include inspiring within them a sense of engagement in their profession. This paper provides the rationale for and the potential implications of this concept, as well as an overview of experiences with professional engagement in student pharmacists at one college of pharmacy. Curricular-based experiences and research will be discussed, including the insights gained and suggestions for developing and encouraging professional engagement. Lastly, this article provides future direction for furthering professional engagement on both the conceptual and curricular level. Introduction When our members fail to be engaged in the profession, our profession has failed. Engagement refers to one’s physical involvement, cognitive vigilance, and emotional connectedness with something, such as one’s profession. Expanding beyond prior conceptions such as work or school engagement, professional engagement encompasses the unique typology of engagement that a professional has within one’s profession. Engagement in a profession is broader and more abstract; whereas a workplace or school are concrete structures and have roles that are easily defined, a profession is tangible only as defined by itself, society, and the professional. In student pharmacists, professional engagement captures their distinct engagement within the profession as they undergo professionalization, becoming acculturated and adopting the professional ethos of pharmacy. This article describes the importance of, and our experiences with professional engagement in student pharmacists at one college of pharmacy. This emerging line of inquiry involves a novel extension of previous conceptualizations of engagement. We describe the unique ramifications of Corresponding Author: Benjamin D. Aronson, PharmD Department of Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota College of Pharmacy 232 Life Science, 1110 Kirby Drive, Duluth, MN 55812 Phone: 218-726-6067; Fax: 218-726-6500; E-mail: arons071@d.umn. edu professional engagement for the development of student pharmacists and propose that professional engagement should be considered as instructors and schools monitor and evolve the student experience. Specifically, the purpose of this article is to describe why professional engagement is important, what our experiences with professional engagement in student pharmacists have been, and how we move forward. The Importance of Professional Engagement Other conceptions of engagement (e.g., student engagement, work engagement) have been correlated to positive outcomes. The Gallup Model for Student Success posits that engagement has direct and indirect effects on academic success, and indeed student engagement has been linked to higher self-reported and actual academic performance. Similarly, the Job Demands-Resources model posits a positive link between work engagement and job-related outcomes. Engagement has been linked to several work-related outcomes including organizational commitment, job satisfaction, customer loyalty and satisfaction, lower turnover, lower absenteeism, and increased productivity and profitability. Businesses with the most engaged employees have higher return on assets, profitability, and shareholder value compared to firms with the least engaged employees. Work engagement is related to fewer accidents at work, and for health care workers, fewer patient safety errors. The benefits of work engagement extend beyond just business outcomes. Engaged employees have higher health and wellbeing. 23 Idea Paper EDUCATION http://z.umn. edu/INNOVATIONS 2015, Vol. 6, No. 3, Article 205 INNOVATIONS in pharmacy 2 However, engagement as a professional is quite different than engagement as an employee or student. Workplaces and schools are physical environments. Engagement can be theorized as the employment of physical, emotional, and cognitive resources during role performances. In fact, some measures of engagement examine the availability and utilization of resources in these roles, or the cognitive state experienced while involved in certain tasks. For instance, as a marker of work engagement, we could ask if time flies while a pharmacist is at their job. A profession, on the other hand, is a more abstract notion. One cannot go to the profession, and it is not necessarily something you do. The work of a profession may or may not take place in a workplace. Certainly, one can engage in the profession outside of a workplace, and almost assuredly a professional can be engaged in their work, but not the profession. For student pharmacists, a similar yet more pronounced variant of this quagmire can be seen. They are students, becoming professionals, interacting and learning about the profession in a variety of manners. Student pharmacists are undergoing the process of professionalization, a unique crossroad between student and professional where they exist in a dual-role state. Other conceptions of engagement fail to capture this dynamic state. Furthermore, research in both pharmacy and nursing suggests that scales intended to assess student engagement do not adequately measure this construct in health professions students. In a multicollege multi-year cohort of pharmacy students, the model fit of the National Survey of Student Engagement (NSSE), a measure of student engagement in undergraduate students, was unacceptable. The exact reason for this incomplete fit is uncertain, but presumably was due to the differences between individuals in a professional program and an undergraduate program. In nursing students, NSSE scores differed significantly from those of undergraduate students. It is notable that the NSSE was not designed or intended for use in professional students. Similar to student and work engagement, professional engagement should be correlated with positive outcomes for student pharmacists. For instance, high professional engagement could be associated with better grades, and less attrition. In addition, high professional engagement in student pharmacists may have much broader implications, such as becoming leaders within our professional associations, advocating for the profession, and working tirelessly to advance the profession. If these outcomes hold true, one can certainly see how nurturing professional engagement in students could dramatically impact the profession and ultimately even the health care system. Despite its potential to influence educational and professional outcomes, there is a lack of published material describing, documenting, and declaring the importance of professional engagement. The literature that is available provides a diverse set of definitions and measures, often times drawing upon closely related concepts. In both medicine and teaching, professional engagement has been defined and conceptualized in a variety of ways. It has been used to refer to commitment to organizational climate, satisfaction with professional working conditions, and commitment to organizational objectives and goals. It has been used synonymously with fulfillment, and similarly to professional identity formation. It has been measured using various indicators, such as number of: professional development activities and professional collaborations, professional memberships and contacts, and within-school interactions, outside of own school interactions, and involvement in leadership activities. Other measures have included planned effort, planned persistence, professional development aspirations, and professional leadership aspirations. Likewise, in student pharmacists, when the term ‘professional engagement’ has been used it is generally as a synonym for something else, often times to mean participating as a professional, connecting with others, or using something; for instance, professional engagement with a new patient counseling technique. The term has been used in close connection to community engagement, professionalism, and leadership. These uses of the term professional engagement have not robustly defined, measured, or elaborated on the concept. One tool has sought to measure aspects of professional engagement in pharmacy students specifically. Within the Professionalism Assessment Tool, the “Citizenship and Professional Engagement” domain contains four items assessing both community and professional engagement. However, this small set of items does not capture the complete breadth of professional engagement and may not be adequate to direct curricular improvements. With a more thorough comprehension of this unique variable in development of professional students, educators would have the opportunity to better support student pharmacists in pursuing a sense of significance and enthusiasm for the profession. Experience with Professional Engagement Our awareness and investigation of professional engagement started in 2010, when it was initially identified as a concept with important ramifications for pharmacy students, yet relatively absent from the literature. Through both curricular experiences and research, we have furthered our understanding of professional engagement in student Idea Paper EDUCATION http://z.umn. edu/INNOVATIONS 2015, Vol. 6, No. 3, Article 205 INNOVATIONS in pharmacy 3 pharmacists. These experiences include: a Delphi-process aimed at gaining consensus around a modified definition of professional engagement, ongoing development of an instrument to measure professional engagement, a reflective assignment about professional engagement completed during experiential education, and several classroom discussions of professional engagement. Overview of Curricular and Research Experiences Student Delphi Process. Our initial research in professional engagement began with a modified-Delphi process in 2010. During this process, consensus was sought from highly engaged student pharmacists around a definition of professional engagement, professionally engaging and disengaging activiti