Evolving Professional Identity: Exploring How Pharmacists Make Sense of their Prescribing Role

  • Author / Creator
    Schindel, Theresa, J
  • Dramatic changes in the pharmacy profession have occurred in the past century. Many of these occurred as the primary focus of the pharmacist transitioned from drug products to providing patient care services. Prescribing by pharmacists gained momentum when it was implemented in the United Kingdom in 2003; other jurisdictions followed, including the province of Alberta, Canada in 2007. Pharmacist prescribing is a mechanism for expanding pharmacists’ roles, changing health care delivery, and enhancing patient care. The approval of pharmacists’ prescribing authority in Alberta facilitated exploration of a new role for pharmacists. This qualitative study examines how practicing pharmacists enact and make sense of their patient care roles as prescribers. Using a social constructionist approach, this study explores pharmacist prescribing from the perspectives of the profession and the individual professional in two intersecting phases. In the first phase, 128 professional texts on pharmacist prescribing were analyzed using a discourse analysis approach based on Potter and Wetherell (1987). In the second phase, interviews of 20 pharmacist prescribers were analyzed using a constructivist grounded theory approach (Charmaz, 2006). Results from phase one identified three discourses associated with the discursive constructs of pharmacists’ identities as prescribers: (1) expertise, (2) interprofessional collaboration, and (3) moving forward. Pharmacists were initially constructed as drug therapy experts, highly educated professionals well suited for the prescribing role. Interprofessional collaboration was acknowledged as essential for successful pharmacist prescribing. The discourse of moving forward framed the pharmacy profession as undergoing dramatic and ongoing changes associated with pharmacist prescribing. These discourses influenced how pharmacists initially enacted the prescribing role. Pharmacists’ experiences with prescribing, in turn, influenced the presentation of the expertise and collaboration discourses in professional texts. In phase two of the study, reconstructing professional identity, the core grounded theory concept, emerged from three categories: (1) integrating information about the prescribing role, (2) limiting and expanding prescribing, and (3) balancing collaboration and independence. Reconstructing professional identity encompasses how pharmacists realize responsibility for prescribing through an iterative process of active engagement with prescribing activities as authorized prescribers within the context of their information environments. As pharmacists gain experience, the prescribing role continually evolves; however, it evolves differently for pharmacists based on their individual experiences and practice settings. For some, the prescribing role gradually became normalized; prescribing became one thread among many others in the course of their daily professional work. This study facilitated an in-depth exploration of pharmacists’ experiences as authorized prescribers. Looking at these experiences through an information behaviour lens revealed ways that information influenced how they enacted the prescribing role and contributed to their evolving professional identity. Pharmacists will benefit from reflecting on the process of reconstructing professional identity described in this study. The results of this study will be of interest to other scholars interested in new professional roles and the role of information in the process of making sense of the prescribing role. Pharmacy educators and regulators may utilize the results of this study to develop programs to support students and practicing pharmacists in the evolution of their roles and professional identity.

  • Subjects / Keywords
  • Graduation date
    Spring 2018
  • Type of Item
  • Degree
    Doctor of Philosophy
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.