Professionalism, professional identity and community pharmacy culture: The context of substance dependency through the lens of student and early career pharmacists.

aimsThis study aimed to explore the reflections of student and newly qualified pharmacists (NQPs) surrounding community pharmacy culture around substance dependency. This study explored professionalism and professional identity formation, and the possibility that a fragmented professional identity may impact behaviours and the provision of compassionate care.

designQualitative study: semi-structured interviews were conducted with student and exploring stigma within community pharmacy environments in relation to people with substance dependency, the community pharmacy culture and their own ideas of professionalism and their professional identity formation. Interviews were undertaken by six pharmacy student researchers, under the supervision of two experienced researchers.

settingCommunity pharmacies across Scotland.

participantsTwenty-eight participants were recruited, including undergraduates based at Scottish Schools of Pharmacy (n = 20); Foundation Year Pharmacy students (n = 2) and NQPs (n = 6). Recruitment utilised university networks and social media platforms. MEASUREMENTS: Interviews were conducted between September and November 2023 on Microsoft Teams®, each lasting 17-60 minutes. Data underwent inductive thematic analysis via NVivo® through data familiarisation, initial coding, theme searching, reviewing and defining and reporting.

findingsStigmatisation of people with substance dependency attending a pharmacy was a prominent observation. This included negative stereotyping, adverse treatment because of judgements made about substance use and structural stigma relating to barriers to accessing care. Positive care provision in pharmacies was evident. Pharmacy staff who were empathetic, respectful, professional and who formed long-term relationships with people with substance dependency were valuable role models for students and influenced their professional identify formation. Students appreciated the exposure to practice and the opportunity to make judgements that would mould the type of pharmacist they aspired to become. A number of participants reported that their university course poorly prepared them for the reality of supporting people with substance dependency.

conclusionsPharmacy practice in Scotland appears to be characterised by stigma and lack of professionalism towards people with substance dependency, although there are examples of compassionate care. Observing staff in practice allowed participants of this study to develop their own professional identity and attitudes, yet there is a need to better prepare students in undergraduate curricula.