Musings from an inaugural Bachelor of Pharmacy curriculum: Teaching of health advocacy via integration of topics

The National University of Singapore (NUS) Department of Pharmacy aims to transform its undergraduate programme to calibrate to a rapidly evolving healthcare system. Health advocacy is an important competency of the new curriculum, to which curriculum integration forms the theoretical basis of how this can be met. In AY2020/21, 150 students were matriculated into the Department’s B.Pharm programme. Each student was asked two questions, both during the orientation and after the final examinations of Year 1. They were asked about their own definition of health advocacy and what a pharmacist could do to engage in health advocacy. Interview invitations were also sent. A total of 215 (72%) responses to the two questions resulted in the pre-survey, with 126 (42%) responses in the post-survey, and five students agreeing to the interview. The pre- and post-survey results were analysed using the overall evaluation model proposed by Westheimer (2003) to test the student’s internalisation. The four levels were: Level 1’s ‘Understanding Pharmacist’, Level 2’s ‘Personally Responsible Pharmacist’, Level 3’s ‘Participatory Pharmacist’, and Level 4’s ‘Justice-oriented Pharmacist’. While there was no significant difference between the four levels (p=0.77), a greater consolidation of health advocacy concepts was seen, with students understanding the responsibility of pharmacists in the medical field, and that they must be knowledgeable to uphold that accountability to patients. However, these Year 1 students had expressed self-doubt that pharmacists could contribute to larger and greater societal good. Besides integration in the curriculum, more should be done to showcase explicit examples of professional pharmacists promoting health advocacy as routine practice.