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Navigating Boundaries: How Pharmacists Develop Their Clinical Identity in a Complex Multidisciplinary Healthcare

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Area of Science:

  • Pharmacy Practice
  • Healthcare Management
  • Professional Identity Development

Background:

  • Clinical pharmacists are vital for medication optimization and patient outcomes, particularly in low- to middle-income countries.
  • Transitioning to clinical roles requires significant professional development and identity transformation.
  • South Africa's public healthcare system presents unique challenges, including resource limitations and role ambiguity for clinical pharmacists.

Purpose of the Study:

  • To explore how clinical pharmacists in South Africa navigate the transition from dispensing to clinical roles.
  • To understand the factors influencing clinical pharmacists' professional identity formation during this transition.
  • To identify strategies for overcoming barriers to the effective integration of clinical pharmacists.

Main Methods:

  • A qualitative study using semi-structured interviews with 12 clinical pharmacists in South Africa's public healthcare sector.
  • Data analysis employed a constructivist approach through the lens of boundary crossing.
  • Thematic analysis was used to explore the complexities of role transition and identity development.

Main Results:

  • Clinical pharmacists navigated both intrapersonal (e.g., role ambiguity, self-doubt) and interpersonal (e.g., hierarchical structures, limited recognition) boundaries.
  • Three key themes emerged: bridging internal gaps for identity, bridging external gaps for collaboration, and building bridges for recognition.
  • Experiences significantly shaped professional identity, highlighting the need for mentorship and interprofessional collaboration.

Conclusions:

  • The transition to clinical pharmacy roles is complex, influenced by internal and external boundary dynamics.
  • Fostering boundary-crossing competence and interprofessional collaboration is crucial for integrating clinical pharmacists.
  • Addressing systemic barriers and promoting recognition will enhance pharmacist roles and patient care in resource-limited settings.